Early formation of the nodule in Guatemalan onchocerciasis.

Thirty-eight nodules containing adults of Onchocerca volvulus were removed from 36 patients who had no detectable microfilariae in skin snips. Worms were digested from nodules in collagenase solution, maintained alive in vitro, and the number, sex, and state of fecundity were recorded. A total of 48 female and 8 male worms were recovered; 39 females were in the nodules without the presence of a male. Eleven females (22.9%) had microfilariae in utero or produced microfilariae in vitro; seven of these were found together with males in the nodules while four were not. No nodules were found around male worms unless a female was also present. These observations indicate that the nodule forms only around female worms and that mating probably occurs before or early during nodule formation. Furthermore, the production of microfilariae by the the female is not essential for nodule formation since many nodules contained non-fecund, living females.