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Krichene MA, Hasnaoui I, Hassina S, Tebbay N, Sinnate A, Serghini L, Abdallah E. [Atypical ocular toxocariasis in a child: A case report]. J Fr Ophtalmol 2024; 47:104191. [PMID: 38713931 DOI: 10.1016/j.jfo.2024.104191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/17/2024] [Accepted: 03/07/2024] [Indexed: 05/09/2024]
Abstract
INTRODUCTION Ocular toxocariasis is a rare disease, predominantly affecting children and young adolescents, and usually presenting as unilateral posterior uveitis. We report the case of a child with toxocariasis associated with serous retinal detachment. OBSERVATION A 8-year-old child with no previous history of toxocariasis was referred for a 1-year decline in visual acuity, unimproved by optical correction, with vitreous condensation on examination, without central or peripheral granulomas, and serous retinal detachment on OCT. The diagnosis was made after extensive questioning, with evidence of contact with dogs and positive serology. Medical treatment combining corticosteroid therapy and antiparasitic therapy was initiated, and the clinical picture improved. DISCUSSION Ocular toxocariasis is a rare infection, unilateral in 90% of cases. Its clinical manifestation in children is pars planitis, posterior uveitis with a posterior pole chorioretinal focus associated with vitreoretinal traction and/or peripheral granuloma. In our case, the patient presented with vitreous condensation only, with OCT serous retinal detachment and no peripheral or central granulomas. Positive plasma serology or ocular samples confirmed the diagnosis. CONCLUSION Ocular toxocariasis should not be ruled out in the absence of a typical clinical picture, and seropositivity enables confirmation of the diagnosis when clinical suspicion arises.
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Affiliation(s)
- M A Krichene
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc.
| | - I Hasnaoui
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
| | - S Hassina
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
| | - N Tebbay
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
| | - A Sinnate
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
| | - L Serghini
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
| | - E Abdallah
- Faculté de médecine et de pharmacie, université Mohamed V de Rabat, Rabat, Maroc
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Abdelatif E, Boulicot C, Zemmouchi H, Boulze M, Marc C. [Ocular toxocariasis in an 8-year-old patient: Case report]. J Fr Ophtalmol 2021; 45:e51-e53. [PMID: 34799149 DOI: 10.1016/j.jfo.2021.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/16/2022]
Affiliation(s)
- E Abdelatif
- Service d'ophtalmologie, hôpital de la Timone, AP-HM, 264, rue saint-Pierre, 13005 Marseille, France.
| | - C Boulicot
- Service d'ophtalmologie, centre hospitalier Henri-Duffaut, 305, rue raoul Follereau, 84000 Avignon, France
| | - H Zemmouchi
- Service d'ophtalmologie, centre hospitalier Henri-Duffaut, 305, rue raoul Follereau, 84000 Avignon, France
| | - M Boulze
- Service d'ophtalmologie, centre hospitalier Henri-Duffaut, 305, rue raoul Follereau, 84000 Avignon, France
| | - C Marc
- Service d'ophtalmologie, centre hospitalier Henri-Duffaut, 305, rue raoul Follereau, 84000 Avignon, France
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Elyadari M, Zarrouki M, Elorch H, Azennoud S, Harchali S, Elmerrouni S, Bouzoubaa T, Hajji Z, Abdallah E, Boulanoir A, Berraho A. Toxocarose oculaire. J Fr Ophtalmol 2018; 41:277-279. [DOI: 10.1016/j.jfo.2017.06.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/14/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022]
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Cella W, Ferreira E, Torigoe AMS, Macchiaverni-Filho N, Balarin V. Ultrasound Biomicroscopy Findings in Peripheral Vitreoretinal Toxocariasis. Eur J Ophthalmol 2018; 14:132-6. [PMID: 15134110 DOI: 10.1177/112067210401400208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To describe the morphologic alterations in ultrasound biomicroscopy (UBM) present in peripheral vitreoretinal toxocariasis. METHODS An observational prospective study of case series. Fifteen eyes of 15 patients with clinical and laboratory diagnosis of peripheral vitreoretinal toxocariasis were enrolled. The patients were submitted to UBM examination of the region corresponding to the pars plana of the affected eye. Results The most common morphologic alterations found by UBM in patients with peripheral vitreoretinal toxocariasis were as follows: vitreal membranes (13 cases), toxocara granuloma (11 cases), and pseudocysts (8 cases). Other less frequent findings were thickening of the ciliary body (6 cases), cystic formation (2 cases), peripheral retinal detachment (2 cases), rectification of the iris root (1 case), and posterior synechiae (1 case). CONCLUSIONS UBM allows detection of well-defined morphologic alterations associated with peripheral vitreoretinal toxocariasis, being useful to reinforce the clinical diagnosis
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Affiliation(s)
- W Cella
- Retina Service, Department of Ophthalmology, State University of Campinas-UNICAMP, Campinas, Brazil.
