Goldberg M A, Kazacos K R, Boyce W M, Ai E, Katz B
Neuro-Ophthalmology Unit, California Pacific Medical Center, San Francisco 94115.
Ophthalmology. 1993 Nov;100(11):1695-701. doi: 10.1016/s0161-6420(93)31415-6.
Several nematodes have been postulated as etiologic agents in diffuse unilateral subacute neuroretinitis (DUSN), but the cause of this condition remains uncertain. The authors report the first case of DUSN from the western United States (northern California), along with morphometric, serologic, and epidemiologic evidence supporting Baylisascaris procyonis as its cause.
One patient was examined and evaluated for disc edema and transient obscurations of vision. A diagnosis of DUSN was confirmed when a motile nematode was identified within the substance of the patient's retina. Morphometric analysis of the nematode was done from projected fundus photographs. Serologic evidence of Baylisascaris infection was suggested by Western blot analysis. A necropsy was done on 12 raccoons from the area. They were examined for evidence of Baylisascaris infection, previously believed to be nonendemic in the region.
The intraocular nematode measured 1727 x 67 microns, most consistent with Baylisascaris. The patient had considerable exposure to raccoons, and was seropositive for B. procyonis infection on Western blot analysis. Necropsy evaluation showed B. procyonis infection in 8 of 12 raccoons examined from the area.
The morphometric, serologic, and epidemiologic findings in this case provide evidence that the raccoon ascarid, B. procyonis, is a cause of the large nematode variant of DUSN.
几种线虫被认为是弥漫性单侧亚急性神经视网膜炎（DUSN）的病原体，但这种疾病的病因仍不明确。作者报告了美国西部（北加利福尼亚）首例DUSN病例，并提供了形态学、血清学和流行病学证据，支持浣熊贝蛔虫是其病因。
对一名患者进行了检查和评估，以确定其视盘水肿和短暂性视力模糊情况。当在患者视网膜实质内发现活动的线虫时，确诊为DUSN。根据眼底照片投影对线虫进行形态学分析。通过蛋白质印迹分析提示有浣熊贝蛔虫感染的血清学证据。对该地区的12只浣熊进行了尸检。检查它们是否有浣熊贝蛔虫感染的证据，此前认为该地区不存在这种寄生虫。
眼内线虫长1727×67微米，最符合浣熊贝蛔虫特征。该患者与浣熊有大量接触，蛋白质印迹分析显示其感染浣熊贝蛔虫呈血清学阳性。尸检评估显示，在该地区检查的12只浣熊中，有8只感染了浣熊贝蛔虫。
该病例的形态学、血清学和流行病学研究结果提供了证据，表明浣熊蛔虫——浣熊贝蛔虫是DUSN大型线虫变种的病因。
