Uveitis: A search for a cause

Toxocariasis: a silent threat with a progressive public health impact

Background

Toxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed.

Main text

Over the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity.

Conclusions

Although progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease.

Electronic supplementary material

The online version of this article (10.1186/s40249-018-0437-0) contains supplementary material, which is available to authorized users.

Canine panuveitis: a retrospective evaluation of 55 cases (2000-2015)

OBJECTIVE

To determine the most common etiologies of panuveitis in a group of dogs, patient response to therapy, and visual outcome.

DESIGN

Retrospective study.

MATERIALS AND METHODS

Medical records of 55 dogs diagnosed with panuveitis at the Purdue University Veterinary Teaching Hospital between December 2000 and December 2015 were reviewed. Data collected included signalment, season of diagnosis, descriptions of ocular lesions, diagnostic testing, treatment protocols, etiologic diagnoses (when determined), and visual outcome.

RESULTS

The most common clinical sign in the anterior segment was aqueous flare and in the posterior segment was serous retinal detachment. The most common diagnosis was idiopathic/immune-mediated disease followed by systemic blastomycosis, lymphoma, and other causes (leptospirosis, aspergillosis, and histoplasmosis). Of the 43 dogs for which follow-up was available, 40% of dogs had resolution of visible inflammation and retinal reattachment, 32% of dogs had slight to moderate improvement, and 28% of dogs had no improvement or deterioration of lesions. Mean follow-up time was 11 months, and mean time to resolution of visible inflammation and retinal reattachment was 32 days. Sixty-five percent of dogs either retained or regained vision in one or both diseased eyes with initial medical therapy.

CONCLUSIONS

Idiopathic/immune-mediated panuveitis was the most common diagnosis. Dogs with idiopathic/immune-mediated panuveitis tended to respond more favorably to medical therapy than dogs with infectious panuveitis. Visual outcome was favorable in those dogs that responded to initial medical therapy, but long-term therapy was required in many dogs to maintain vision and prevent recurrence of disease.