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Wang ZJ, Zhou M, Cao WJ, Ji J, Bi YW, Huang X, Xu GZ. Evaluation of the Goldmann-Witmer coefficient in the immunological diagnosis of ocular toxocariasis. Acta Trop 2016; 158:20-23. [PMID: 26899678 DOI: 10.1016/j.actatropica.2016.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/10/2016] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
Abstract
Ocular toxocariasis (OT) is a zoonotic parasitic infection mainly caused by the intraocular tissue invasion of second-stage Toxocara canis or Toxocara cati larva. Measuring specific anti-T. canis antibodies in the intraocular fluid (IF) can increase OT diagnosis accuracy using Goldmann-Witmer coefficient (GWC). However, there is no systemic evaluation of GWC application in the immunological diagnosis of OT. To assess GWC for the immunodiagnosis of ocular toxocariasis, paired IF and serum samples from 72 patients diagnosed with OT were retrospectively analyzed for specific anti-T. canis IgG by enzyme linked immunosorbent assay (ELISA). GWC values were calculated to determine intraocular specific IgG production. Clinical features and other laboratory data were recorded, and their correlations with GWC evaluated. Of the 72 OT patients, 60 (83.33%) showed intraocular specific IgG production confirmed by GWC, while intraocular nonspecific IgE production was found in 64/69 (92.75%) cases. No significant correlation was found among clinical features and IF specific IgG production. Values for peripheral blood samples were lower than those of intraocular fluid regarding OT screening, and vitreous humor samples showed increased local specific IgG and nonspecific IgE production compared with aqueous humor samples. Overall, our results indicate that GWC and intraocular IgE production have referential values in diagnosing ocular toxocariasis.
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Ahn SJ, Ryoo NK, Woo SJ. Ocular toxocariasis: clinical features, diagnosis, treatment, and prevention. Asia Pac Allergy 2014; 4:134-41. [PMID: 25097848 PMCID: PMC4116038 DOI: 10.5415/apallergy.2014.4.3.134] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 07/23/2014] [Indexed: 11/04/2022] Open
Abstract
Despite being one of the most common zoonotic infections worldwide, human toxocariasis has been one of the neglected tropical diseases. Although most human infections are asymptomatic, two main syndromes of human toxocariasis are classically recognized: systemic toxocariasis, which encompasses diseases in major organs; and ocular toxocariasis (OT), disease in the eye or optic nerve, caused by the migration of Toxocara larvae into the eye. OT is usually a unilateral disease, which typically presents as retinal granuloma, a yellowish or whitish inflammatory mass, in the posterior pole or peripheral retina. Granuloma itself or other comorbid conditions such as epiretinal membrane, macular edema, and retinal detachment can lead to permanent retinal damage and visual loss in eyes with OT. OT is diagnosed clinically by identification of clinical signs on ophthalmologic examination. Serological tests, such as enzyme-linked immunosorbent assay (ELISA) for detection of serum antibody against the Toxocara larvae, can confirm the diagnosis. In addition, serum immunoglobulin E and detection of ocular fluid antitoxocara antibody by ELISA may give additional aid to the diagnosis. Standard treatment of OT is corticosteroid in patients with active intraocular inflammation. Although the role of anthelmintic therapy is unclear, favorable outcome has been reported by combined corticosteroid and albendazole therapy in eyes with active inflammation. Prevention, by increasing public awareness and reducing the risk of infection, is also important. Recently, the association between ingestion of uncooked meat or liver and toxocariasis was reported, especially in adult patients. Future research on the potential source of infection, diagnosis, and treatment should be performed.
