Recently, scrotal elephantiasis caught the attention of people, especially men, worldwide. This happened after Wesley Warren Jr, a brave man from Los Angeles, exposed his unusual condition on Howard Stern’s radio and even on national television. He is hoping to raise $1 million for a surgery that will treat his swelling scrotum.

Elephantiasis is the visible enlargement of the legs, arms, and genitals to a huge size. It is a parasitic condition involving microscopic worms that can be spread by female mosquitoes.

The main target is the lymphatic system. The worms block the lymph nodes, which makes fluid collect in tissues. This causes great swelling called lymphedema. When the swelling goes massive, enlargement of arms, legs, or genitals can be noticed – depending on the affected lymph nodes.

Causes of Elephantiasis

Scrotal and other types of elephantiasis can be mainly caused by parasites. This rare condition is usually seen in Asia and Africa. The parasite Wuchereria bancrofti undergoes a life cycle between man and mosquitoes. At its larval stage, it will be sucked by a female mosquito that bites a person. Once injected, the larva will then target man’s lymph nodes to where it will grow. The growing larvae will then block the lymph nodes causing inflammation to legs, arms, and genitals.

Elephantiasis can also be non-parasitic, normally called nonfilarial elephantiasis or podoconiosis. Men with nonfilarial elephantiasis are commonly seen in Tanzania, Kenya, Burundi, Egypt, Rwanda, and Ethiopia. Studies have shown that nonparasitic elephantiasis is caused by constant contact with irritant soils, especially those rich in alkali metals like sodium and potassium.

A study from University of London found that heavy metals can cause nonparasitic elephantiasis. Scientists conducted a study on the surface of water in Lake Abaya in Ethiopia, where high incidence of nonparasitic elephantiasis was also noted. They found mercury and other heavy metals around the lake which made them think that heavy metals can cause elephantiasis.

However, the cause of Wesley Warren Jr.’s case is completely different. He claimed that he got scrotal elephantiasis after an accident where he twisted his legs and direct trauma was applied to his scrotum.

Elephantiasis Treatments

Antibiotics can be taken to reduce swelling. Normally, a common antibiotic is fine but the drug of choice is diethylcarbamazine (DEC, trade name Hetrazan). The typical treatment schedule is 2 mg/k per day to be taken thrice a day for three weeks.

However, surgery is still the most preferred and most effective treatment in treating scrotal elephantiasis.