Back in 2014, dermatologist Bridget McIlwee saw a 3-year-old patient in central Texas with unusual bumps on his ear.
"They looked a little bit like almost kind of a benign mole that you would see in a child, except that you wouldn't expect something like that to come up quickly and then multiply," she says.
McIlwee sent off a sample for laboratory testing, and the results came back pointing to a surprising culprit: The boy had tested positive for cutaneous leishmaniasis, a neglected tropical disease. The World Health Organization says between 600,000 and 1 million new infections happen worldwide every year, mostly in tropical regions of the Americas, the Mediterranean basin, the Middle East and Central Asia — not in Texas. These illnesses can be disfiguring, even if they are rarely fatal.
Treatments for Onchocerca volvulus
Usage/Drug -- Adult Dose -- Pediatric dose
To kill microfilariae:
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ivermectin 150 mcg/kg orally in one dose every 6 months
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150 mcg/kg orally in one dose every 6 months
To kill macrofilariae: -
doxycycline* 200 mg orally daily for 6 weeks
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200 mg orally daily for 6 weeks
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Doxycycline is not standard therapy, but several studies support its use and safety. Treatment with ivermectin should be given one week prior to treatment with doxycycline in order to provide symptom relief to the patient. If the patient cannot tolerate 200 mg PO daily of doxycycline, 100mg PO daily is sufficient to sterilize female Onchocerca
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