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Affiliation(s)
- Seong Joon Ahn
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 463-707, Korea. ; Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam 463-040, Korea
| | - Na-Kyung Ryoo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 463-707, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 463-707, Korea
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Daoudi C, Laghmari M, Naciri K, Handor H, Hafidi Z, Hajji C, Daoudi R. [Ocular toxocariasis: report of two cases and review of the literature]. Pan Afr Med J 2014; 17:71. [PMID: 25018821 PMCID: PMC4085946 DOI: 10.11604/pamj.2014.17.71.3823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 01/21/2014] [Indexed: 11/11/2022] Open
Abstract
Toxocara canis est un nématode de la famille des Ascaridés, il peut être responsable de manifestations oculaires et générales lors d'une contamination accidentelle dans le cadre d'une pathologie du “péril fécal“, les atteintes oculaires sont plus fréquentes chez l'enfant en raison du contact souvent répété avec de jeunes animaux favorisant ainsi la dissemination de cette pathologie dite des “mains sales“, nous rapportons deux cas d'enfants présentant une toxocarose oculaire à granulome postérieur, négatif pour le sérodiagnostic spécifique. La réalisation de la ponction de la chambre antérieure et d'un test ELISA par antigènes homologues de Toxocara canis sur l'humeur acqueuse ont permis de poser le diagnostic formel.
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Affiliation(s)
- Chama Daoudi
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Mina Laghmari
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Kamal Naciri
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Hanane Handor
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Zouhir Hafidi
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Chaimae Hajji
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
| | - Rajae Daoudi
- Université Mohammed V Souissi, Service d'Ophtalmologie A de l'Hôpital des Spécialités, Centre Hospitalier Universitaire, Rabat, Maroc
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Ahn SJ, Woo SJ, Jin Y, Chang YS, Kim TW, Ahn J, Heo JW, Yu HG, Chung H, Park KH, Hong ST. Clinical features and course of ocular toxocariasis in adults. PLoS Negl Trop Dis 2014; 8:e2938. [PMID: 24922534 PMCID: PMC4055477 DOI: 10.1371/journal.pntd.0002938] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/29/2014] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the clinical features, clinical course of granuloma, serologic findings, treatment outcome, and probable infection sources in adult patients with ocular toxocariasis (OT). Methods In this retrospective cohort study, we examined 101 adult patients diagnosed clinically and serologically with OT. Serial fundus photographs and spectral domain optical coherence tomography images of all the patients were reviewed. A clinic-based case-control study on pet ownership, occupation, and raw meat ingestion history was performed to investigate the possible infection sources. Results Among the patients diagnosed clinically and serologically with OT, 69.6% showed elevated immunoglobulin E (IgE) levels. Granuloma in OT involved all retinal layers and several vitreoretinal comorbidities were noted depending on the location of granuloma: posterior pole granuloma was associated with epiretinal membrane and retinal nerve fiber layer defects, whereas peripheral granuloma was associated with vitreous opacity. Intraocular migration of granuloma was observed in 15 of 93 patients (16.1%). Treatment with albendazole (400 mg twice a day for 2 weeks) and corticosteroids (oral prednisolone; 0.5–1 mg/kg/day) resulted in comparable outcomes to patients on corticosteroid monotherapy; however, the 6-month recurrence rate in patients treated with combined therapy (17.4%) was significantly lower than that in patients treated with corticosteroid monotherapy (54.5%, P = 0.045). Ingestion of raw cow liver (80.8%) or meat (71.2%) was significantly more common in OT patients than healthy controls. Conclusions Our study discusses the diagnosis, treatment, and prevention strategies for OT. Evaluation of total IgE, in addition to anti-toxocara antibody, can assist in the serologic diagnosis of OT. Combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence. Migrating feature of granuloma is clinically important and may further suggest the diagnosis of OT. Clinicians need to carefully examine comorbid conditions for OT. OT may be associated with ingestion of uncooked meat, especially raw cow liver, in adult patients. Toxocariasis is one of America's most common neglected infections of poverty and a helminthiasis of global importance. Little is known about the epidemiologic, demographic, and clinical features of ocular toxocariasis (OT) in adult patients, and the treatment regimen for OT has not been standardized. We conducted a retrospective cohort study examining the clinical features, serologic markers, clinical course of granuloma, probable infection sources, and treatment outcome in 101 adult patients diagnosed clinically and serologically with OT. All the patients had unilateral involvement. Ninety-three (92.1%) and 78 (77.2%) of 101 adult patients had retinal granuloma and intraocular inflammation, respectively. In addition to retinal granuloma, retinal nerve fiber layer defect, epiretinal membrane, vitreous opacity, retinal detachment, macular edema, and macular hole were observed in the eyes with OT. Granuloma in OT can involve all retinal layers, and its intraocular migration was observed in 15 patients (16.1%). Among the 101 patients, 69.6% and 11.6% showed elevated immunoglobulin E levels and eosinophilia, respectively. We believe that OT may be associated with ingestion of uncooked meat, especially cow liver, in adult patients. Furthermore, we suggest that combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence.
