[Ocular thelaziosis in a dog in Germany - an autochthonous case?] / Okuläre Thelaziose bei einem Hund in Deutschland ­ ein autochthoner Fall?

Thelazia callipaeda is a vector-borne nematode transmitted by Phortica spp. (fruit flies) and one of the causes of mild to severe conjunctivitis and keratitis in dogs, cats, rabbits and humans. It has been formerly known as the oriental eye worm based on its geographic occurrence. By now, it has been shown to be endemic in several southern and eastern European countries as well as extending its geographic distribution further throughout Europe. In the present case report, T. callipaeda infection was diagnosed in a female dog from Germany. The dog was referred by a local veterinarian due to a treatment-resistant conjunctivitis. A comprehensive ophthalmologic examination revealed 3 adult eye worms in the conjunctival sac as well as on the bulbar side of the nictitating membrane of the left eye. These were identified by morphological features and molecular techniques as T. callipaeda and represented the primary cause of the dog's unilateral blepharospasm, hyperemic conjunctiva and epiphora. Treatment consisted of manual collection of the adult worms and the administration of moxidectin/imidacloprid as spot on (Advocate®, Bayer). All clinical signs resolved within one week after treatment. In Germany, ocular thelaziosis still represents a rare disease. Usually, it is diagnosed in cats and dogs either imported from abroad or accompanying the owners on holiday travels to endemic countries. The dog presented in this case report was born in Germany. Except for a one-week stay in the Netherlands 11 months before the symptoms began, it had never traveled abroad. Considering the prepatency of T. callipaeda, an autochthonous transmission in this case is highly probable.

Eye to eye: classification of conjunctival sac polystomes (Monogenea: Polystomatidae) revisited with the description of three new genera Apaloneotrema n. g., Aussietrema n. g. and Fornixtrema n. g.

Polystomes (Monogenea: Polystomatidae) of freshwater turtles are currently represented by five genera, namely Neopolystoma, Polystomoides, Polystomoidella, Uropolystomoides and Uteropolystomoides. These parasites can infect the urinary, oral and/or the conjunctival sac systems of their hosts, showing strict site specificity. A recent phylogenetic study showed that the two most diverse genera within chelonian polystomes, i.e. Neopolystoma and Polystomoides, are not monophyletic. Furthermore, polystomes infecting the conjunctival sacs of their host, except for one species, formed a robust lineage. A fusiform egg shape has been reported for conjunctival sac polystomes and it was assumed that this characteristic could be a good character for the systematics of polystomes. Our objective in the present work was, therefore, to study more in depth the morphology of polystomes collected from the conjunctival sacs of chelonians to find characters defining a putative new genus. To achieve this objective, more specimens were collected in 2018 and 2019 from turtles sampled in North Carolina and Florida (USA) to extend taxon sampling for the phylogenetic analysis. Morphological characters of relevant polystome specimens were re-examined from several collections from Asia, Australia, Europe, South Africa, South America and North America. Based on a Bayesian tree inferred from the analysis of four concatenated genes, namely 12S, 18S, 28S and COI, polystomes found in the conjunctival sacs were grouped in three distinct lineages, the first one including a single species infecting an Australian pleurodire turtle; the second one including eleven species infecting cryptodire turtles of South America, North America and Asia; and the last one including a single species infecting a softshell cryptodire turtle of North America. Based on observations of live specimens by Dr. Sylvie Pichelin and our morphological analysis, the conjunctival sac polystomes from Australian turtles are small, cannot extend their body significantly, have a spherical ovary and egg, have a large genital bulb and possess latero-ventral vaginae at the level of the testis. Based on observations of live specimens and morphological analysis of whole mounted specimens, polystomes of the second lineage share the following morphological characteristics: the ability to stretch out and double their length, a long oval ovary, a separate egg-cell-maturation-chamber, fusiform to diamond-shaped eggs with acute tips, small genital bulb and vaginae peripheral on the side of the body at the level of the testis. The polystome species of the third lineage occupies a basal position, has the ability to stretch out and possess an elongated ovary, a large fusiform egg with rounded tips, a small genital bulb and small latero-ventral vaginae at the level of the ovary. These three distinct conjunctival sac polystome lineages are herein described as separate new genera, Aussietrema, Fornixtrema and Apaloneotrema, respectively.

First report of canine ocular thelaziosis in the Republic of Moldova.

