Microfilaria

微丝虫病
  • 文章类型: Case Reports
    微丝寄生虫会阻塞淋巴树,从而引起不同的淋巴和淋巴外症状。肾脏表现可以从无症状的蛋白尿,乳糜尿,和肾病综合征,急性肾小球肾炎。丝虫病的诊断通常是通过在外周血涂片中显示寄生虫来进行的,有或没有嗜酸性粒细胞增多症。在文献中很少报道这种寄生虫的肾脏受累。我们在此报告5例丝虫病在肾活检的组织病理学检查中发现,为其他适应症而进行的,以及其他组织学发现的简短报告。包括三个天然和两个移植物活检。我们所有的病人都是男性,平均年龄为47岁(范围为37至66岁)。血清肌酐范围为1.2至12.9mg/dL。平均24小时尿蛋白为3.6gm/天。在任何情况下都没有记录到外周血嗜酸性粒细胞增多,然而,在所有情况下都提高了ESR。尿液检查显示不同的蛋白尿,有血尿2例。组织学检查显示在所有五个活检中都有微丝菌,伴有两例局灶性节段性肾小球硬化,细胞和体液联合排斥反应,微小病变和急性肾小管坏死各1例。所有患者均接受二乙基卡巴嗪6mg/kg/天或12天治疗,除了肾脏药物。诊断寄生虫至关重要,因为患者可能会因为疾病的及时治疗而受益。报告此病例系列突出了肾病学中的一个有趣发现。
    Microfilarial parasites can obstruct the lymphatic tree giving rise to varying lymphatic and extra-lymphatic symptoms. Renal manifestations can range from asymptomatic proteinuria, chyluria, and nephrotic syndrome, to acute glomerulonephritis. The diagnosis of filariasis is usually made by the demonstration of the parasite in the peripheral blood smear, with or without eosinophilia. The renal involvement by this parasite has been sparsely reported in the literature. We hereby report five cases of filariasis detected on histopathological examination of renal biopsies, performed for other indications, along with a brief report of the additional histological findings. Three native and two graft biopsies were included. All our patients were male, with a mean age of 47 years (range 37 to 66 years). The serum creatinine ranged from 1.2 to 12.9 mg/dL. The mean 24-hour urinary protein was 3.6 gm/day. Peripheral blood eosinophilia was not recorded in any case, however, ESR was raised in all cases. Urine examination revealed varying proteinuria, with hematuria in two cases. Histological examination revealed microfilaria in all five biopsies, along with focal segmental glomerulosclerosis in two cases, combined cellular and humoral rejection, minimal change disease and acute tubular necrosis in one case each respectively. All patients were treated with diethylcarbamazine 6mg/kg/day or 12 days, in addition to the renal medications. Diagnosing the parasite is crucial as the patient is likely to benefit due to the timely treatment of the disease. Reporting this case series highlights an interesting finding in nephropathology.
