The larva in the third stage of development is inoculated into a vertebrate organism during the insect’s feeding through a sting, after which it crosses the dermis and enters to the lymphatic vessels. In humans the life cycle of the parasite lasts between five to 12 months and in the vector between 10 and 12 days. Over a period of 9 month the larva transform into an adult worm with dimensions between 20 and 100 milimeters. In general the parasite can survive for about 5 years [1]. When it reaches maturity, the parasite eliminates the microfilariae that migrate in the peripheral blood, cerebrospinal fluid and sputum during the day, and in the lungs during the night. Adult worms tend to move subcutaneously and have tactics for the eyeball, locating subconjunctivally. The tendency to migrate from one eye to another, causing conjunctivitis, can also be observed. The disease minimal incubation lasts between 4-5 months, but it can extend to 1-2 years [2].

The most common symptom is localized or extensive allergic edema in the upper and lower limbs. Edema of cutaneous filariasis is fleeting, lasting up to 36-72 de ore, slightly painful, accompanied by hyperesthesia and local itching, which can generalize [3]. Other complications that may occur in cutaneous filariasis are abscesses of subcutaneous tissue, tenosynovitis, eosinophilic fasciitis, lymhadenophaty, elephantiasis, ocular complications (retinophaty, conjunctivitis), neurological (dizziness, headache, coma), cardiovascular (cardiomyopathy), renal (glomerulonephritis, chronic, proteinuria) or pulmonary complications. Frequently patients may be asymptomatic and have only eosinophilia [4].

Filariasis may be suspected in patients who have  travelled to endemic areas or who have specific symptoms (allergic edema, febrile syndromes, adult worms at subconjunctival or subcutaneous level). Laboratory tests showing the presence of eosinophilia and elevated C-reactive protein values are required to establish a definite diagnostic. Hematological diagnosis identifies the presence of microfilariae in the peripheral blood using Giemsa or methylene blue coloration. Immunological diagnosis identifies elevated levels of specific IgE and IgG4 antibodies by Elisa technique [5]. The histopathological diagnosis consists in recognition by the anatomopathologist of the adult worm after its extraction from subconjunctivalk or subcutaneous level. If internal organs are affected, other imaging investigations can be performed to detect the associated lesions (computer tomography, nuclear magnetic resonance, soft tissue  ultrasound etc).

The surgical treatment consist of extracting the adult worm from the eye ball or from the subcutaneous tissue, surgery performed under local anesthesia. Rupture of the filaria or its incomplete extraction is associated with important local and general hypersensitivity reactions, but also an increased risk of infection. Postoperatively patients will be treated with Diethylcarbamazine, Ivermectin or Albendazole in doses prescribed by a specialist [6].

Treatment with antiparasitic drugs is administered in progressively increasing doses. These drugs have the role of eliminating the larval worm by inhibiting reproduction and destroying it. Side effects caused by these drugs can be tempereted by concomitant administration of antihistamines or steroidal antiinflamatory drugs. The elimination of worms must be done with caution because a very high concentration of them in the blood or lymphatic flow can cause violent allergic reactions and lymphadenopathy [7].

Diethylcarbamazine is an affective treatment against filariasis with effect on adult worms and is prescribed only after confirmation of the diagnosis. Treatment has a significant risk of allergic reactions, much higher than Ivermectin, but with a lower risk of neurological comlications. In patients with specific symptoms of cutaneous filariasis and with less than 8000 microfilariae/ml of blood, is recommended 3-5 mg of Diethylcarbamazine/kg body weith/day for a period of 21 days. Ivermectin is also used to reduce the number of microfilariae, but under the protection of antihistamines, repeated monthly for 4 months. Because side effects of ivermectin can be severe, especially in neurological field (headache, ataxia, confusion, sphincter incontinence, encephalopathy, central hypertension, coma); lately Albendazole is preferred because it has lower risks [6].

The prognosis in filariasis depends on how large the number of pathogens is and the period of contact. During the disease the immune system is affected and the body has a predisposition to other diseases. Especially in tropical regions, subsequent infections can lead to severe life-threatening complications. Adults worms can survive in the host s body for many years. It may take several months or years for the microfilariae to appear in the blood, so that the infection can be diagnosed late [8]. An early  treatment is associated with a  better prognosis. In lymphatic filariasis lymphatic vessels can be destroyed, lymphatic drainage being affected, with significant aesthetic and functional damage.