Ocular myocysticercosis: an unusual case of ptosis.

BACKGROUND: Cysticercosis is common in endemic countries like India. It can have various clinical manifestations depending on the tissue involved. It refers to a parasitic infestation by Cysticercus cellulosae, the larval form of the pork tapeworm or Taenia solium. OBJECTIVE: To report an unusual case of ocular cysticercosis involving the levator palpebrae superioris and superior rectus muscle of the right eye. CASE DESCRIPTION: A young, male adult was diagnosed by Magnetic Resonance Imaging (MRI) scan of the skull and orbit to have right-sided ocular cysticercosis. The patient was treated with oral prednisolone and albendazole, to which he showed a significant improvement. CONCLUSION: Ocular myocysticercosis can be diagnosed by MRI and be treated medically with steroid and albendazole.

Multiple brain parenchymal neurocysticercosis with extraocular muscle cysticercosis affecting levator palpebral superioris and superior rectus complex: an unusual association.

An 8-year-old girl presented to the neurology department with a complaint of insidious onset of left-sided ptosis and restricted elevation of the left eye. A CT scan orbit and brain revealed a ring-enhancing lesion in the levator palpebral superioris (LPS) and superior rectus (SR) muscle complex of the left eye and left parietal and right temporal region. She was started on steroid, followed by albendazole with improvement. The LPS/SR complex is the least common site of involvement among extraocular muscles in ocular cysticercosis. Specially, with brain neurocysticercosis (NCC), it is extremely rare. We report an unusual association of multiple brain NCC with ocular cysticercosis involving LPS and SR muscle.

Bilateral ptosis: an atypical presentation of neurocysticercosis.

Isolated ptosis is a rare presentation of neurocysticercosis (NCC). Here we report the case of a 45-year-old woman who presented with acute onset bilateral symmetrical ptosis with no other neurological deficit. Her imaging revealed a single cystic ring-enhancing lesion with perilesional oedema in the midbrain suggestive of NCC. She responded well to prednisolone.

Cryptosporidium baileyi infection associated with an outbreak of ocular and respiratory disease in otus owls (Otus scops) in a rehabilitation centre.

Cryptosporidiosis has been reported in more than 30 avian species worldwide. Although some cases of cryptosporidiosis have been described in captive birds of prey in the order Falconiformes, to date there have been no reports of the disease in wild raptors. Here we describe for first time an ocular and respiratory disease associated with Cryptosporidium baileyi in wild scops owl (Otus scops, order: Strigiformes). Sixteen otus owl fledglings born in the wild during the summer of 2008 were admitted to the Torreferrussa Wildlife Rehabilitation Centre (Catalonia, northern Spain) in July and August of the same year. In the middle of September, blepharoedema, conjunctival hyperaemia and mucopurulent ocular discharge were diagnosed unilaterally in 75% (12/16) of the birds and bilaterally in 25% (4/16). Moreover, five birds (31%) developed diffuse epithelial corneal oedema, one owl (6%) displayed mild anterior exudative uveitis and another developed rhinitis (6%). Two birds were euthanized because of the severity of disease. The histopathology demonstrated cryptosporidia-like structures in the conjunctival cells and in the nasal respiratory epithelium of one owl. Cryptosporidium spp. oocysts (6.5 to 7.0 x 5.0 to 5.5 microm) were identified by immunofluorescent antibody test (IFAT) in histological sections from eyelids, trachea and respiratory sinuses and in swab samples from the glottis, choanal slit and conjunctival sac. Polymerase chain reaction and DNA sequence analysis confirmed the presence of C. baileyi. Birds were treated orally with azithromycin (40 mg/kg) once a day for 15 days, and by the end of the treatment all owls tested negative for the parasites, by IFAT, and did not display further signs of disease.

Sudden-onset ptosis caused by midbrain neurocysticercosis in 2 children.

Neurocysticercosis is the most common parasitic infestation of the central nervous system, which manifests commonly as acute-onset focal seizures. We report a rare nonepileptic manifestation of neurocysticercosis: midbrain neurocysticercosis presenting as sudden-onset ptosis in 2 children. To our knowledge, this has not been reported previously in children.

Uniocular ptosis due to cysticercosis of extraocular muscle.

Involvement of extraocular muscle by Cysticercus cellulosae is very rare. Rarer still is the isolated involvement of the levator palpebrae superioris muscle presenting clinically as ptosis. We report here such a presentation in an eleven years old girl.

Orbital dirofilariasis.

Dirofilariasis is a parasitic disease of domestic and wild animals that occasionally may present as zoonotic infection in humans. The microfilariae are accidentally transmitted to humans by Culex and Aedes mosquitoes. Ophthalmic infections with Dirofilaria are well documented all over the world, including America, Europe and Australia. The infection may be periorbital, subconjunctival or intraocular. In this report a case is described of orbital dirofilariasis that presented as ptosis and lid swelling. Australian ophthalmologists should consider dirofilariasis as part of the differential diagnosis of orbital swelling and inflammation.