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Affiliation(s)
- Seong Joon Ahn
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Se Joon Woo
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea
- * E-mail:
| | - Yan Jin
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Tae Wan Kim
- Department of Ophthalmology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jeeyun Ahn
- Department of Ophthalmology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jang Won Heo
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeong Gon Yu
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hum Chung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Hyung Park
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea
| | - Sung Tae Hong
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
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Arevalo JF, Espinoza JV, Arevalo FA. Ocular toxocariasis. J Pediatr Ophthalmol Strabismus 2013; 50:76-86. [PMID: 22938514 DOI: 10.3928/01913913-20120821-01] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 07/26/2012] [Indexed: 11/20/2022]
Abstract
Ocular toxocariasis is an uncommon worldwide parasitic infection that affects mostly children and is found in both rural and metropolitan areas. In many parts of the world, parasitic infections of the eye are a major cause of blindness. The diagnosis of toxocariasis is essentially clinical, based on the lesion morphology and supportive laboratory data such as serum enzyme-linked immunosorbent assay (ELISA) titers and ELISA Toxocara titers on aqueous humor; other diagnostic methods are imaging studies including optical coherence tomography, fluorescein angiography, computed tomography, and ocular ultrasound. Treatment is directed at complications arising from intraocular inflammation and vitreous membrane traction. Early vitrectomy may be of value both diagnostically and therapeutically.
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Affiliation(s)
- J Fernando Arevalo
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Helminthic Disease. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00086-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Biswas J. Posterior Parasitic Uveitis. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00132-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Madigan WP, Raymond WR, Wroblewski KJ, Thebpatiphat N, Birdsong RH, Jaafar MS. A review of pediatric uveitis: Part I. Infectious causes and the masquerade syndromes. J Pediatr Ophthalmol Strabismus 2008; 45:140-9. [PMID: 18524191 DOI: 10.3928/01913913-20080501-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Uveitis is a manifestation of complex processes that can represent an infectious or a purely immune system modulated condition and may have grave effects on the eye. Much of the morbidity in these conditions is the result of the immune response to these stimuli. These infectious diseases may be successfully treated by addressing the inciting organism with recognized interventions. Treatment of the immune response to the organism often must be pursued simultaneously to minimize long-term complications caused by structural changes within the eye. Assisting the individual's immune response to eliminate the organism while minimizing the immune response's damaging effects remains a unique challenge drawing on both the science and the art of medicine. Several non-infectious conditions that are not autoimmune diseases may commonly masquerade as uveitis, leading to delays in appropriate treatment.
