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Konar KD, Pillay S. A case and literature review of intraocular echinococcus causing bilateral visual loss in a HIV-infected patient. SAGE Open Med Case Rep 2022; 10:2050313X221113699. [PMID: 36051405 PMCID: PMC9425879 DOI: 10.1177/2050313x221113699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Although echinococcosis is a common parasitic disease endemic to Africa, ocular echinococcosis is rare. We present a case of intraocular echinococcosis in a HIV-infected patient. A 38-year-old South African HIV-infected woman presented to a district-level hospital in Kwa-Zulu Natal on 10 March 2020. Her main presenting complaint was that of progressive, painless, bilateral visual loss. A B-ultrasonography scan revealed tractional retinal detachment on the right eye, while the left eye had tractional bands with a ‘double-walled’ cystic cavity causing retinal traction. A systemic work-up revealed a positive Echinococcus ELISA IgG with a value of 1.3, eosinophilia of 5.70% (0.41 × 109), and elevated C-reactive protein and erythrocyte sedimentation rate of 47 mg/L and 93 mm/hr, respectively. Based on the above clinical, biochemical and ultrasonographical evidence, a diagnosis of ocular echinococcosis was made. Our differential diagnosis includes toxic optic neuropathy, Jarisch-Herxheimer-like reaction secondary to immune reconstitution and necrotizing herpetic retinitis. She was initiated on topical and intravitreal steroids which led to decreased intraocular inflammation and dry maculae. Five months after presentation, her visual acuity remained unchanged with no light perception in both eyes. We conclude that ocular echinococcosis, although rare, can lead to severe visual impairment as there are no known definite treatment modalities for intraocular hydatid disease. Reports on co-infections with HIV and Echinococcus are limited with a potential scope for research.
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Affiliation(s)
| | - Somasundram Pillay
- Department of Internal Medicine, King Edward VIII Hospital (KEH), Durban, South Africa
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Chtira K, Benantar L, Aitlhaj H, Abdourafiq H, Elallouchi Y, Aniba K. The surgery of intra-orbital hydatid cyst: a case report and literature review. Pan Afr Med J 2019; 33:167. [PMID: 31565128 PMCID: PMC6756819 DOI: 10.11604/pamj.2019.33.167.18277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 05/09/2019] [Indexed: 11/29/2022] Open
Abstract
Intra-orbital hydatid cyst is a very rare pathological entity that affects children and the young adults; it is secondary to the development in the orbit of the echinococcus granulosis tapeworm. Its frequency does not exceed 1% of all cases of hydatid disease. Clinical presentation of intra-orbital hydatid cyst is dominated by proptosis and a decrease in visual acuity, complete surgical excision is difficult, evolution is generally better when the treatment is early before the installation of irreversible optic atrophy. We report one case of a 3 years old girl operated for right intra-orbital hydatid cyst who presented with proptosis and blindness. Complete removal was difficult and puncture of the cyst was performed followed by excision of its membrane with good post-operative results. We also discuss the different epidemiological, clinical, radiological and therapeutic aspects of intra-orbital hydatid cyst and a review of literature of this rare pathology.
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Affiliation(s)
- Kamal Chtira
- Neurosurgery Department, Ibn Tofail Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Lamia Benantar
- Neurosurgery Department, Ibn Tofail Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Houssaine Aitlhaj
- Ophtalmology Department, Avicenne Miltary Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Hasna Abdourafiq
- Neurosurgery Department, Ibn Tofail Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Yassine Elallouchi
- Neurosurgery Department, Ibn Tofail Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Khalid Aniba
- Neurosurgery Department, Ibn Tofail Hospital, University Hospital Mohammed VI, Marrakesh, Morocco
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Orbital alveolar echinococcosis: A case report. J Curr Ophthalmol 2018; 30:182-185. [PMID: 29988895 PMCID: PMC6033784 DOI: 10.1016/j.joco.2017.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/03/2017] [Accepted: 09/21/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose To report a rare case of orbital alveolar echinococcosis in Iran. Methods A 23-year-old woman with multi-lobular mass lesion in the right orbit underwent excisional biopsy via a deep lateral orbitotomy approach. The pathologic investigation of the lesion was a multilobulated cystic lesion shown where the cyst wall structure was compatible with alveolar Hydatid cyst in histopathology. Clinical course, surgical, and medical management of the disease is noted briefly in the case of orbital involvement of the alveolar echinococcosis. Results Patient was treated with anti-fungal medication, and the cysts were successfully removed by a surgical excision. Conclusion Although orbital alveolar echinococcosis is extremely rare, it is noteworthy to study its clinical manifestations and radiological examinations to be able to make a true diagnosis.
