Ocular larva migrans

Last updated
Ocular larva migrans
Other namesOcular toxocariasis
2009-08-16 Puppy at Duke East 1.jpg
Puppies are a major source of environmental contamination with Toxocara eggs

Ocular larva migrans (OLM), also known as ocular toxocariasis, is the ocular form of the larva migrans syndrome that occurs when Toxocara canis (dog roundworm) larvae invade the eye. They may be associated with visceral larva migrans. Unilateral visual disturbances, strabismus, and eye pain are the most common presenting symptoms.

Contents

Diagnosis

The disease presents with an eosinophilic granulomatous mass, most commonly in the posterior pole of the retina. The granulomatous mass develops around the entrapped larva, in an attempt to contain the spread of the larva.[ citation needed ]

ELISA testing of intraocular fluids has been demonstrated to be of great value in diagnosing ocular toxocariasis.[ citation needed ]

Differential diagnosis

The retinal lesion can mimic retinoblastoma in appearance, and mistaken diagnosis of the latter condition can lead to unnecessary enucleation.

Complications

The eye involvement can cause the following inflammatory disorders:[ citation needed ]

Epidemiology

In contrast to visceral larva migrans, ocular toxocariasis usually develops in older children or young adults with no history of pica. These patients seldom have eosinophilia or visceral manifestations.

Related Research Articles

<span class="mw-page-title-main">Conjunctivitis</span> Inflammation of the eye

Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be "stuck shut" in the morning. Swelling of the white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes.

<span class="mw-page-title-main">Granuloma</span> Aggregation of macrophages in response to chronic inflammation

A granuloma is an aggregation of macrophages that forms in response to chronic inflammation. This occurs when the immune system attempts to isolate foreign substances that it is otherwise unable to eliminate. Such substances include infectious organisms including bacteria and fungi, as well as other materials such as foreign objects, keratin, and suture fragments.

Toxocariasis is an illness of humans caused by the dog roundworm and, less frequently, the cat roundworm. These are the most common intestinal roundworms of dogs, coyotes, wolves and foxes and domestic cats, respectively. Humans are among the many "accidental" or paratenic hosts of these roundworms.

<span class="mw-page-title-main">Uveitis</span> Inflammation of the uvea of the eye

Uveitis is inflammation of the uvea, the pigmented layer of the eye between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye and includes the iris, ciliary body, and choroid. Uveitis is described anatomically, by the part of the eye affected, as anterior, intermediate or posterior, or panuveitic if all parts are involved. Anterior uveitis (iridocyclitis) is the most common, with the incidence of uveitis overall affecting approximately 1:4500, most commonly those between the ages of 20-60. Symptoms include eye pain, eye redness, floaters and blurred vision, and ophthalmic examination may show dilated ciliary blood vessels and the presence of cells in the anterior chamber. Uveitis may arise spontaneously, have a genetic component, or be associated with an autoimmune disease or infection. While the eye is a relatively protected environment, its immune mechanisms may be overcome resulting in inflammation and tissue destruction associated with T-cell activation.

Gnathostomiasis, also known as larva migrans profundus, is the human infection caused by the nematode Gnathostoma spinigerum and/or Gnathostoma hispidum, which infects vertebrates.

<span class="mw-page-title-main">Albendazole</span> Chemical compound

Albendazole is a broad-spectrum anthelmintic and antiprotozoal agent of the benzimidazole type. It is used for the treatment of a variety of intestinal parasite infections, including ascariasis, pinworm infection, hookworm infection, trichuriasis, strongyloidiasis, taeniasis, clonorchiasis, opisthorchiasis, cutaneous larva migrans, giardiasis, and gnathostomiasis, among other diseases.

<span class="mw-page-title-main">Veliger</span> Larval stage of some snails

A veliger is the planktonic larva of many kinds of sea snails and freshwater snails, as well as most bivalve molluscs (clams) and tusk shells.

<span class="mw-page-title-main">Toxocaridae</span> Family of roundworms

The Toxocaridae are a zoonotic family of parasitic nematodes that infect canids and felids and which cause toxocariasis in humans. The worms are unable to reproduce in humans.

The term leukemoid reaction describes an increased white blood cell count, which is a physiological response to stress or infection. It often describes the presence of immature cells such as myeloblasts or red blood cells with nuclei in the peripheral blood.

<span class="mw-page-title-main">Cutaneous larva migrans</span> Medical condition

Cutaneous larva migrans is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). The parasites live in the intestines of dogs, cats, and wild animals; they should not be confused with other members of the hookworm family for which humans are definitive hosts, namely Ancylostoma duodenale and Necator americanus.

