Clinical Features:
The clinical manifestations are localized but incapacitating.  The worm emerges as a whitish filament (duration of emergence: 1 to 3 weeks) in the center of a painful ulcer, accompanied by inflammation and frequently by secondary bacterial infection.

A	B

The female guinea worm induces a painful blister (A); after rupture of the blister, the worm emerges as a whitish filament (B) in the center of a painful ulcer which is often secondarily infected.  Images contributed by Global 2000/The Carter Center, Atlanta, Georgia.

Laboratory Diagnosis:
The clinical presentation of dracunculiasis is so typical, and well known to the local population, that it does not need laboratory confirmation.  In addition, the disease occurs in areas where such confirmation is unlikely to be available.  Examination of the fluid discharged by the worm can show rhabditiform larvae.  No serologic test is available.

Treatment:
Local cleansing of the lesion and local application of antibiotics, if indicated because of bacterial superinfection.  Mechanical, progressive extraction of the worm over a period of several days.  No curative antihelminthic treatment is available.