Decisions about treatment of loaisis are sometimes difficult and should be made in consultation with an expert in infectious diseases or tropical medicine. The most straightforward treatment is surgical removal of adult worms migrating under the skin or across the eye. This can be done with local anesthesia and offers immediate relief, though this only relieves local symptoms and does not cure the patient of the underlying infection. There are two antiparasitic agents that can be used to treat the infection and manage the symptoms. These medications are diethylcarbamazine (DEC), which kills both the larvae and the adult worms and is the treatment of choice, and albendazole, which is thought to kill the adult worms. There is a risk of fatal brain inflammation from treatment with DEC, which can be reduced through appropriate testing and management at a center with experience managing the disease prior to initiation of treatment. The treatment of choice in patients with low levels of larvae in the blood is DEC. Sometimes, other medical conditions or infections that might be present will need to be addressed first to make it safer to use DEC. In some instances, treatment is not recommended.