1/23. albendazole therapy for loiasis refractory to diethylcarbamazine treatment.Although diethylcarbamazine is curative in approximately 60% of patients who acquire loiasis as long-term visitors to an endemic area, some individuals continue to have signs and symptoms of infection despite multiple courses of diethylcarbamazine. On the basis of a study of albendazole treatment of loiasis in microfilaremic patients that suggested a macrofilaricidal effect of the drug, we treated three patients who had symptomatic loiasis refractory to more than four courses of diethylcarbamazine with albendazole. At the time of treatment, all patients had persistent symptoms despite decreasing titers of antifilarial antibodies and normal eosinophil counts. Symptoms resolved in all three patients following albendazole therapy. In one patient, nonspecific symptoms recurred 2 years later, but unlike her symptoms before albendazole therapy, they were not accompanied by the appearance of subcutaneous nodules containing adult worms. The other two patients have been symptom-free in the 8 years after albendazole treatment. In summary, albendazole may be useful for the treatment of loiasis when diethylcarbamazine is ineffective or cannot be used.- - - - - - - - - - ranking = 1keywords = filaria (Clic here for more details about this article) |
2/23. Subconjunctival loa loa worm: case report.A 38-year old Ghanaian suddenly had the sensation of a foreign body in his right eye. Slit-lamp examination revealed a transparent worm underneath the conjunctiva. With topical anesthesia, the complete worm, 3.5 cm long, was removed surgically. A microbiological analysis at the Institute of tropical medicine confirmed the diagnosis of loa loa. Laboratory tests showed negative blood eosinophilia, positive blood film examination for microfilariae and positive results for filarial serology. The postoperative treatment consisted of progressive doses of di-ethyl-carbamazine (50-->100-->200 mg/d). A subconjunctival loa loa worm is rare in belgium and usually occurs in immigrants or travellers returning from Tropical (Equatorial) West and Central africa. Our patient visited nigeria in 1985 and Ivory Coast in 1986. Those regions are highly endemic for loa loa.- - - - - - - - - - ranking = 2keywords = filaria (Clic here for more details about this article) |
3/23. A case of loiasis in Rome.BACKGROUND: Owing to the increase of an immigrant population and of Italian citizens travelling for tourism or on business, it is nowadays possible to observe clinical pictures characteristic of tropical regions, often with indistinct symptoms. One of these is loa loa infestation, or loiasis, a form of filariasis caused by loa loa and transmitted by the Chrysops fly. We present the case of a male immigrant from cameroon. Characteristic symptoms were intense xerosis, mostly of the third inferior part of the legs, intensely pruritic, with numerous lesions from scratching. No benefit was obtained by emollient topics, anti-acarus and systemic antihistamines. METHOD: serum samples and Giemsa, haematoxylin, haematoxylin Giemsa concentration-on-membrane stains, have evidenced the presence of loa loa microfilariae. RESULTS: A diagnosis for L. loa (loiasis) infestation was made. CONCLUSIONS: At the beginning of the migration phenomenon, particularly from africa, Italian physicians, especially dermatologists, were eagerly looking for 'tropical' diseases; this approach can be defined as 'Salgari's syndrome' from the name of the Italian novelist who, though never travelling out of italy, had perfectly described environments and habits typical of far away countries. Now, conversely, we have to avoid the opposite approach of considering real tropical diseases as related to social or psychological difficult conditions.- - - - - - - - - - ranking = 2keywords = filaria (Clic here for more details about this article) |
4/23. There's a worm in my eye.OBJECTIVE: To report a case of an unusual worm infestation of the eye. CLINICAL FEATURES: A 28-year-old veterinary surgeon complained of the intermittent appearance of a worm in her eyes. Her previous camping travels in west and central africa suggested the diagnosis of loa loa, which was confirmed on surgical removal of the worm from beneath the conjunctiva. Laboratory investigations showed peripheral blood eosinophilia, negative thick blood film examinations for microfilariae and positive results of filarial serology. INTERVENTION AND OUTCOME: The worm was removed intact after incision of the overlying conjunctiva. diethylcarbamazine was prescribed and the patient remained asymptomatic in the subsequent 12 months. CONCLUSIONS: The sighting of a worm in the eye is rare in australia and usually occurs in immigrants or returned travellers. loa loa is the most common offending species and is identifiable and treatable.- - - - - - - - - - ranking = 2keywords = filaria (Clic here for more details about this article) |