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  • 文章类型: Journal Article
    淋巴丝虫病是一种被忽视的热带病,影响人类的淋巴系统。主要的病原体是一种名为Wucherriabancrofti的线虫,但是有时会遇到BrugiaMalayi和BrugiaTimoriois作为病原体。蚊子是媒介,而人类是最终的宿主。尼日利亚的疾病负担比非洲其他流行国家更重。这种情况随着国内不同地点的发病率和死亡率的增加而发生,世界卫生组织推荐的淋巴丝虫病治疗方法包括在与loaloa共同流行的地区每年使用阿苯达唑(400mg)两次,伊维菌素(200mcg/kg)与阿苯达唑(400mg)在与盘尾丝虫病共同流行的地区联合使用,在没有盘尾丝虫病的地区,伊维菌素(200mcg/kg)与柠檬酸二乙基卡巴嗪(DEC)(6mg/kg)和阿苯达唑(400mg)。本文进行了系统的回顾,荟萃分析,以及对该国各自地缘政治地区的淋巴丝虫病进行范围审查。使用的文献是通过包括PubMed和GoogleScholar在内的在线搜索引擎获得的,标题为“以国家名义的淋巴丝虫病”,尼日利亚。这篇综述显示,西北地区的总体患病率为11.18%(1.59%),中北部和东北部,(4.52%),西南(1.26%),和南南与东南(3.81%)患病率。该疾病已在Kebbi州的Argungu地方政府地区(LGA)成功消除,高原,分别是纳萨拉瓦州。大多数临床表现(31.12%)包括鞘膜积液,淋巴水肿,象皮病,疝气,和皮炎。夜间血液样本适用于微丝菌调查。持续的MDAs,正确的测试方法,感染病例的早期治疗,和病媒控制有助于消除淋巴丝虫病,用于该国的发病率管理和残疾预防。区域控制策略,提高对调查和干预计划的质量监测,并记录需要干预的发病率和残疾,是及时消除尼日利亚疾病的重要方法。
    Lymphatic filariasis is a neglected tropical disease that affects the lymphatic system of humans. The major etiologic agent is a nematode called Wuchereria bancrofti, but Brugia malayi and Brugia timoriare sometimes encountered as causative agents. Mosquitoes are the vectors while humans the definitive hosts respectively. The burden of the disease is heavier in Nigeria than in other endemic countries in Africa. This occurs with increasing morbidity and mortality at different locations within the country, the World Health Organization recommended treatments for lymphatic filariasis include the use of Albendazole (400mg) twice per year in co-endemic areas with loa loa, Ivermectin (200mcg/kg) in combination with Albendazole (400mg) in areas that are co-endemic with onchocerciasis, ivermectin (200mcg/kg) with diethylcarbamazine citrate (DEC) (6mg/kg) and albendazole (400mg) in areas without onchocerciasis. This paper covered a systematic review, meta-analysis, and scoping review on lymphatic filariasis in the respective geopolitical zones within the country. The literature used was obtained through online search engines including PubMed and Google Scholar with the heading \"lymphatic filariasis in the name of the state\", Nigeria. This review revealed an overall prevalence of 11.18% with regional spread of Northwest (1.59%), North Central and North East, (4.52%), South West (1.26%), and South-South with South East (3.81%) prevalence. The disease has been successfully eliminated in Argungu local government areas (LGAs) of Kebbi State, Plateau, and Nasarawa States respectively. Most clinical manifestations (31.12%) include hydrocele, lymphedema, elephantiasis, hernia, and dermatitis. Night blood samples are appropriate for microfilaria investigation. Sustained MDAs, the right testing methods, early treatment of infected cases, and vector control are useful for the elimination of lymphatic filariasis for morbidity management and disability prevention in the country. Regional control strategies, improved quality monitoring of surveys and intervention programs with proper records of morbidity and disability requiring intervention are important approaches for the timely elimination of the disease in Nigeria.
