CC BY-NC-ND 4.0 · Ultrasound Int Open 2019; 05(02): E65-E74
DOI: 10.1055/a-0918-3678
Eigentümer und Copyright ©Georg Thieme Verlag KG 2019

Review of Dancing Parasites in Lymphatic Filariasis

Christoph F. Dietrich
1   Caritas-Krankenhaus, Medizinische Klinik 2, Bad Mergentheim, Germany
Nitin Chaubal
2   Thane Ultrasound Centre, Thane Ultrasound Centre, Thane, India
Achim Hoerauf
3   Institut für Med. Mikrobiologie, Immunologie und Parasitologie (IMMIP), Universität Bonn, Bonn, Germany
Kerstin Kling
4   Department of Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
Markus Schindler Piontek
5   Caritas Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Medical Clinic 2, Bad Mergentheim, Germany
Ludwig Steffgen
6   Trainings-Zentrum Ultraschall-Diagnostik LS GmbH, Ultrasound, Mainleus, Germany
Sabine Mand
3   Institut für Med. Mikrobiologie, Immunologie und Parasitologie (IMMIP), Universität Bonn, Bonn, Germany
Yi Dong
7   Zhongshan Hospital, Ultrasound, Shanghai, China
› Author Affiliations
Further Information

Publication History

received 28 November 2018
revised 04 April 2019

accepted 01 May 2019

Publication Date:
15 July 2019 (online)


Lymphatic filariasis is an infection transmitted by blood-sucking mosquitoes with filarial nematodes of the species Wuchereria bancrofti, Brugia malayi und B. timori. It is prevalent in tropical countries throughout the world, with more than 60 million people infected and more than 1 billion living in areas with the risk of transmission. Worm larvae with a length of less than 1 mm are transmitted by mosquitoes, develop in human lymphatic tissue to adult worms with a length of 7–10 cm, live in the human body for up to 10 years and produce millions of microfilariae, which can be transmitted further by mosquitoes. The adult worms can be easily observed by ultrasonography because of their size and fast movements (the so-called “filarial dance sign”), which can be differentiated from other movements (e. g., blood in venous vessels) by their characteristic movement profile in pulsed-wave Doppler mode. Therapeutic options include (combinations of) ivermectin, albendazole, diethylcarbamazine and doxycycline. The latter depletes endosymbiotic Wolbachia bacteria from the worms and thus sterilizes and later kills the adult worms (macrofilaricidal or adulticidal effect).