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Lokdarshi G, Pushker N, Sen S, Shameer A, Bajaj MS. Simple dacryops: Do we really need imaging? Taiwan J Ophthalmol 2017; 6:193-194. [PMID: 29018740 PMCID: PMC5525631 DOI: 10.1016/j.tjo.2016.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gautam Lokdarshi
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Neelam Pushker
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Seema Sen
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Abdul Shameer
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Mandeep S Bajaj
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Pujari A, Urkude JS, Rakheja V, Saluja G. Ultrasound B scan: a simple tool to simplify the diagnosis. BMJ Case Rep 2017. [DOI: 10.1136/bcr-2017-220982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Panda A, Sharma S, Jana M, Arora A, Sharma SK. Ophthalmic manifestations of systemic diseases--part 2: metabolic, infections, granulomatoses, demyelination, and skeletal dysplasias. Curr Probl Diagn Radiol 2015; 43:242-53. [PMID: 25088219 DOI: 10.1067/j.cpradiol.2014.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The orbit and globe can be secondarily involved in various systemic diseases. These range from tumor and tumorlike conditions, metabolic, infective, inflammatory, granulomatous demyelinating diseases, and skeletal dysplasias. In this article, we discuss the imaging appearances of the remaining systemic pathologies affecting the orbit such as (1) endocrine or metabolic, (2) infectious, (3) inflammatory or granulomatous, (4) demyelinating diseases, and (5) skeletal dysplasias. As the imaging appearances of various systemic diseases tend to overlap, we also introduce a list of pattern-based systemic differential diagnoses for commonly encountered orbital imaging findings. Awareness of the imaging appearances of the various ophthalmic manifestations of systemic diseases can help a radiologist to suggest the most appropriate differential diagnosis to guide further workup and facilitate correct treatment.
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Affiliation(s)
- Ananya Panda
- Department of Radio-diagnosis, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjay Sharma
- Department of Radio-diagnosis, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Manisha Jana
- Department of Radio-diagnosis, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Arundeep Arora
- Department of Radio-diagnosis, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Shefali K Sharma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Pushker N, Khurana S, Kashyap S, Sen S, Shrey D, Meel R, Chawla B, Bajaj MS. Orbital schwannoma: a clinicopathologic study. Int Ophthalmol 2014; 35:481-6. [PMID: 25052540 DOI: 10.1007/s10792-014-9973-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 07/09/2014] [Indexed: 10/25/2022]
Abstract
The aim of the study was to study the clinical, radiological and histopathological characteristics of orbital schwannomas. It is a retrospective study conducted at a tertiary eye care hospital. A review of histopathological records of the orbital tumors operated between 1993 and 2011 was done. The clinical, imaging and histopathological details of cases of orbital schwannoma were analyzed. Forty-nine cases of orbital schwannomas identified. The age ranged from 8 to 65 years with a female preponderance. The median duration of symptoms was 3 years. Computed tomography findings varied from a hypodense to hyperdense lesion with nil to marked contrast enhancement. USG demonstrated a defined lesion with variable internal reflectivity. Varied proportions of Antoni A and Antoni B areas were found on histopathology of the masses. Hypodense or cystic areas on imaging significantly correlated with Antoni B areas on histopathology. Orbital schwannoma is a rare tumor. The incidence of schwannoma in our institution is 6.5 %. Variable imaging features were found. The definite diagnosis can be established on the basis of histopathological and immunohistochemical studies.
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Affiliation(s)
- Neelam Pushker
- Oculoplasty and Paediatric Ophthalmology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Mehta M, Sen S, Sethi S, Pushker N, Bajaj MS, Chandra M. Large orbital hydatid cyst presenting as subconjunctival mass. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 104:601-4. [DOI: 10.1179/136485910x12786389891560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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9
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Nimir AR, Saliem A, Ibrahim IAA. Ophthalmic parasitosis: a review article. Interdiscip Perspect Infect Dis 2012; 2012:587402. [PMID: 23024652 PMCID: PMC3457613 DOI: 10.1155/2012/587402] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 08/10/2012] [Accepted: 08/15/2012] [Indexed: 12/03/2022] Open
Abstract
Ocular parasitosis in human is more prevalent in geographical areas where environmental factors and poor sanitary conditions favor the parasitism between man and animals. Lesions in the eye can be due to damage directly caused by the infectious pathogen, indirect pathology caused by toxic products, or the immune response incited by infections or ectopic parasitism. The epidemiology of parasitic ocular diseases reflects the habitat of the causative parasites as well as the habits and health status of the patient. An ocular examination may provide clues to the underlying disease/infection, and an awareness of the possibilities of travel-related pathology may shed light on an ocular presentation. This paper is a comprehensive review of the parasitic diseases of the eye. The majority of the clinically important species of parasites involved in eye infection are reviewed in this paper. Parasites are discussed by the disease or infection they cause.