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  • 文章类型: Journal Article
    Dirofilariaimmitis是一种蚊媒寄生线虫,可导致犬科动物致命的心丝虫病。微丝虫对研究至关重要,包括药物筛选和蚊子-寄生虫相互作用。然而,目前尚无可靠的长期维持微丝菌的方法。因此,我们使用严重联合免疫缺陷(SCID)小鼠来开发维持D.immitis微丝病的可靠方法。用从感染D.immitis的狗分离的微丝虫静脉注射SCID小鼠。在接种后218天(dpi)和通过心脏穿刺296dpi从尾静脉收集的血液中检测到微丝菌。维持在SCID小鼠中并从SCID小鼠中提取的微丝菌在媒介蚊子埃及伊蚊中表现出感染性并成熟为第三阶段幼虫(L3s)。L3s可在体外发育为第四期幼虫。SCID小鼠的微丝菌在体外对伊维菌素反应正常。SCID小鼠的微丝菌在外周循环中表现出周期性。SCID小鼠模型有助于从冷冻保存的标本中分离微丝虫。使用SCID小鼠能够从临床样品中分离和持续培养微丝虫。这些发现强调了SCID小鼠模型在研究犬心丝虫研究中的D.immitis微丝血症的有用性。
    Dirofilaria immitis is a mosquito-borne parasitic nematode that causes fatal heartworm disease in canids. The microfilariae are essential for research, including drug screening and mosquito-parasite interactions. However, no reliable methods for maintaining microfilaria long-term are currently available. Therefore, we used severe combined immunodeficiency (SCID) mice to develop a reliable method for maintaining D. immitis microfilaria. SCID mice were injected intravenously with microfilariae isolated from a D. immitis-infected dog. Microfilariae were detected in blood collected from the tail vein 218 days post-inoculation (dpi) and via cardiac puncture 296 dpi. Microfilariae maintained in and extracted from SCID mice showed infectivity and matured into third-stage larvae (L3s) in the vector mosquito Aedes aegypti. L3s can develop into the fourth stage larvae in vitro. Microfilariae from SCID mice respond normally to ivermectin in vitro. The microfilariae in SCID mice displayed periodicity in the peripheral circulation. The SCID mouse model aided in the separation of microfilariae from cryopreserved specimens. The use of SCID mice enabled the isolation and sustained cultivation of microfilariae from clinical samples. These findings highlight the usefulness of the SCID mouse model for studying D. immitis microfilaremia in canine heartworm research.
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  • 文章类型: Case Reports
    淋巴丝虫病在印度的一些州流行,是最常见的公共卫生问题之一。Wuchereriabancrofti(W.bancrofti)是在印度引起淋巴丝虫病的最常见寄生虫。微丝虫普遍存在于外周血和体液中,以及在细针抽吸(FNA)和支气管细胞学中显示。在骨髓抽吸物中很少报道它们。由于W.bancrofti的夜间周期性,它可能在白天的外周血中被遗漏。虽然外周嗜酸性粒细胞增多是丝虫病的一个表现特征,在大多数情况下可能不存在,在这种情况下。我们报告了W.bancrofti在患有慢性肾脏疾病的72岁男性的骨髓穿刺液中的偶然发现。
    Lymphatic filariasis is endemic in a few states of India and is one of the most common public health concerns. Wuchereria bancrofti (W. bancrofti) is the most common parasite that causes lymphatic filariasis in India. Microfilariae have been commonly found in the peripheral blood and body fluid, as well as demonstrated in fine needle aspirates (FNA) and bronchial cytology. They have been rarely reported in bone marrow aspirates. Due to the nocturnal periodicity of W. bancrofti, it may be missed in peripheral blood during the day. Though peripheral eosinophilia is a presenting feature of filariasis, it may be absent in the majority of cases, as in this case. We report an incidental finding of W. bancrofti in the bone marrow aspirate of a 72-year-old male who had chronic kidney disease.
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  • 文章类型: Journal Article
    丝虫线虫通常在脊椎动物宿主的血流中产生幼虫期(微丝虫),微丝虫存在于血液或皮下组织中。丝虫线虫引起人类疾病,比如河盲症和象皮病,被广泛研究。然而,在鸟类中,它们被忽视,因为它们是非致病性的。在泰国,在野生鸟类和家鸡中可以发现微丝虫病。最近,向兽医诊断实验室提交的血液样本数量的增加可能会增加微丝虫的数量。因此,有关丝虫物种的知识和可靠的检测方法很重要。因此,本研究旨在探讨血沉棕黄层涂片和基于聚合酶链反应(PCR)的方法检测家鸡微丝菌的效果。此外,使用细胞色素c氧化酶亚基1(COX1)基因的序列鉴定寄生虫。
    重新分析了来自先前研究的Giemsa染色的血沉棕黄层涂片。这些可用的血沉棕黄层涂片是由在泰国南部散养的55只家鸡制成的。从鸡血中提取的57个冷冻基因组DNA用于检测Onchocercidae线虫中COX1基因的存在。用于扩增COX1基因的OnchoCOI_R2-OnchoCOI_R2片段的巢式PCR方案应用于先前的报道。分析了COX1的序列以鉴定Onchocercidae线虫,以及它们是单一感染还是混合感染。我们构建了贝叶斯系统遗传学来鉴定寄生虫并评估鸟类和其他脊椎动物宿主中丝虫线虫之间的关系。
