As a rule injury to the adult filarial worms, which results in their death, is not followed by abscess formation but such termination may occur. These abscesses have been found deeply seated in the extremities. Wise and Minett in a careful examination of 28 such cases found evidences of adult filariae in 22 cases. In 21 of these abscesses, infections with streptococci or staphylococci were demonstrated. Very interesting also is the finding of filarial worms in deep-seated abdominal abscesses.
As regards location, these filarial abscesses were found 31 times in the pelvis of the kidney, 18 times in the epididymis, 12 times in the retro-peritoneal tissues, 25 times in the inguinal glands, 4 times in the ilio-psoas muscles and 8 times in the lymphatic vessels.
They regard the endemic funiculitis to which attention has been directed by Castellani as simply a similar process involving the tissues about the spermatic cord. The treatment of filarial abscesses is similar to that of other abscesses.
Chyluria
As the result of obstruction of the lymphatic vessels varices may form in the bladder lymphatics and, as the result of their rupture, milky urine may be passed. If the thoracic duct be occluded the urine will show an abundance of fat, while if the obstruction exists only in other lymphatics, the milky fluid will be found to show but little fat. Blood is usually present in chyluria so that the urine will show an pinkish tinge.
Chylous urine coagulates rapidly and we have in such a specimen of urine, upon standing, an upper fatty layer and pinkish sediment at the bottom, with a clot between.
The sediment shows lymphocytes and at times filarial embryos. When the exudate is lymph mixed with blood the term haematolymphuria would be a better one.
Clots may form in the bladder and give rise to obstruction to the flow of urine from the bladder.
The appearance of the chyluria is often preceded by heaviness about the loins and pains in the region of the bladder.
The morning urine in such a case is apt to be clear while that passed later in the day is milky in appearance.