Care of Patients with Lymphedema, Elephantiasis, or Hydrocele
Lymphedema and elephantiasis are not indications for DEC treatment because most people with lymphedema are not actively infected with the filarial parasite and lab tests are generally negative in these patients.
To prevent the lymphedema from worsening, physicians should consider referring lymphedema patients to a certified lymphedema therapist so patients can be informed about basic principles of care such as hygiene, exercise, elevation, treatment of wounds and infections, and use of appropriate footwear. Complex decongestive physiotherapy can be effective for treating lymphedema. The National Lymphedema Network website lists certified lymphedema therapists and lymphedema organizations in the U.S.
There is limited evidence to suggest that a 4-6 week course of doxycycline (200 mg / day) may stabilize or reverse the progression of disease in persons with lymphedema.
Patients with hydrocele may have evidence of active infection, but typically do not improve clinically following treatment with DEC. The treatment for hydrocele is surgery (hydrocelectomy).