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Stewart JM, Cubillan LDP, Cunningham ET. Prevalence, clinical features, and causes of vision loss among patients with ocular toxocariasis. Retina 2006; 25:1005-13. [PMID: 16340531 DOI: 10.1097/00006982-200512000-00009] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND To describe the prevalence, clinical features, and causes of vision loss among patients with ocular toxocariasis seen at a uveitis referral center. METHODS A review was completed of the charts of patients with ocular toxocariasis who were examined between 1977 and 1996 at the Francis I. Proctor Foundation of the University of California at San Francisco. The prevalence of ocular toxocariasis among all uveitis patients seen at the center was determined. Demographic features, symptoms, and signs in all patients were evaluated. RESULTS Ocular toxocariasis occurred in 22 (1.0%) of 2,185 uveitis patients. The mean patient age was 16.5 years. Inflammation was usually unilateral (90.9%). Toxocara uveitis presented as a granuloma in the peripheral retina in 50% of cases, as a granuloma in the macula in 25% of cases, and as a moderate to severe vitreous inflammation mimicking endophthalmitis in 25% cases. The primary causes of vision loss were vitritis (52.6%), cystoid macular edema (47.4%), and traction retinal detachment (36.8%). CONCLUSIONS Ocular toxocariasis is an uncommon cause of uveitis that mainly affects younger patients. Inflammation is typically unilateral and presents as either a granuloma in the peripheral or posterior retina or a moderate to severe vitreous inflammation mimicking endophthalmitis.
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Affiliation(s)
- Jay M Stewart
- Francis I. Proctor Foundation and the Department of Ophthalmology, University of California at San Francisco, San Francisco, California, USA
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15
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Wilkinson C. Ocular Toxocariasis. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Magnaval JF, Malard L, Morassin B, Fabre R. Immunodiagnosis of ocular toxocariasis using Western-blot for the detection of specific anti-Toxocara IgG and CAP for the measurement of specific anti-Toxocara IgE. J Helminthol 2002; 76:335-9. [PMID: 12498639 DOI: 10.1079/joh2002143] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A prospective multicentric study was carried out to assess both the performance of Western-blot (WB) detecting specific anti-Toxocara IgG and that of CAP measuring specific IgE titre for the immunodiagnosis of ocular toxocariasis. For 14 outpatients presenting ophthalmic symptoms (choroiditis, chorioretinitis, papillar oedema, hyalitis, retinal detachment and/or uveitis), samples of serum and aqueous fluid (AF) were sent to the Department of Parasitology, University Hospitals, Toulouse, France. All patients but two tested positive with WB on the serum; 13 WB tests were performed on the AF, 12 of which were positive. The two patients who had a negative WB serum result tested positive for the AF. Specific IgE detection was considered as a complementary test of WB. Two patients showed a greater specific IgE titre in the AF than in the serum, and one had a positive result in the AF, but not in the serum. These six patients were considered as clear cases of ocular toxocariasis. Western-blot coupled with specific anti-Toxocara IgE detection appeared therefore to be an accurate procedure for the immunodiagnosis of ocular toxocariasis, provided the testing was simultaneously performed on the serum and AF.
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Affiliation(s)
- J-F Magnaval
- Service de Parasitologie, CHU Rangueil, 31403 Toulouse 4, France.
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Affiliation(s)
- C M Samson
- Massachusetts Eye and Ear Infirmary, Boston 02114, USA
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Magnaval JF, Glickman LT, Dorchies P, Morassin B. Highlights of human toxocariasis. THE KOREAN JOURNAL OF PARASITOLOGY 2001; 39:1-11. [PMID: 11301585 PMCID: PMC2721060 DOI: 10.3347/kjp.2001.39.1.1] [Citation(s) in RCA: 299] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Human toxocariasis is a helminthozoonosis due to the migration of Toxocara species larvae through human organism. Humans become infected by ingesting either embryonated eggs from soil (geophagia, pica), dirty hands or raw vegetables, or larvae from undercooked giblets. The diagnosis relies upon sensitive immunological methods (ELISA or western-blot) which use Toxocara excretory-secretory antigens. Seroprevalence is high in developed countries, especially in rural areas, and also in some tropical islands. The clinical spectrum of the disease comprises four syndromes, namely visceral larva migrans, ocular larva migrans, and the more recently recognized "common" (in adults) and "covert" (in children) pictures. Therapy of ocular toxocariasis is primarily based upon corticosteroids use, when visceral larva migrans and few cases of common or covert toxocariasis can be treated by anthelmintics whose the most efficient appeared to be diethylcarbamazine. When diagnosed, all of these syndromes require thorough prevention of recontamination (especially by deworming pets) and sanitary education.