    来自15个样本的棕黄层涂片显示微丝菌。在这15个样本中,只有8例COX1巢式PCR扩增呈阳性.另外两个血沉棕黄层阴性样品的巢式PCR也是阳性的。对这11个巢式PCR阳性样品进行测序显示,几乎所有样品都是Onchocercidae线虫。贝叶斯系统发育分析表明,鸡the。与其他禽类丝虫线虫分组。然而,所有鸡Onchocercidaespp。在测序色谱图中显示了一个双峰,表明混合丝虫感染(物种或单倍型)。因此,国家生物技术信息中心没有保藏鸡Onchocercidae序列,GenBank。
    Giemsa染色的血沉棕黄层涂片是在常规兽医诊断实验室中检测鸡肉微丝菌的可靠方法。开发新的基于PCR的方法是必要的。该方法可以提供更高的检测灵敏度和特异性。此外,PCR方法使我们能够获得线虫的遗传特征,这有助于我们最大限度地了解线虫。进一步调查,如丝虫线虫对鸡及其潜在载体的致病性,是必需的。
    UNASSIGNED: Filarial nematode typically produces a larval stage (microfilariae) in the bloodstream of vertebrate hosts, where microfilariae reside in the blood or subcutaneous tissues. Filarial nematodes cause human diseases, such as river blindness and elephantiasis, which are widely studied. However, in avian species, they are overlooked because they are nonpathogenic. In Thailand, microfilaria can be found in wild birds and domestic chickens. Recently, an increase in the number of blood samples submitted to veterinary diagnostic laboratories may have increased the number of microfilariae. Therefore, knowledge about filarial species and reliable detection methods are important. Therefore, this study aimed to investigate the efficacy of buffy coat smear and polymerase chain reaction (PCR)-based methods for the detection of microfilaria in domestic chickens. In addition, parasites were identified using the sequence of the cytochrome c oxidase subunit 1 (COX1) gene.
    UNASSIGNED: Giemsa-stained buffy coat smears from a previous study were reanalyzed. These available buffy coat smears were prepared from 55 domestic chickens raised as backyard free-ranging in Southern Thailand. Fifty-seven frozen genomic DNA extracted from chicken blood were used to detect the presence of the COX1 gene in Onchocercidae nematodes. The nested PCR protocol for amplification of the OnchoCOI_R2-OnchoCOI_R2 fragment of the COX1 gene was applied from a previous report. Sequences of COX1 were analyzed to identify Onchocercidae nematodes and if they were single or mixed infections. We constructed Bayesian phylogenetics to identify parasites and assessment of the relationship between filarial nematodes in avian species and other vertebrate hosts.
    UNASSIGNED: Buffy coat smears from 15 samples revealed microfilaria. Of these 15 samples, only eight were positive for COX1 nested-PCR amplification. The other two buffy coat-negative samples were also positive for nested-PCR. Sequencing of these 11 nested PCR-positive samples revealed that almost all of them were Onchocercidae nematodes. Bayesian phylogenetic analysis showed that chicken Onchocercidae spp. were grouped with other avian filarial nematodes. However, all chickens Onchocercidae spp. showed a double peak in the sequencing chromatogram, indicating mixed filarial infection (species or haplotypes). Therefore, no chicken Onchocercidae sequence was deposited on National Center for Biotechnology Information, GenBank.
    UNASSIGNED: Giemsa-stained buffy coat smear was a reliable method for the detection of chicken microfilaria in routine veterinary diagnostic laboratories. Development of a new PCR-based method is necessary. This method may provide greater sensitivity and specificity of detection. In addition, the PCR method allowed us to access the genetic characteristics of nematodes, which helped us maximize our knowledge of nematodes. Further investigations, such as the pathogenicity of filarial nematodes in chickens and their potential vectors, are required.