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Affiliation(s)
- Amal R. Nimir
- Division of Basic Medical Sciences, Faculty of Medicine, Cyberjaya University College of Medical Sciences, 63000 Selangor, Malaysia
| | - Ahmed Saliem
- Division of Basic Medical Sciences, Faculty of Medicine, Cyberjaya University College of Medical Sciences, 63000 Selangor, Malaysia
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Abstract
Hydatid cysts rarely appear in the orbital cavity without the involvement of the other organs. Most of them are situated in the superolateral and superomedial angles of the orbit. Inferiorly located cysts are very uncommon. The authors report a case of a primary hydatid cyst of the orbit with inferolateral localization. The cyst was removed surgically via a frontotemporoorbitozygomatic approach combination with puncture-aspiration-injection-reaspiration technique. This case was considered as a primary infection, because there was no previous history of hydatid disease and no findings of liver and lung cysts on radiological examination. Physicians should include orbital hydatid cyst in the differential diagnosis of unilateral proptosis. To avoid complications that might occur during surgery, the cyst can be easily removed using the combination technique detailed in this report.
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Affiliation(s)
- Ramazan Kahveci
- Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, 1st Neurosurgery Clinic, Ankara, Turkey.
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Kashyap S, Pushker N, Meel R, Sen S, Bajaj MS, Khuriajam N, Mehta M, Chawla B. Orbital schwannoma with cystic degeneration. Clin Exp Ophthalmol 2009; 37:293-8. [PMID: 19472538 DOI: 10.1111/j.1442-9071.2009.02029.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Seema Kashyap
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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12
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Jeblaoui Y, Bouguila J, Yacoub K, Bouguila H, Ben Neji N, Besbes G. [Orbital hydatid cyst]. ACTA ACUST UNITED AC 2008; 109:117-9. [PMID: 18314148 DOI: 10.1016/j.stomax.2007.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2007] [Accepted: 12/17/2007] [Indexed: 11/28/2022]
Abstract
CASE A 72-year-old man presented with left exophthalmia, impaired visual acuity and ocular pain. CT revealed a posterolateral homogeneous unilocular cyst in the left orbital cavity. Ultrasound showed a 38 x 17 mm purely cystic retro-ocular thin lined mass. Hydatid serologic tests were positive. The cyst was completely enucleated, after irrigation with hypertonic saline solution. The diagnosis was confirmed histologically. DISCUSSION The orbital hydatic cyst is a rare pathology in Western countries but remains relatively frequent in North-African countries. It can be observed in urban centers a high percentage of immigrant population. It is thus necessary to keep this pathology in mind when confronted to an intra-orbital cystic formation and to avoid its rupture.
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Affiliation(s)
- Y Jeblaoui
- Service d'otorhinolaryngologie et de chirurgie maxillofaciale, CHU La Rabta, 1007 Tunis, Tunisie.
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Narang S, Handa U, Nanda A, Bansal R, Nahar R, Sood S. Primary intravitreal hydatid cyst: diagnosis on cytological examination. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2006; 100:371-4. [PMID: 16762117 DOI: 10.1179/136485906x91495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- S Narang
- Department of Ophthalmology, Government Medical College Hospital, Sector 32, Chandigarh 160 030, India.
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Ciurea AV, Giuseppe G, Machinis TG, Coman TC, Fountas KN. Orbital Hydatid Cyst in Childhood: A Report of Two Cases. South Med J 2006; 99:620-4. [PMID: 16800420 DOI: 10.1097/01.smj.0000217492.03019.16] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Intraorbital hydatid disease (IHD) is quite rare and represents < 1% of the Echinococcus cases. In our current communication, we report two children with solitary, primary intraorbital hydatid cysts. Both children presented with nontender, nonpulsatile proptosis. Imaging workup, including CT and MRI scans of the head and the orbits, revealed a retro-bulbar cyst in both patients. Surgical resection was performed by employing a fronto-temporo-orbito-zygomatic (FTOZ) approach. Accidental intraoperative rupture occurred in one case with no further consequences. Albendazole was postoperatively employed for 12 weeks. Outcome was excellent in both cases with complete resolution of their symptoms and complete visual recovery. Pertinent literature was reviewed with this opportunity.
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