Visceral larva migrans (VLM) is a condition in humans caused by the migratory larvae of certain nematodes, humans being a dead-end host, and was first reported in 1952. Nematodes causing such zoonotic infections are Baylisascaris procyonis, Toxocara canis, Toxocara cati, and Ascaris suum. These nematodes can infect but not mature in humans and after migrating through the intestinal wall, travel with the blood stream to various organs where they cause inflammation and damage. Affected organs can include the liver, heart and the CNS. A special variant is ocular larva migrans where usually T. canis larvae travel to the eye.

Larva migrans generally refers to disease caused by the migration of the larvae of a helminth to various tissues. Some variants of larva migrans include:

<span class="mw-page-title-main">Ancylostomiasis</span> Medical condition

Ancylostomiasis is a hookworm disease caused by infection with Ancylostoma hookworms. The name is derived from Greek ancylos αγκύλος "crooked, bent" and stoma στόμα "mouth".

<i>Toxocara canis</i> Species of roundworm

Toxocara canis is a worldwide-distributed helminth parasite that primarily infects dogs and other canids, but can also infect other animals including humans. The name is derived from the Greek word "toxon," meaning bow or quiver, and the Latin word "caro," meaning flesh. T. canis live in the small intestine of the definitive host. This parasite is very common in puppies and somewhat less common in adult dogs. In adult dogs, infection is usually asymptomatic but may be characterized by diarrhea. By contrast, untreated infection with Toxocara canis can be fatal in puppies, causing diarrhea, vomiting, pneumonia, enlarged abdomen, flatulence, poor growth rate, and other complications.

<i>Toxocara cati</i> Species of worm

Toxocara cati, also known as the feline roundworm, is a parasite of cats and other felids. It is one of the most common nematodes of cats, infecting both wild and domestic felids worldwide. Adult worms are localised in the gut of the host. In adult cats, the infection – which is called toxocariasis – is usually asymptomatic. However, massive infection in juvenile cats can be fatal.

<i>Toxascaris leonina</i> Species of roundworm

Toxascaris leonina is a common parasitic roundworm found in dogs, cats, foxes, and related host species. T. leonina is an ascarid nematode, a worldwide distributed helminth parasite which is in a division of eukaryotic parasites that, unlike external parasites such as lice and fleas, live inside their host. The definitive hosts of T. leonina include canids and felines (cats), while the intermediate hosts are usually rodents, such as mice or rats. Infection occurs in the definitive host when the animal eats an infected rodent. While T. leonina can occur in either dogs or cats, it is far more frequent in cats.

Trichuris vulpis is a whipworm that lives in the large intestine of canines in its adult stages. Out of different types of worms, Trichuris vulpis is one of the smaller worms with a size ranging from 30–50 mm in length. As the name suggests, the worm has a whip-like shape with distinct features including a small, narrow anterior head, which is the digestive part of the worm, and a larger posterior tail, which is the reproductive part of the worm. Eggs from T. vulpis are oval shaped with bipolar plugs and contain a thick outer shell. Their sizes range from 72–90 μm in length and 32–40 μm in width. Because of their thick outer shell, T. vulpis eggs are very resistant to environmental extremes such as freezing or hot temperatures, thus allowing for their long viability in the outside world.

Gnathostoma hispidum is a nematode (roundworm) that infects many vertebrate animals including humans. Infection of Gnathostoma hispidum, like many species of Gnathostoma causes the disease gnathostomiasis due to the migration of immature worms in the tissues.

<span class="mw-page-title-main">Retinal vasculitis</span> Medical condition

Retinal vasculitis is inflammation of the vascular branches of the retinal artery, caused either by primary ocular disease processes, or as a specific presentation of any systemic form of vasculitis such as Behçet's disease, sarcoidosis, multiple sclerosis, or any form of systemic necrotizing vasculitis such as temporal arteritis, polyarteritis nodosa, and granulomatosis with polyangiitis, or due to lupus erythematosus, or rheumatoid arthritis. Eales disease, pars planitis, birdshot retinochoroidopathy, and Fuchs heterochromic iridocyclitis (FHI) can also cause retinal vasculitis. Infectious pathogens such as Mycobacterium tuberculosis, visceral larva migrans can also cause retinal vasculitis. Drug-induced vasculitis may involve retina as well, as seen in methamphetamine induced vasculitis.

References