Skin abrasion, moisture, and barefoot walking predispose to bacterial penetration of the filarial lymphedematous limb. The common ports of entry are the interdigital spaces, but any other foot skin damage may also facilitate bacterial colonization. Dilatation of collecting lymphatic trunks is responsible for the later dysfunction and subsequent lymph stasis. Stasis predisposes to secondary bacterial infection and tis­sue colonization. Lack of elimination of microbes brings about host immune response diagnosed as DLA.4 Acute attacks of DLA are followed by chronic DLA character­ized by hyperkeratosis, fibrosis of the skin, and increase in limb volume. The mixed bacterial flora of the patient’s own skin is presumably responsible for this condition.4 The tissue fluid, lymph and lymph node specimens obtained from lower limbs show the presence of bacterial isolates in 70% of cases. The dominant strains are coagu­lase-negative staphylococci and bacilli. Bacterial infections in lymph stasis are eas­ily controlled by antibiotics. Long-term administration of, for example, benzathine penicillin at a dose of 1,200,000 IU every 21 days has decreased the recurrence rate of DLA attacks by 80%, without a change in sensitivity to antibiotics.