[Ocular manifestations in mansonelliasis]. / Acometimento ocular em pacientes com mansonelose.

PURPOSE: To evaluate eye manifestations in mansonelliasis patients from Coari, AM, rural area on the middle Amazonas River. METHODS: Cross-sectional study consisted of evaluation of 543 subjects from Coari rural area on Solimões River right margin. All subjects were submitted to blood test for microfilaria and the subjects who had a positive test also were submitted to skin biopsies and ophthalmologic examination. Histopathology and PCR research for microfilaria were done on eye biopsies of suspect lesions. RESULTS: Mansonella ozzardi was found in peripheral blood of 103 (18.9%) subjects. Ninety-five mansonelliasis patients were examined. Punctate keratitis was observed in 12 of them, nummular keratitis in one subject and sclerosing keratitis in another one. Skin biopsies were negative in all subjects. Conjunctival and limbal biopsies were done in five mansonelliasis patients and corneal biopsy in another three patients. Conjunctival and limbal biopsies of two patients and corneal biopsy of one patient showed no microfilaria or alterations due to its presence on histopathology. PCR showed no evidence of microfilaria in the other biopsies. CONCLUSION: Association between Mansonella ozzardi infection and corneal lesions with no evident etiology was observed in this study, but the lack of conclusive findings on histopathology and PCR make us doubt the corneal involvement in mansonelliasis. Large studies of high mansonelliasis prevalence populations and extensive employment of microfilaria identification tests in ocular tissue are needed to evaluate the microfilaria corneal pathogenicity.

Acometimento ocular em pacientes com mansonelose / Ocular manifestations in mansonelliasis

OBJETIVOS: Avaliar as alterações oculares observadas em indivíduos com mansonelose residentes na área rural do município de Coari, AM, na região do médio Amazonas. MÉTODOS: Foi conduzido um estudo de corte transversal envolvendo 543 moradores residentes na área rural do município de Coari, na margem direita do rio Solimões. Todos os indivíduos foram submetidos a exame de gota espessa para pesquisa de microfilária e os indivíduos positivos foram submetidos a exame oftalmológico. Lesões oculares suspeitas foram biopsiadas e enviadas para exame histopatológico. RESULTADOS: Mansonella ozzardi foi encontrada no sangue periférico em 103 (18,9 por cento) indivíduos. Noventa e cinco pacientes com mansonelose foram examinados, observando ceratite puntata em 12 (11,7 por cento) destes, ceratite numular em um indivíduo (1 por cento) e esclerosante em outro (1 por cento). Biópsia de pele foi negativa em todos os indivíduos. Biópsia de conjuntiva e limbo foi realizada em cinco pacientes com mansonelose e biópsia de córnea em outros três pacientes. Duas biópsias de conjuntiva e limbo e uma biópsia de córnea foram enviadas para exame histopatológico, não sendo observadas microfilárias ou alterações sugestivas da presença destas nas peças estudadas. O restante das biópsias foi enviado para pesquisa de DNA do parasita por PCR, não se encontrando microfilária. CONCLUSÕES: Associação entre infecção por Mansonella ozzardi e lesões corneanas sem etiologia aparente foi verificada neste estudo, mas a ausência de achados específicos no exame histopatológico e a não identificação de microfilárias por PCR em lesões suspeitas põem em dúvida a o acometimento corneano na mansonelose. Estudos mais amplos de populações com alta prevalência de M. ozzardi e a realização de outros testes para identificação de microfilárias em tecido ocular são necessários para investigar a patogenicidade da microfilária ao tecido ocular.

PURPOSE: To evaluate eye manifestations in mansonelliasis patients from Coari, AM, rural area on the middle Amazonas River. METHODS: Cross-sectional study consisted of evaluation of 543 subjects from Coari rural area on Solimões River right margin. All subjects were submitted to blood test for microfilaria and the subjects who had a positive test also were submitted to skin biopsies and ophthalmologic examination. Histopathology and PCR research for microfilaria were done on eye biopsies of suspect lesions. RESULTS: Mansonella ozzardi was found in peripheral blood of 103 (18.9 percent) subjects. Ninety-five mansonelliasis patients were examined. Punctate keratitis was observed in 12 of them, nummular keratitis in one subject and sclerosing keratitis in another one. Skin biopsies were negative in all subjects. Conjunctival and limbal biopsies were done in five mansonelliasis patients and corneal biopsy in another three patients. Conjunctival and limbal biopsies of two patients and corneal biopsy of one patient showed no microfilaria or alterations due to its presence on histopathology. PCR showed no evidence of microfilaria in the other biopsies. CONCLUSION: Association between Mansonella ozzardi infection and corneal lesions with no evident etiology was observed in this study, but the lack of conclusive findings on histopathology and PCR make us doubt the corneal involvement in mansonelliasis. Large studies of high mansonelliasis prevalence populations and extensive employment of microfilaria identification tests in ocular tissue are needed to evaluate the microfilaria corneal pathogenicity.

First report of presumed parasitic keratitis in Indians from the Brazilian Amazon.

PURPOSE: To describe corneal disorders in patients with systemic parasitic disease. METHODS: Cross-sectional study consisted of ophthalmologic examinations, peripheral blood tests and skin biopsies in 496 subjects (395 Indians and 101 non-indians) from the upper Negro River, Brazilian Amazon. RESULTS: Mansonella ozzardi was detected in the blood of 140 (28.23%) subjects. Seventy-six (55.07%) of them also presented multiple nummular opaque superficial lesions in the cornea. None of the examined patients presented onchocercal-related skin lesions or positive skin biopsies for filaria. CONCLUSION: There was a significant association between mansonelliasis and keratitis.

Estudio de un grupo de estudiantes africanos parasitados con Manzonella perstans en Cuba (área no endémica) durante 1979 a 1982 / Study of a group of African students parasited with Manzonella perstans in Cuba (non-endeic area) during 1979-1982

Se estudiaron 60 casos de Manzonella perstans por un período de 3 años mediante estudios clínicos y parasitológicos de sangre. Se observó que el 31,2

se negativizó y que la microfilaremia media disminuyó de 49,3 en el inicio del estudio a 32,9 al final en los casos que aún continuaban positivos. Por la microfilaremia persistente que traduce una relativa longevidad de los parásitos adultos, se recomienda la vigilancia de estos individuos al llegar a un área no endémica donde existan los vectores de esta enfermedad

Estudio de un grupo de estudiantes africanos parasitados con Manzonella perstans en Cuba (área no endémica) durante 1979 a 1982 / Study of a group of African students parasited with Manzonella perstans in Cuba (non-endemic area) during 1979-1982

Se estudiaron 60 casos de Manzonella perstans por un período de 3 años mediante estudios clínicos y parasitológicos de sangre. Se observó que el 31,2% se negativizó y que la microfilaremia media disminuyó de 49,3 en el inicio del estudio a 32,9 al final en los casos que aún continuaban positivos. Por la microfilaremia persistente que traduce una relativa longevidad de los parásitos adultos, se recomienda la vigilancia de estos individuos al llegar a un área no endémica donde existan los vectores de esta enfermedad

Microfilariae of Mansonella ozzardi in human skin biopsies.

Microfilariae of Mansonella ozzardi were seen in specimens of skin taken by biopsy from 4 of 6 subjects previously shown to be positive for microfilariae in the blood. While most of the microfilariae were confined to small blood vessels in the papillary and superficial reticular dermis, some were in perivascular spaces and a few were noted in the dermal interstitium. There was no microscopic evidence that the minimal cutaneous disease seen could be directly attributed to the microfilariae.