The adult worm is extracted from the patient using a stick at the skin surface and wrapping or winding the worm a few centimeters per day. This slow process can take many days and up to a few weeks in some cases, but it is required to avoid breakage and leaving behind a portion of the worm. Suspicion of dracunculiasis by history or examination warrants consultation of an infectious disease specialist for involvement in management and follow-up. This also will allow for initiation of epidemiologic protocol if the patient presents in a nonendemic country. No particular dietary changes are required during the extraction process, regardless of the time frame involved.
Activity usually is self-restricted due to discomfort.
Recommendations are tailored for the individual, with no particular general guidelines. Antiparasitics - These are used to speed the pace of worm extraction. Intermediate-metabolized compounds formed bind DNA and inhibit protein synthesis, causing cell death. Pregnancy B - Usually safe but benefits must outweigh the risks. Pregnancy C - Safety for use during pregnancy has not been established.