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  • 文章类型: Case Reports
    Dirofilariaimmitis是一种由蚊子传播的线虫引起的犬心丝虫病,成虫位于肺动脉和右心。在极少数情况下,可能发生异位迁移,和成人和血液循环微丝虫可以在不寻常的器官或液体中发现(例如,眼睛,腹腔,骨髓,和尿液)。在意大利的一家私人兽医诊所中,一只17岁的混血雌性狗因血尿和排尿困难而出现。体格检查显示心脏二尖瓣杂音,处理后出现明显的呼吸窘迫和紫红色粘膜。腹部超声显示非特异性慢性膀胱病,而超声心动图显示右心增大与三尖瓣关闭不全和二尖瓣反流有关,右心室腔中存在成年丝虫。在血液涂片中观察到循环的微丝虫,并在分子上鉴定为D.immitis。在尿沉渣中检测到异常的微丝尿症。提供的数据提高了人们对在不寻常位置发生微丝虫的认识,比如膀胱,这表明需要在D.immitis是地方性的地方进行全面的临床和实验室评估。
    Dirofilaria immitis is a mosquito-borne nematode-causing canine heartworm disease, with adult worms localized in the pulmonary arteries and right heart. In rare cases, ectopic migration might occur, and adults and blood circulating microfilariae can be found in unusual organs or fluids (e.g., eyes, abdominal cavity, bone marrow, and urine). A 17-year-old mixed-breed female dog was presented in a private veterinary clinic in Italy for hematuria and dysuria. Physical examination showed cardiac mitral murmur with marked respiratory distress and cyanotic mucous membranes after handling. Abdominal ultrasounds revealed a non-specific chronic cystopathy, while the echocardiography showed enlargement of the right heart associated with tricuspid insufficiency and mitral regurgitation, with the presence of an adult filariae in the right ventricular chamber. Circulating microfilariae were observed in the blood smear and molecularly identified as D. immitis. Unusual microfilaruria was detected in the urine sediment. Data presented raise awareness about the occurrence of microfilariae in unusual locations, such as the bladder, suggesting the need of a thorough clinical and laboratory assessment where D. immitis is endemic.
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  • 文章类型: Journal Article
    背景:盘尾丝虫病引起慢性全身性炎症。一些研究已经使用诸如血液生化指标的标志物来预测全身性炎症的发生。这项研究评估了盘尾肉瘤参与者的微丝虫阳性(MF)和微丝虫阴性(MF-)亚组的血液生化指标和血液复合比(BCR)的变异性和可预测性。
    方法:回顾性招募了105名MF+和34名MF-参与者。使用已建立和批准的方案,从参与者的左,右髂峰的皮肤剪断中筛选出微丝虫的存在。使用标准实验室自动分析仪测量血液学和生化指标。将血液复合比率(BCR)计算为所涉及的绝对参数的比率。
    结果:A显着增加了总白细胞,绝对嗜酸性粒细胞,与MF-参与者相比,在MF+参与者中观察到嗜酸性粒细胞百分比和绝对嗜碱性粒细胞。与MF参与者相比,降低的γ-谷氨酰转移酶(GGT)与估计的肾小球滤过率(eGFR)显着相关。嗜酸性粒细胞与中性粒细胞比率(ENR)的BCR显着升高,嗜酸性粒细胞与单核细胞比率(EMR),与MF参与者相比,MF参与者的嗜酸性粒细胞与嗜碱性粒细胞比率(EBR)和嗜酸性粒细胞与淋巴细胞比率(ELR)。经过多变量调整后,嗜酸性粒细胞计数增加的盘尾肉瘤参与者(aOR=13.86,95%CI[2.07-92.90],p=0.007),ENRx10(aOR=1.42,95%CI[1.05-1.93],p=0.025),EMR(aOR=2.64,95%CI[1.25-5.60],p=0.011),EBR(aOR=1.07,95%CI[1.01-1.10],p=0.020)和ELRx10(aOR=1.69,95%CI[1.14-2.51],p=0.009)更有可能患有微丝虫病。
    结论:嗜酸性粒细胞计数升高,ENR升高,EMR,EBR和ELR水平与盘尾肉瘤参与者的微丝虫病显着相关。将BCR与嗜酸性粒细胞计数相结合,显着改善了用于预测微丝体病的常规模型。
    BACKGROUND: Onchocerciasis causes chronic systemic inflammation. Several studies have used markers such as haemato-biochemical indices to predict the occurrence of systemic inflammation. This study assessed the variability and predictability of haemato-biochemical indices and blood composite ratios (BCRs) in microfilariae positive (MF+) and microfilariae negative (MF-) subgroups of onchocercomata participants.
