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Jange RG, Koka K, Alam MS, Krishnakumar S, Muthusamy R, Biswas J. A rare case of lacrimal sac dirofilariasis confirmed by polymerase chain reaction. Orbit 2023:1-3. [PMID: 37978818 DOI: 10.1080/01676830.2023.2278611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
A 69-year-old female presented with complaints of persistent watering in the left eye for the past 8 years. She underwent a left external dacryocystorhinostomy (DCR) 8 years ago. On examination, left lacrimal passage irrigation showed regurgitation of fluid from opposite punctum. She underwent a revision external DCR with bicanalicular intubation and a portion of fibrosed sac was sent for histopathological examination (HPE). HPE showed a Microfilarial worm with surrounding granulomatous inflammation. Polymerase chain reaction (PCR) on the DNA extracted from the specimen identified the species to be Dirofilaria repens. Dirofilariasis is an accidental zoonotic infection in humans. Due to its migration, the worm can affect ocular and periocular structures. There are two case reports of perilacrimal dirofilariasis. This is the first case to report a filarial worm in the lacrimal sac causing chronic inflammation which probably led to failure of DCR. Treatment of choice is the complete eradication of the worm. PCR aids in the identification of species.
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Affiliation(s)
- Ruhi Girish Jange
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Kirthi Koka
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Md Shahid Alam
- Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya (A Unit of Medical Research Foundation, Chennai, India), Kolkata, India
| | - Subramanian Krishnakumar
- Larson and Toubro Department of Ocular Pathology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Raman Muthusamy
- Department of Microbiology, Centre for Infectious Diseases, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | - Jyotirmay Biswas
- Director of Uveitis and Ocular Pathology Department, Medical Research Foundation, Chennai, India
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Shaikh Z, Kar P, Mohanty S, Dey M, Samal DK. Ocular dirofilariasis: A report from Odisha. Indian J Med Microbiol 2023; 45:100388. [PMID: 37573051 DOI: 10.1016/j.ijmmb.2023.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/31/2022] [Accepted: 05/17/2023] [Indexed: 08/14/2023]
Abstract
We report a case of ocular dirofilariasis in a 68-year-old man manifesting as pre-septal abscess with gradually increasing swelling of the left eyelid and near complete ptosis of eye. A live worm was seen wriggling in the lesion while the abscess was being drained and was extracted carefully. Subsequently, it was identified as an adult female Dirofilaria repens worm. The lid edema and swelling resolved and the patient was discharged without any residual complaints.
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Affiliation(s)
- Zaid Shaikh
- Department of ENT, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Punyatoya Kar
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Srujana Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Monalisa Dey
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Dillip Kumar Samal
- Department of ENT, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
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ONDRISKA F, BOLDIŠ V, STANISLAVOVÁ M, ANTOLOVÁ D, MITERPÁKOVÁ M, HANÁČEK A, VEŠPEROVÁ S, JANČOVIČ I. Ocular Dirofilariasis after Clinically Manifested Subcutaneous Migration of the Parasite: A Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:147-152. [PMID: 32489388 PMCID: PMC7244843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Dirofilaria repens is the causative agent of human subcutaneous or, less often, ocular dirofilariasis. The work presents a rare case of ocular dirofilariasis manifested by previous subcutaneous migration accompanied by severe headache symptoms. In February 2017, a 58-yr-old man from Trnava region, western Slovakia, noticed red and itchy stripes on his left leg. Inflamed but painless stripes disappeared and showed up again every 5-7 days, migrating gradually towards the head. Approximately one month after the first skin's alterations, strong pain in the left temple, with the swelling of the left face and the enlargement of mandibular lymph nodes appeared. Several days later, the patient felt excruciating pain of the right eyeball accompanied by strong nausea and subsequent vomiting. Ocular examination revealed the presence of a live worm in the subconjunctival space and morphological and molecular analyses of extracted helminth confirmed D. repens as etiological agent of the infection. According to clinical manifestation of the infection, it could be supposed that ocular form of the disease was the result of the migration of a parasite through the subcutaneous tissues. Moreover, a rare phenomenon of lymphadenitis of underlying lymph nodes and the swelling of left face accompanied the migration.
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Affiliation(s)
- František ONDRISKA
- Department of Laboratory Testing Methods in Health Care, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovakia, Department of Parasitology, Medirex (Ltd), Bratislava, Slovakia
| | - Vojtech BOLDIŠ
- Department of Laboratory Testing Methods in Health Care, Faculty of Health Care and Social Work, Trnava University, Trnava, Slovakia
| | - Marta STANISLAVOVÁ
- Department of Ophthalmology, University Hospital of Bratislava, Bratislava, Slovakia
| | - Daniela ANTOLOVÁ
- Department of Zoonotic Diseases, Institute of Parasitology SAS, Košice, Slovakia,Correspondence
| | - Martina MITERPÁKOVÁ
- Department of Zoonotic Diseases, Institute of Parasitology SAS, Košice, Slovakia
| | - Anton HANÁČEK
- Department of Ophthalmology, Faculty Hospital of Trnava, Trnava, Slovakia
| | - Soňa VEŠPEROVÁ
- Department of Infectology, Faculty Hospital of Trnava, Trnava, Slovakia
| | - Ivan JANČOVIČ
- ENT Outpatient Department, Bánovce nad Bebravou, Slovakia
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Rajan RP, Jena S, Ramachandran NO, Kohli P. Rare cause of floaters: A motile live worm in vitreous cavity. Indian J Ophthalmol 2019; 67:1490-1492. [PMID: 31436210 PMCID: PMC6727692 DOI: 10.4103/ijo.ijo_79_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ocular filariasis commonly presents as subconjunctival or eyelid nodules. We report a rare case of a live, motile worm causing floaters. The worm was isolated from the vitreous cavity and revealed to be Dirofilaria repens. Correct recognition of the worm is necessary as human dirofilariasis does not present as microfilaremia and does not require systemic therapy; in contrast to other causes of ocular filariasis, which require systemic therapy. As ophthalmologist may be the first physician to encounter such patients, a high index of suspicion is required for timely and adequate management.
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Affiliation(s)
- Renu P Rajan
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Soumya Jena
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - N Obuli Ramachandran
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
| | - Piyush Kohli
- Vitreo-Retinal Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
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Venugopal NP, Kummararaj G, Kummararaj S, Bharathi B. Chemo-paralysis for removal of anterior chamber motile parasite. Indian J Ophthalmol 2014; 62:661. [PMID: 24881620 PMCID: PMC4065532 DOI: 10.4103/0301-4738.133527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Nataraja Pillai Venugopal
- Department of Neuro-Ophthalmology Clinic and Glaucoma Service, AG Eye Hospital, Trichy, Tamil Nadu, India
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Gupta V, Sankaran P, Mohanraj, Samantaray JC, Menon V. Author's reply: To PMID 24008780. Indian J Ophthalmol 2014; 62:662. [PMID: 25006639 PMCID: PMC4065533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Viney Gupta
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India,Correspondence to: Prof. Viney Gupta, Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. E-mail:
| | - Preeti Sankaran
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India
| | - Mohanraj
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India
| | | | - Vimla Menon
- Department of Ophthalmology, Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India
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