ABSTRACT
We report the first case of ocular infestation by Loa loa in Brazil. Loiasis is caused by infestation with Loa loa, a filarial parasite originally found in the rainforests of western and central Africa. It is transmitted by the bite of the fly Chrysops and has been recently described in other places other than Africa, in African immigrants or travellers. Our case is a 33 year-old woman from Cameroon who was living in São Paulo, Brazil, for 5 years. She was asymptomatic until one morning she started feeling "something moving" in the left eye. Under topical anesthesia, on the slit lamp, a moving worm was removed from the subconjunctival space, which later was confirmed to be a male Loa loa adult specimen. Blood tests revealed microfilaraemia of 129 mf/mL. The patient was treated with 400 mg oral albendazole for 3 weeks and 60 mg prednisone. This report illustrates an unusual ocular disease, which is extremely rare outside of Africa, but easily diagnosed and treated. Ophthalmologists should be aware of it, in face of an increasingly globalized world.
Este é o primeiro relato na literatura nacional e internacional de infestação ocular por Loa loa no Brasil. A loíase é uma filariose causada pelo parasita Loa loa, encontrado nas florestas tropicais da África equatorial. A transmissão se dá pela picada do mosquito Chrysops e casos têm sido descritos em países não africanos, em imigrantes e viajantes. O presente caso trata-se de uma paciente de 33 anos natural de Camarões e residente em São Paulo, Brasil, há 5 anos. Até então assintomática, uma manhã sentiu algo "se mexendo" em seu olho esquerdo. Sob anestesia tópica, na lâmpada de fenda, um verme altamente móvel foi removido do espaço subconjuntival e enviado para identificação, que confirmou tratar-se de um espécime macho adulto de Loa loa. Testes sanguíneos revelaram microfilaremia de 129 mf/mL. A paciente foi tratada com albendazol 400 mg e prednisona 60 mg esquema regressivo por 3 semanas. Este relato ilustra uma doença excepcionalmente rara no Brasil, e praticamente desconhecida dos oftalmologistas em nosso país.
Subject(s)
Adult , Animals , Female , Humans , Conjunctival Diseases/parasitology , Eye Infections, Parasitic/parasitology , Loa/isolation & purification , Loiasis/parasitology , Brazil , Conjunctival Diseases/diagnosis , Eye Infections, Parasitic/diagnosis , Loiasis/diagnosisABSTRACT
Loiasis is a filarial disease transmitted by the Chrysops spp. tabanid flies in West and Central Africa. It is most commonly diagnosed by the clinical manifestations of Calabar swellings (transient localized inflammatory edema) or, most dramatically, by the appearance of a migrating worm through the conjunctival tissues or the bridge of the nose. We report the case of a 35-year-old resident in the city of Rio de Janeiro who displayed a moving Loa loa in the bulbar conjunctival tissue two years after returning from a six-month trip to Uganda. Surgical removal of the worm was performed.
A loaíase é uma filaríase transmitida por tabanídeos (mutucas) do gênero Chrysops na África central e ocidental, comumente diagnosticada pela apresentação clínica de edema de Calabar (edema inflamatório transitório e localizado) ou, mais dramaticamente, pela migração de um verme adulto pelo tecido conjuntival ou asa do nariz. Descrevemos o caso clínico de um paciente do sexo masculino, 35 anos, residente no Rio de Janeiro, que se apresentou com um verme adulto de Loa loa migrando sobre o tecido conjuntival bulbar dois anos após retornar de uma viagem de seis meses de duração a Uganda. Procedeu-se a remoção cirúrgica do verme.
Subject(s)
Adult , Animals , History, 20th Century , Humans , Male , Conjunctival Diseases/diagnosis , Eye Infections, Parasitic/diagnosis , Loiasis/diagnosis , Conjunctival Diseases/history , Conjunctival Diseases/parasitology , Eye Infections, Parasitic/history , Loiasis/history , Travel , UgandaABSTRACT
An unusual case of loiasis from Assam is reported here. Loa loa is a subcutaneous filarial parasite of man and is transmitted to humans by chrysops flies. The patient presented with foreign body sensation and visual disturbances of the right eye. Examination revealed a white coiled structure in the cornea. Routine blood and other investigations were within normal limits. A live adult worm was extracted and identity was confirmed by microscopy to be Loa loa. Patient was treated with diethylcarbamazine and steroid. We found this case interesting as the worm was present in the anterior chamber--an unusual site and there were no other positive findings besides the lone worm.