RESUMO
Presentation of one case of extraocular muscle enlargement caused by cysticercosis, its clinical, diagnostic and treatment aspects, and review of the literature on this theme. A female 38-year-old patient with extraocular muscle enlargement and a small cystic lesion at the superior rectus muscle insertion was treated with oral prednisone for almost one year, with a non-specific inflammation of right orbit diagnosis. There were important ocular motility restriction and pain. Computerized tomography disclosed a superior rectus muscle thickening with a small cystic and apparently empty lesion at the muscle's insertion. Excisional biopsy and histopathological study confirmed the clinical suspicion of cysticercosis. There was partial resolution of the restricted motility. Extraocular muscle cysticercosis is the most common site of this disease when involving the orbit. Oral albendazole and prednisone are efficient, but a long history of disease can lead to important residual ocular motility restriction.
Apresentação de um caso de aumento de músculo extra-ocular causado por cisticercose, seus aspectos diagnósticos, clínicos, tratamento e revisão da literatura sobre o tema. Paciente de 38 anos do sexo feminino com aumento de músculo reto superior e pequena lesão cística foi tratada por um ano com prednisona oral com o diagnóstico de inflamação inespecífica da órbita. Havia importante restrição da motilidade ocular e dor. Tomografia computadorizada demonstrou espessamento do reto superior e pequena lesão cística, aparentemente sem conteúdo, na inserção do músculo. Biópsia excisional e estudo histopatológico confirmaram a suspeita de cisticercose. Houve melhora parcial da restrição de motilidade. A cisticercose de músculo extra-ocular é a mais frequente forma orbitária da doença. Tratamento clínico com albendazol e prednisona é eficiente, mas um atraso no diagnóstico pode levar a importante restrição residual na motilidade ocular.
Assuntos
Adulto , Feminino , Humanos , Cisticercose/diagnóstico , Infecções Oculares Parasitárias/diagnóstico , Doenças Orbitárias/diagnóstico , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Cisticercose/tratamento farmacológico , Diagnóstico Diferencial , Infecções Oculares Parasitárias/tratamento farmacológico , Inflamação/diagnóstico , Transtornos da Motilidade Ocular/parasitologia , Músculos Oculomotores/parasitologia , Prednisona/uso terapêutico , Tomografia Computadorizada por Raios XRESUMO
In an attempt to determine whether the finding of human ocular lesions due to B. malayi was due to the site of entry of the infective larvae, cats were infected via ocular instillation, subconjunctival inoculation, subcutaneous inoculation around and infective mosquito bites over the eyes. Although no conjunctival lesion was seen patent infections were produced via ocular instillation, subconjunctival and subcutaneous inoculation of infective larvae. Adult worms were also recovered from periorbital tissues. Adult worms were localized mainly in the lymphatic system of the head and neck regions of the cat. The results show that the conjunctival lesions seen in humans could be due to the site of bite of the mosquito and thus the entry of the infective larvae.