ABSTRACT
Objetivo: Caracterizar clínica y epidemiológicamente la toxocariasis ocular. Métodos: Se realizó un estudio observacional, descriptivo, de corte transversal con pacientes diagnosticados de toxocariasis ocular, atendidos en el Instituto Cubano de Oftalmología Ramón Pando Ferrer en el período de abril de 2019 a diciembre de 2022. Resultados: Predominó el sexo masculino (53,7 %) y el grupo etario de 0 a 10 años (73,1 %). El 56,1 % de los pacientes vivían en área rural. La convivencia con animales domésticos representó el 75,6 %. El síntoma más referido fue la disminución de la agudeza visual (48,8 %). La forma de presentación más frecuente fue el granuloma periférico de forma unilateral en ojo derecho (52,4 %). La complicación más observada fue el desprendimiento de retina (58,5 %). Conclusiones: La infección ocular por Toxocara spp. es una enfermedad prevenible e incapacitante que limita el desenvolvimiento educacional, laboral y de la vida en general de los pacientes afectados, particularmente la población infantil, el sexo masculino y los que residen en área rural en convivencia con animales domésticos, en especial perros.
Objective: To characterize ocular toxocariasis clinically and epidemiologically. Methods: An observational, descriptive and cross-sectional study was conducted with patients diagnosed with ocular toxocariasis, attended at the Instituto Cubano de Oftalmología Ramón Pando Ferrer in the period from April 2019 to December 2022. Results: The male sex predominated (53.7 %), together with the age group 0-10 years (73.1 %). 56.1 % of the patients lived in rural areas. Cohabitation with domestic animals accounted for 75.6 %. The most frequently reported symptom was decreased visual acuity (48.8 %). The most frequent form of presentation was peripheral granuloma in the right eye (52.4 %). The most observed complication was retinal detachment (58.5 %). Conclusions: Ocular infection by Toxocara spp. is a preventable, as well as incapacitating, disease that limits the educational, occupational and general life development of affected patients, particularly children, males and those living in rural areas cohabitating with domestic animals, especially dogs.
ABSTRACT
La toxocariasis es una zoonosis parasitaria. Se describen las alteraciones anatómicas y funcionales producidas por membranas que traccionan el polo posterior y la periferia de la retina, las cuales provocan hemorragia vítrea parcial asociada a neovascularización del disco óptico con membrana epirretiniana, y un agujero macular lamelar relacionado con la presencia de granuloma periférico. Se presenta un caso clínico de un paciente sano, quien comenzó con disminución de la agudeza visual del ojo izquierdo y se le diagnosticó, por cuadro clínico y examen oftalmológico con resultado positivo de la prueba de Toxocara, una toxocariasis ocular complicada. Se le realizó cirugía de vitrectomía mínimamente invasiva 23 G asociada a membranectomía, y pelado de la membrana limitante interna, así como endofotocoagulación con láser panretiniana. Se usó como tamponador al final de la cirugía el gas SF6 y el posicionamiento del paciente. Se aplicó tratamiento antiparasitario y esteroideo sistémico previo a la cirugía, y se obtuvieron resultados satisfactorios tanto anatómicos como funcionales del paciente(AU)
Toxocariasis is a parasitic zoonosis. A description is provided of the anatomical and functional alterations produced by membranes that pull the posterior pole and the periphery of the retina, causing partial vitreous hemorrhage associated to neovascularization of the optic disk with epiretinal membrane, and a lamellar macular hole related to the presence of peripheral granuloma. A clinical case is presented of a healthy male patient who started out with a decrease in the visual acuity of his left eye and was diagnosed with a complicated ocular toxocariasis based on his clinical status and ophthalmological examination with a positive toxocara test. Minimally invasive vitrectomy was performed: 23G associated to membranectomy and internal limiting membrane peeling, as well as panretinal laser endophotocoagulation, using patient positioning and gas (SF6) as tamponade at the end of surgery. Systemic steroid and antiparasitic treatment was provided before surgery, and satisfactory anatomical and functional results were obtained(AU)
Subject(s)
Humans , Male , Adult , Ophthalmoscopy/adverse effects , Vitrectomy/methods , Toxocariasis/diagnosis , Toxocariasis/complications , Eye Infections, Parasitic/therapyABSTRACT
El granuloma periférico de células gigantes se define como una lesión de tejidos blandos no neoplásica, ocasionada por una reacción hiperplásica como consecuencia de un traumatismo o inflamación local. Clínicamente se observa como un nódulo asintomático, generalmente de coloración rojiza azulada de diámetro variable y que afecta frecuentemente la encía marginal. Histológicamente se caracteriza por la proliferación de células gigantes mononucleadas y multinucleadas. En general, su tratamiento consiste en la exéresis quirúrgica más legrado de las paredes óseas afectadas, pudiendo existir la posibilidad de recidiva. A continuación se presenta una revisión de la literatura y se describe un caso clínico diagnosticado como granuloma periférico de células gigantes en un paciente de 14 años, cuya lesión fue removida quirúrgicamente utilizando electrobisturí, y con recidiva de la lesión. Se discute la epidemiología, características clínicas, radiográficas e histológicas de dicha patología, así como las posibles opciones terapéuticas y protocolos. Además, se comentan brevemente los aspectos relacionados al diagnóstico diferencial de las lesiones reactivas hiperplásicas del complejo periodontal, priorizando las posibles causas de la recidiva.