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Affiliation(s)
- J F Magnaval
- Service de Parasitologie, Centre Hospitalier Universitaire Rangueil 31403 Toulouse 4, France.
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Affiliation(s)
- M A Afshari
- Massachusetts Eye and Ear Infirmary, Boston 02114, USA
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Rayes AA, Lambertucci JR. [The association between human toxocariasis and pyogenic abscesses]. Rev Soc Bras Med Trop 1999; 32:425-38. [PMID: 10495673 DOI: 10.1590/s0037-86821999000400014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The association between hepatic abscesses and schistosomiasis mansoni was confirmed by clinical and experimental studies. Other parasites may cause systemic immunologic changes and local structural alterations in the affected organs that can facilitate the seeding of these areas by bacteria. Tropical pyomyositis, pyogenic liver and renal abscesses are frequent diseases in tropical areas. The visceral larva migrans syndrome is caused by the presence, in the human body, of larvae of worms that have other animals as their definitive host, most commonly being caused by Toxocara canis. The larvae migrate to various body organs leading to many inflammatory reactions in the form of granuloma and tissue necrosis. In this review we discuss the possible host-parasite-bacteria interactions that would favour the formation of abscesses in the organs involved by the larva of T. canis and present preliminary results of a clinical and experimental study undertaken during the last four years to define the role of this parasite in the pathogenesis of the abscesses.
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Affiliation(s)
- A A Rayes
- Departamento de Clínica Medica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte
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21
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Tran VT, Lumbroso L, LeHoang P, Herbort CP. Ultrasound biomicroscopy in peripheral retinovitreal toxocariasis. Am J Ophthalmol 1999; 127:607-9. [PMID: 10334359 DOI: 10.1016/s0002-9394(98)00403-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report ultrasound biomicroscopic features in peripheral retinovitreal Toxocara uveitis. METHODS Three patients with unilateral vitreitis suspected to be caused by peripheral toxocariasis were referred for ultrasound biomicroscopic examination of the peripheral retina, pars plana, and adjacent vitreous. RESULTS In two of the three patients, characteristic pseudocystic transformation of the peripheral vitreous was seen. In both patients, Toxocara serology was positive and eosinophilia was present. In the third patient, no pseudocystic transformation of the peripheral vitreous was seen; however, there was the dense thickening adjacent to the pars plana usually seen by ultrasound biomicroscopy in pars planitis and corresponding to clinically visible snowbanks. The third patient had a negative Toxocara serology and later developed bilateral intermediate uveitis of the pars planitis type. In none of 48 patients with diverse inflammatory conditions of the retroiridal space that were examined by ultrasound biomicroscopy were the characteristic Toxocara-associated pseudocystic images seen. CONCLUSIONS Pseudocystic transformation of the peripheral vitreous appears to be a rather specific and sensitive ultrasound biomicroscopic sign in patients with presumed peripheral toxocariasis that will likely aid diagnosis in difficult cases.
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Affiliation(s)
- V T Tran
- Department of Ophthalmology, Hôpital Jules Gonin, University of Lausanne, Switzerland
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Gueglio B, de Gentile L, Nguyen JM, Achard J, Chabasse D, Marjolet M. Epidemiologic approach to human toxocariasis in western France. Parasitol Res 1994; 80:531-6. [PMID: 7809006 DOI: 10.1007/bf00932703] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Toxocara canis is a common parasite in puppies. The danger to human health has not been properly established. We estimated the current incidence of this pathogen in two western districts of France, Loire-Atlantique and Maine et Loire. Blood samples from 1836 eosino-philic patients were collected and tested by an enzyme-linked immunosorbent assay (ELISA) excretory-secretory Toxocara antigen test. We obtained positive results in 22% of the cases and highly positive results in 7%. The ELISA data seemed to be age-dependent, with older patients having more positive results (P < 0.0001). The interlaboratory distribution of positive test results was statistically significantly different (P < 0.0001), suggesting regional sources. The main clinical expressions of toxocariasis were: asthenia, gastric pain, and pulmonary disease. Individual and collective surveys of this zoonotic disease need to be carried out.
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Affiliation(s)
- B Gueglio
- Laboratoire de Parasitologie Pathologie Exotique, Faculté de Médicine, Nantes, France
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