A Case of Thelazia callipaeda Infestation with Preseptal Cellulitis

PURPOSE: To report a case of Thelazia callipaeda infection with preseptal cellulitis. CASE SUMMARY: A 24-year-old female presented with symptoms of conjunctival injection and ocular pain in her left eye and a parasite was found in her conjunctival sac. Using light microscopy, we identified Thelazia callipaeda and many larvae were observed in the vulva of an adult female worm. Three days later, erythematous swelling occurred in the left upper eyelid and four adult worms were found and removed with forceps. Third-generation cephalosporin and nonsteroidal anti-inflammatory drugs were administered orally; the eyelid swelling improved but the conjunctival injection remained. Later five and seven adult worms were removed every 4 weeks and the conjunctival injection improved with no parasites detected after the final extraction. CONCLUSIONS: In the case of Thelazia callipaeda infection, it is necessary to identify eggs and larvae and to observe the patient for more than 1 month because of postextraction growth of the larvae. In addition, the possibility of preseptal cellulitis by Thelazia callipaeda should be considered.

Human ocular Thelaziasis in Karnataka.

Thelaziasis is an Arthropod‑born disease of the eye and adnexa caused by Thelazia callipaeda, a nematode parasite transmitted by drosophilid flies to carnivores and humans. Because of its distribution mainly confined to South Asian countries and Russia, it is commonly known as Oriental Eye worm. It is often under‑reported and not been given its due clinical importance. We report first case of human Thelaziasis from Hassan District, Karnataka. Five creamy‑white, translucent worms were removed from the conjunctival sac of a 74‑year‑old male patient. Based on morphological characters, the worms were identified as nematodes belonging to the genus Thelazia and speciation was confirmed by CDC, Atlanta as callipaeda. Rarity of the disease and its ability to cause both extra and intraocular manifestations leading to ocular morbidity is the reason for presenting this case. From the available data, this is the first case report from Karnataka, India.