5/23. Pulmonary involvement in loiasis.A 40-yr-old West African man presented acutely with pleural effusion. Cytologic evaluation of the pleural fluid revealed loa loa microfilariae. No additional etiology for the pleural effusion could be identified, and antifilarial treatment with diethylcarbamazine led to a rapid resolution of the patient's symptoms and pulmonary abnormalities. loa loa must be considered as a treatable cause of eosinophilic pleural effusions in persons from endemic areas of West and Central africa.- - - - - - - - - - ranking = 2keywords = filaria (Clic here for more details about this article) |
6/23. loa loa in the anterior chamber of the eye: a case report.An unusual case of loiasis from Assam is reported here. loa loa is a subcutaneous filarial parasite of man and is transmitted to humans by chrysops flies. The patient presented with foreign body sensation and visual disturbances of the right eye. Examination revealed a white coiled structure in the cornea. Routine blood and other investigations were within normal limits. A live adult worm was extracted and identity was confirmed by microscopy to be loa loa. Patient was treated with diethylcarbamazine and steroid. We found this case interesting as the worm was present in the anterior chamber--an unusual site and there were no other positive findings besides the lone worm.- - - - - - - - - - ranking = 1keywords = filaria (Clic here for more details about this article) |
7/23. First case of ivermectin-induced severe hepatitis.loiasis, caused by the filarial parasite loa loa, is endemic in West and Central africa. ivermectin has been shown to be an effective treatment of loiasis. We report the case of a 20-year-old woman originally from cameroon who was infected by the L. loa parasite and developed severe hepatitis, identified 1 month after a single dose of ivermectin. liver biopsy showed intralobular inflammatory infiltrates, confluent necrosis and apoptosis, compatible with drug-induced liver disease. To our knowledge, this is the first case of ivermectin-induced severe liver disease published in the literature.- - - - - - - - - - ranking = 1keywords = filaria (Clic here for more details about this article) |
8/23. Diagnosing multiple parasitic infections: trypanosomiasis, loiasis and schistosomiasis in a single case.A case is reported of a 32-year-old traveller with loiasis, schistosomiasis and African trypanosomiasis. The patient had been working in oil exploration in nigeria and gabon and presented with Calabar swellings and carpal tunnel syndrome. serology for all 3 diseases was positive but microfilariae of loa loa and ova of schistosomiasis were not found. Treatment with diethylcarbamazine and praziquantel was given for loiasis and schistosomiasis respectively. Trypanosomes were isolated from a lymph node aspirate only after repetition of the procedure 2 months later and the patient was treated with suramin. He developed a drug induced nephritis and was then treated successfully with alpha-difluoromethylornithine. There is a discussion of the difficulties encountered making these diagnoses in Europeans particularly where there are atypical clinical features. The risks of rural work in West africa are noted and the importance of considering all parasitic diseases relevant to the travel/occupational history is emphasised.- - - - - - - - - - ranking = 1keywords = filaria (Clic here for more details about this article) |
9/23. Five cases of encephalitis during treatment of loiasis with diethylcarbamazine.Five cases of encephalitis following treatment with diethylcarbamazine (DEC) were observed in Congolese patients with loa loa filariasis. Two cases had a fatal outcome and one resulted in severe sequelae. The notable fact was that this complication occurred in three patients hospitalized before treatment began, with whom particularly strict therapeutic precautions were taken, i.e., initial dose less than 10 mg of DEC, very gradual dose increases, and associated anti-allergic treatment. This type of drug-induced complication may not be that uncommon in highly endemic regions. It occurs primarily, but not exclusively, in subjects presenting with a high microfilarial load. The relationship between the occurrence of encephalitis and the decrease in microfilaremia is evident. The pathophysiological mechanisms are discussed in the light of these observations and the few other comments on this subject published in the literature.- - - - - - - - - - ranking = 2keywords = filaria (Clic here for more details about this article) |
10/23. Microfilarial polyarthritis in a massive loa loa infestation. A case report.A Cameroonian affected with massive loa loa infection developed febrile arthritis with involvement of both knees and the left ankle. Although the patient was first seen by us after one month of treatment with indomethacin, at this time the joints were still inflamed and microfilariae of loa loa were found in the synovial fluid. No other etiological mechanism was identified. Following the articular puncture and treatment with ketoprofen, the arthritis subsisted within a week. This is the first case to be studied in which arthritis during loasis has been explicitly documented by the presence of intra-articular microfilariae.- - - - - - - - - - ranking = 6keywords = filaria (Clic here for more details about this article) |
| | Next -> |