A Case of Thelazia callipaeda Infestation with Preseptal Cellulitis

ABSTRACT

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.