Giant cell peripheral granuloma is defined as a non-neoplastic soft-tissue lesion caused by a hyperplastic reaction resulting from trauma or local inflammation. Clinically it can be observed as an asymptomatic nodule, generally exhibiting a reddish-bluish hue and variable diameter. It frequently affects marginal gingival tissue. Histologically, it is characterized by the proliferation of mono-nucleated and multi-nucleated giant cells. In general, treatment consists of surgical extirpation and curettage of affected bone walls. Recurrence is a distinct possibility. In the present paper, a scientific literature review is presented along with the presentation of a clinical case of a 14 year old patient diagnosed with Giant cell peripheral granuloma: the lesion was surgically removed using an electric scalpel. The lesion recurred 4 weeks after surgery. Epidemiology of the case was reviewed, along with its clinical, radiographic and histological characteristics. Available therapeutic options and protocols were equally reviewed as well as issues related to differential diagnosis of hyperplastic reactive lesions of the periodontal complex. Priority was given to the causes of the lesion's recurrence.
ABSTRACT
Peripheral giant cell granuloma (PGCG) is a non-neoplastic lesion representing a local hyperplastic reaction. It is a tumorlike pathologic condition arising on the buccal or lingual attached gingival or alveolar mucosa and the crest of the edentulous alveolar ridge, of uncertain etiology; it is probably a reactive lesion caused by chronic local irritants or trauma rather than a true neoplasm. PGCG is thought to originate from elements of the periodontal ligament or from the periosteum. Clinically, it appears as a sessile or broadly pedunculated, bluish to purple-red, fleshy or firm swelling with a frequently ulcerated surface. It may be difficult to distinguish PGCG from pyogenic granuloma and peripheral odontogenic tumors. The clinical appearance of all these lesions is similar, the definitive diagnosis with histological examination is mandatory. Treatment of choice is surgical excision with total removal of the base of the lesion This case aims to present a case of PGCG in 11 year old girl in which surgical resection of the lesion was done to restore functions and esthetics.
ABSTRACT
São conhecidas diversas lesões que apresentam particular predileção pelo periodonto. A lesão periférica de células gigantes é um processo proliferativo reacional não neoplásico, apresentando-se relativamente freqüente na clínica estomatológica, podendo atingir dimensão variada e, subseqüentemente necessidades terapêuticas particulares. O propósito deste trabalho foi relatar um caso de uma paciente que apresentou uma lesão de tamanho avançado, localizada em mucosa palatina de prémolares e molares, na qual dificultou a fonação e a deglutição. A lesão foi removida pela exérese cirúrgica e o diagnóstico foi lesão periférica de células gigantes. Foram discutidas as características clínicas e histopatológicas, incidência e freqüência, diagnóstico diferencial, etiopatogênese, modalidades de tratamento e prognóstico.
Many lesions with periodontal predilection are known. The giant cell peripheral granuloma is a reaction proliferative process, non neoplasic, that is relatively frequent in stomatologic clinic, can arrive variable size and, subsequently, needs particulary therapeutic. The purpose of this work is to report a patient case that show an advanced size lesion, localized in palatine mucous of molar and premolar teeth that complicated deglutition and phonation. The lesion was removed by surgical excision and the diagnosis was giant cell peripheral granuloma. Clinical and histopatological characteristics, incidence and frequency, differential diagnosis, etiopathogenesis, therapeutic modalities and follow-up were discussed.