    METHODS: One hundred and five (105) MF + and 34 MF- participants were retrospectively recruited into the study. Screening for the presence of O. volvulus microfilariae was done from skin snips taken from the left and right iliac crests of participants using established and approved protocols. Haematological and biochemical indices were measured using standard laboratory automated analyzers. Blood composite ratios (BCRs) were calculated as ratios of the absolute parameters involved.
    RESULTS: A significantly increased total WBC, absolute eosinophil, eosinophil percent and absolute basophil were observed in the MF + participants compared to MF- participants. Reduced gamma-glutamyl transferase (GGT) with increased estimated glomerular filtration rate (eGFR) was significantly associated with MF + participants compared to MF- participants. BCRs were significantly higher for eosinophil-to-neutrophil ratio (ENR), eosinophil-to-monocyte ratio (EMR), eosinophil-to-basophil ratio (EBR) and eosinophil-to-lymphocyte ratio (ELR) in MF + participants compared to MF- participants. After multivariate adjustment, onchocercomata participants with increased eosinophil counts (aOR = 13.86, 95% CI [2.07-92.90], p = 0.007), ENR x10 (aOR = 1.42, 95% CI [1.05-1.93], p = 0.025), EMR (aOR = 2.64, 95% CI [1.25-5.60], p = 0.011), EBR (aOR = 1.07, 95% CI [1.01-1.10], p = 0.020) and ELR x10 (aOR = 1.69, 95% CI [1.14-2.51], p = 0.009) were more likely to have microfilaridermia.
    CONCLUSIONS: Elevated eosinophil counts with higher ENR, EMR, EBR and ELR levels are significantly associated with microfilaridermia in onchocercomata participants. Combining BCRs with eosinophil count significantly led to an improvement in the conventional model for predicting microfilaridermia.
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  • 文章类型: Journal Article
    Elaeophosis,丝虫感染,是北美野生有蹄类动物的寄生虫病;然而,我们对Schneideri与驼鹿(Alcesalces)发病率和死亡率的相关性的理解是不完整的。在2020年3月至2022年7月之间,对爱达荷州的61只Shiras驼鹿(Alcesalcesshirasi)进行了尸检和组织病理学检查,US.在41名成年人(大于1岁)中,21头驼鹿来自爱达荷州北部,20人来自爱达荷州东南部。24%的人被诊断为Elaeophorosis(41个中的10个)。所有10只感染的驼鹿都来自爱达荷州东南部;来自爱达荷州北部的21只驼鹿均未被感染。没有幼年驼鹿(来自北部的9只和来自爱达荷州东南部的11只)被感染。在10只感染的驼鹿中,有9只在组织学上检测到微丝虫,在与病变相关的脑组织中最一致,该病变表明由于微丝虫或纤维蛋白血栓阻塞小动脉和毛细血管引起的神经实质缺血性损伤,包括水肿,坏死,和神经胶质结节.在头部的其他组织中发现的微丝虫,包括眼睛,舌头,和一些动物的耳廓,以及在肺部,心,肝脏,和肾脏,通常与炎症有关。10只被感染的驼鹿中有3只由于脱毛病而长出了耳朵,四个人表现出异常行为,这可能是由于与大脑中的施氏细丝菌相关的神经病理学。
    Elaeophorosis, infection by the filarial worm Elaeophora schneideri, is a parasitic disease of wild ungulates in North America; however, our understanding of the relevance of E. schneideri to moose (Alces alces) morbidity and mortality is incomplete. Between March 2020 and July 2022, necropsy and histopathology were performed on 61 Shiras moose (Alces alces shirasi) in Idaho, US. Among the 41 adults (greater than 1 yr old), 21 moose were from northern Idaho, and 20 were from southeastern Idaho. Elaeophorosis was diagnosed in 24% (10 of 41). All 10 infected