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[眼丝虫病:一例报告]

[Ocular dirofilariasis: a case report].

作者信息

Janjetović Zeljka, Arar Zeljka Vuković, Paradzik Maja Tomić, Sapina Lidija, Bitunjac Milan, Lojen Gordana, Marinculić Albert

机构信息

Department of Ophthalmology, Dr. Josip Bencević General Hospital, Slavonski Brod, Croatia.

出版信息

Acta Med Croatica. 2010 Mar;64(1):41-5.

Abstract

A case of ocular dirofilariasis in a female patient is presented. The zoonosis caused by parasites of the genus Dirofilaria is relatively rare in humans, with a higher incidence in south and central Europe, Asia and Africa. In Europe, dirofilariasis is mostly caused by the species Dirofilaria repens. In the past 50 years, the number of individuals involved has been on an increase, with about 780 cases reported in the literature to date. Dirofilaria is a parasite found in the dog, cat, racoon and bear. The parasite replicates in the animal's body and enters circulation in the form of microfilariae. These microfilariae reach the insect's digestive tract and are transmitted to another animal or human with subsequent mosquito bites. When transmitted to humans, the parasite is found in the skin and subcutaneous tissue, mucous membranes, and less frequently visceral organs. Concerning ocular involvement, infections of the eye and adnexa oculi and tumorous noninfectious growth of eyelid or orbit have been described to date. The symptoms of the disease vary and include local pain, proptosis, diplopia, palpebral and conjunctival edema, redness, feeling of foreign body, and impaired vision. The diagnosis is generally made by histologic identification of the parasite micro- and macroscopic characteristics, Dirofilaria DNA analysis by the method of polymerase chain reaction, and serology (ELISA) demonstrating the presence of Dirofilaria antibodies in serum. Treatment includes surgical excision of the parasite as an appropriate and efficient therapeutic procedure. A 76-old-female patient presented to outpatient ophthalmology clinic for occasional sensation of pain, rubbing and redness in her right eye. Initial therapy was introduced, resulting in short-lasting improvement. In two weeks, the patient was re-examined for recurrence of discomforts. Slit lamp examination performed temporally revealed a whitish motile, live parasite under the injected and chemotic bulbar conjunctiva. Upon surgical extirpation of the parasite, the diagnosis of dirofilariasis was verified by microbiologic identification.

摘要

本文报告了一例女性眼部恶丝虫病病例。由恶丝虫属寄生虫引起的人畜共患病在人类中相对罕见,在欧洲南部、中部、亚洲和非洲发病率较高。在欧洲,恶丝虫病主要由匐行恶丝虫引起。在过去50年中,涉及的病例数量一直在增加,迄今为止文献报道约有780例。恶丝虫是一种在狗、猫、浣熊和熊体内发现的寄生虫。该寄生虫在动物体内繁殖,并以微丝蚴的形式进入血液循环。这些微丝蚴到达昆虫的消化道,并在随后的蚊虫叮咬时传播给另一只动物或人类。当传播给人类时,寄生虫存在于皮肤和皮下组织、粘膜中,较少见于内脏器官。关于眼部受累,迄今为止已描述了眼部和眼附件感染以及眼睑或眼眶的肿瘤性非感染性生长。该病症状各异,包括局部疼痛、眼球突出、复视、眼睑和结膜水肿、发红、异物感和视力受损。诊断通常通过组织学鉴定寄生虫的微观和宏观特征、采用聚合酶链反应方法进行恶丝虫DNA分析以及血清学(ELISA)检测血清中恶丝虫抗体的存在来进行。治疗包括手术切除寄生虫,这是一种合适且有效的治疗方法。一名76岁女性患者因右眼偶尔出现疼痛、摩擦和发红感前往眼科门诊就诊。进行了初始治疗,症状得到短暂缓解。两周后,患者因不适复发接受复查。当时进行的裂隙灯检查发现,在充血和水肿的球结膜下有一条白色可活动的活寄生虫。手术切除寄生虫后,通过微生物鉴定证实为恶丝虫病。

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