ABSTRACT
This report describes a 10-month-old dog with a sudden loss of vision and severe dyspnoea. The ocular examination revealed bilateral panuveitis, lens subluxation, secondary glaucoma, and retinal detachment. In addition, the ocular ultrasound showed in the vitreous body of the right eye, a small doubled-lined foreign body compatible with an intraocular parasite. Radiographs of the thorax revealed an increased opacity with mixed lung pattern (alveolar and bronchial) and thoracic ultrasonography showed several subpleural nodules. The presence of Angiostrongylus vasorum first stage larvae was confirmed with 324 larvae per gram of feces and an antigen test for the parasite (AngioDetect, IDEXX) also yielded a positive result. The severe and irreversible ocular lesions described in this case enhanced the complexity of the clinical picture of canine angiostrongylosis. Infection with the parasite should be included in the list of differential diagnoses for ocular uveitis to avoid potentially serious complications related to a missed or delayed diagnosis.
Subject(s)
Angiostrongylus/isolation & purification , Dog Diseases/parasitology , Eye Diseases/veterinary , Strongylida Infections/veterinary , Animals , Dog Diseases/diagnosis , Dog Diseases/drug therapy , Dogs , Eye Diseases/diagnosis , Eye Diseases/drug therapy , Eye Diseases/parasitology , Feces/parasitology , Female , Glaucoma/complications , Italy , Lens Subluxation/parasitology , Lens Subluxation/veterinary , Lung Diseases, Parasitic/diagnostic imaging , Lung Diseases, Parasitic/veterinary , Panuveitis/parasitology , Panuveitis/veterinary , Retinal Detachment/parasitology , Retinal Detachment/veterinary , Strongylida Infections/diagnosis , Strongylida Infections/drug therapyABSTRACT
BACKGROUND: Echinococcosis is a dangerous zoonotic parasitic disease. Ocular echinococcosis is very rare, especially the hydatid cysts in subretinal space. We present a case of subretinal echinococcosis and management. CASE PRESENTATION: A 37-year-old man with subretinal echinococcosis who developed panuveitis and visual impairment. The patient lives on agriculture and animal husbandry, which made him susceptible to parasitic infection. He had severe panuveitis and blurred vision on arrival at hospital. According to his ocular examination and systemic review, the subretinal echinococcosis diagnosis was made. The patient received pars plana lensectomy and pars plana vitrectomy. The lesion underneath his retina was removed, and histopathology examination confirmed the subretinal echinococcosis diagnosis. CONCLUSIONS: Echinococcosis is a dangerous zoonotic parasitic disease in pastoral areas. Ocular echinococcosis is usually secondary to systemic infection. Although the incidence is rare, the disease could lead to destructive visual function impairment.
Subject(s)
Echinococcosis/parasitology , Eye Infections, Parasitic/parasitology , Retinal Diseases/parasitology , Adult , Angiogenesis Inhibitors/therapeutic use , Combined Modality Therapy , Echinococcosis/diagnostic imaging , Echinococcosis/therapy , Echinococcosis, Pulmonary/diagnostic imaging , Echinococcosis, Pulmonary/parasitology , Echinococcosis, Pulmonary/therapy , Eye Infections, Parasitic/diagnostic imaging , Eye Infections, Parasitic/therapy , Glucocorticoids/therapeutic use , Humans , Magnetic Resonance Imaging , Male , Panuveitis/diagnostic imaging , Panuveitis/parasitology , Panuveitis/therapy , Prednisolone/therapeutic use , Ranibizumab/therapeutic use , Retinal Diseases/diagnostic imaging , Retinal Diseases/therapy , Tomography, Optical Coherence , Tomography, X-Ray Computed , Triamcinolone Acetonide/therapeutic use , Vision Disorders/diagnostic imaging , Vision Disorders/parasitology , Vision Disorders/therapy , Visual Acuity/physiology , VitrectomyABSTRACT
Most panuveitis in children are caused by infectious agents. A detailed clinical history and clinical examination are helpful in the diagnosis, but specific techniques are sometimes required to identify the causing specimen. We report the first published case of panuveitis in a child caused by simultaneous ocular infection by Toxocara canis and a fly larva and the innovative use of immunodiffusion technique in the vitreous for the diagnosis.