moose were from southeastern Idaho; none of the 21 moose from northern Idaho were infected. No juvenile moose (nine from northern and 11 from southeastern Idaho) were infected. Microfilariae were detected histologically in 9 of 10 infected moose, most consistently in brain tissue associated with lesions indicative of ischemic injury to the neuroparenchyma attributed to occlusion of arterioles and capillaries by microfilariae or fibrin thrombi, including edema, necrosis, and glial nodules. Microfilariae found in other tissues of the head, including the eye, tongue, and pinnae of some animals, as well as in lung, heart, liver, and kidney, typically were associated with inflammation. Three of the 10 infected moose had cropped ears attributed to elaeophorosis, and four exhibited abnormal behavior, which may have been due to neuropathology associated with E. schneideri microfilariae in the brain.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景由于过去三十年眼科文献中缺乏报道,在发达国家执业的新一代眼科医生对一些热带眼病并不十分熟悉。由于世界全球化或来自撒哈拉以南非洲的移民涌入,在眼科诊所中经常遇到外来视网膜疾病。
    方法:多中心病例系列脉络膜视网膜炎或视神经炎,病因不明,使用连续多模态成像。
    结果:有4例病例根据其居住在流行地区的快速河流附近而被诊断为眼部盘尾丝虫病,多模态成像,长期随访显示进行性疾病和其他疾病的阴性检查。特征性表现包括乳头周围脉络膜炎伴视神经炎或萎缩,微丝虫病的视网膜下束,多灶性脉络膜视网膜病变周围的进行性RPE萎缩,视网膜下白色或结晶点,和对伊维菌素的反应。在这种脉络膜视网膜炎患者中通常没有典型的皮肤发现,从而使诊断更具挑战性。
    结论:熟悉盘尾丝虫病的无数眼部表现,对居住在流行地区的受试者高度怀疑有助于正确诊断和实施适当的治疗。盘颈脉络膜视网膜炎是一种缓慢的,阴险的,进步,和长期的多形性疾病。
    BACKGROUND: Newer generation ophthalmologists practicing in the developed world are not very familiar with some tropical ocular diseases due to the absence of reports in the ophthalmic literature over the past thirty years. Because of world globalization or due to influx of immigrants from sub-Saharan Africa, exotic retinal diseases are being encountered more often in ophthalmology clinics.
    METHODS: A multicenter case series of chorioretinitis or optic neuritis with obscure etiology that used serial multimodal imaging.
    RESULTS: Four cases qualified with the diagnosis of presumed ocular onchocerciasis based on their residence near fast rivers in endemic areas, multimodal imaging, long term follow-up showing progressive disease and negative workup for other diseases. Characteristic findings include peripapillary choroiditis with optic neuritis or atrophy, subretinal tracts of the microfilaria, progressive RPE atrophy around heavily pigmented multifocal chorioretinal lesions of varying shapes, subretinal white or crystalline dots, and response to ivermectin. Typical skin findings are often absent in such patients with chorioretinitis rendering the diagnosis more challenging.
    CONCLUSIONS: Familiarity with the myriad ocular findings of onchocerciasis, and a high-degree of suspicion in subjects residing in endemic areas can help in the correct diagnosis and implementation of appropriate therapy. Onchocercal chorioretinitis is a slow, insidious, progressive, and prolonged polymorphous disease.
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