Subject(s)
Eye Infections, Parasitic/diagnosis , Larva Migrans, Visceral/diagnosis , Myiasis/diagnosis , Panuveitis/diagnosis , Animals , Antibodies, Helminth/immunology , Child , Coinfection , Eye Infections, Parasitic/immunology , Humans , Larva Migrans, Visceral/complications , Larva Migrans, Visceral/immunology , Male , Myiasis/complications , Panuveitis/immunology , Panuveitis/parasitology , Toxocara canis/immunology , Vitreous Body/immunologyABSTRACT
PURPOSE: To determine the infectious causes of posterior uveitis (PU) and panuveitis (panU) in Thailand. METHODS: We investigated the infectious causes of uveitis involving the posterior segment of the eye by using real-time polymerase chain reaction (PCR) for cytomegalovirus (CMV), herpes simplex virus (HSV-1, HSV-2), varicella zoster virus and Toxoplasma gondii (T. gondii) DNA in intraocular samples of 80 human immunodeficiency virus (HIV)-negative patients. Additionally, in 61 patients, we performed Goldmann-Witmer coefficient (GWC) analysis for T. gondii. RESULTS: Twenty-four (30 %) patients with PU and/or panU had a positive PCR result. Overall, CMV was the most frequently identified organism. While CMV was the most common cause of uveitis in the patients on immunosuppressive medications for nonocular disorders, HSV was the most common cause of posterior and panuveitis in the patients not receiving such medication. In 38 PU patients, CMV was the most common detected pathogen. In 42 panU patients, CMV and HSV-2 were the most frequently identified pathogens. Out of 61 paired samples analyzed for T. gondii by GWC analysis, only 1 revealed a positive result. There was no difference in PCR results between aqueous humor and vitreous samples. CONCLUSIONS: CMV was the most frequently identified infectious organism in posterior and panuveitis of HIV-1-negative Thai patients. Aqueous humor and vitreous samples showed similar diagnostic values in PCR analysis.
Subject(s)
Eye Infections, Viral , Panuveitis/parasitology , Panuveitis/virology , Toxoplasmosis, Ocular , Uveitis, Posterior/parasitology , Uveitis, Posterior/virology , Adolescent , Adult , Aged , Antibodies, Protozoan/analysis , Aqueous Humor/immunology , Aqueous Humor/parasitology , Aqueous Humor/virology , Child , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/virology , DNA, Protozoan/analysis , DNA, Viral/analysis , Enzyme-Linked Immunosorbent Assay , Eye Infections, Viral/diagnosis , Eye Infections, Viral/virology , Female , Herpes Simplex/diagnosis , Herpes Simplex/virology , Herpes Zoster Ophthalmicus/diagnosis , Herpes Zoster Ophthalmicus/virology , Humans , Male , Middle Aged , Panuveitis/diagnosis , Real-Time Polymerase Chain Reaction , Thailand , Toxoplasmosis, Ocular/diagnosis , Toxoplasmosis, Ocular/parasitology , Uveitis, Posterior/diagnosis , Vitreous Body/immunology , Vitreous Body/parasitology , Vitreous Body/virology , Young AdultABSTRACT
Visceral leishmaniasis (VL) is an important cause of morbidity and mortality that affects multiple organs. Post-kala-azar ocular involvement is a serious complication that can manifest as blepharo-conjuctivitis or pan-uveitis. Failure of prompt diagnosis and treatment can result in blindness. We report five cases with pan-uveitis that followed the successful treatment of VL and consequent post-kala-azar dermal leishmaniasis were presented. Two patients lost their sight permanently but the rest were successfully treated. A high index of suspicion and prompt treatment are of paramount importance in order to avoid blindness following post-kala-azar ocular uveitis.