BACKGROUND: Countries of eastern Europe are considered, due to several risk factors, more vulnerable to infections with newly (re)emerging pathogens. During the last decade, in several European countries, reports of autochthonous cases of ocular thelaziosis due to Thelazia callipaeda have been published, posing a great concern from both veterinary and public health perspective. However, in the Republic of Moldova only limited epidemiological data are available regarding zoonotic vector-borne pathogens and, until now, no data exist on the zoonotic nematode T. callipaeda. METHODS: In September 2018, an 11-year-old dog, mixed-breed, intact male was referred to a private veterinary clinic from Chișinau, Republic of Moldova, with a history of 2 weeks of an ocular condition affecting the right eye. The ophthalmological exam revealed the presence of nematode parasites in the conjunctival sac and under the third eyelid. The collected parasites were identified by morphological techniques and molecular analysis. RESULTS: A total of 7 nematodes were collected, and 5 females and 2 males of T. callipaeda were identified morphologically. The BLAST analysis confirmed the low genetic variability of this parasite in Europe. The travel history of the patient allowed us to confirm the autochthonous character of the case. CONCLUSIONS: To the best of our knowledge, this is the first report of thelaziosis in dogs from the Republic of Moldova, which confirms the spreading trend of T. callipaeda and the existence of an autochthonous transmission cycle of this zoonotic parasite in the country.

Nematode Thelazia callipaeda is spreading across Europe. The first survey of red foxes from Slovakia.

Canine thalaziosis caused by the spirurid nematode Thelazia callipaeda has started to spread across Western and Central Europe during the last decade. In Slovakia, the first autochthonous cases of this infection were recorded in 2016 in four dogs from the south-eastern part of the country. In August 2017 other autochthonous case, again from the same locality, was reported. Seeing that red foxes are considered the main reservoir hosts for T. callipaeda, their examination could provide an integrated view of the real parasite distribution. Within the present study, 523 red foxes were examined by necropsy, and T. callipaeda nematodes were recovered from the conjunctival sacs of 7 animals, which represents an overall positivity of 1.3%. Six infected foxes originated in eastern Slovakia, which is consistent with the area where positive dogs were recently found. Also, single positive red fox was found in north-western Slovakia. Regarding morphology and morphometry, the specimens recovered from the foxes in this study were evaluated as larger in size when compared to nematodes isolated from Slovak dogs as well as dogs and foxes from other studies. BLAST analyses of the cox1 gene showed that all specimens isolated from Slovak red foxes were identified as haplotype 1 which circulated also in other European countries. Considering that majority of the infected animals, dogs and foxes, came from Kosice region, we can presume that this area might become endemic in a short period of time.

An unusual presentation of lacrimal gland dirofilariasis.

Dirofilariasis is a helminthic infection caused by filarial parasite of the genus Dirofilaria. It is a common zoonotic disease mostly affecting canines and uncommon in humans. It is endemic to Mediterranean countries, with few reports from other parts of the world. The clinical forms in humans are pulmonary, subcutaneous, and ocular. Ocular involvement is rare. We report a case of lacrimal gland dirofilariasis, an unusual ocular presentation which masquerades as a lacrimal gland tumor. Ours would be the third reported case in the world and first in India. This case was managed with excision of the lacrimal gland mass. Postoperatively the patient recovered completely and there has been no recurrence in the 1-year follow-up.

Tracking platyhelminth parasite diversity from freshwater turtles in French Guiana: First report of Neopolystoma Price, 1939 (Monogenea: Polystomatidae) with the description of three new species.

BACKGROUND: Polystomatid flatworms in chelonians are divided into three genera, i.e. Polystomoides Ward, 1917, Polystomoidella Price, 1939 and Neopolystoma Price, 1939, according to the number of haptoral hooks. Among the about 55 polystome species that are known to date from the 327 modern living chelonians, only four species of Polystomoides are currently recognised within the 45 South American freshwater turtles. METHODS: During 2012, several sites in the vicinity of the cities Cayenne and Kaw in French Guiana were investigated for freshwater turtles. Turtles were collected at six sites and the presence of polystomatid flatworms was assessed from the presence of polystome eggs released by infected specimens. RESULTS: Among the three turtle species that were collected, no polystomes were found in the gibba turtle Mesoclemmys gibba (Schweigger, 1812). The spot-legged turtle Rhinoclemmys punctularia (Daudin, 1801) was infected with two species of Neopolystoma Price, 1939, one in the conjunctival sacs and the other in the urinary bladder, while the scorpion mud turtle Kinosternon scorpioides (Linnaeus, 1766) was found to be infected with a single Neopolystoma species in the conjunctival sacs. These parasites could be distinguished from known species of Neopolystoma by a combination of morphological characteristics including body size, number and length of genital spines, shape and size of the testis. They were also differentiated at the molecular level using the cox1 gene marker. Based on morphological and genetic evidences, three new species are described herein, namely Neopolystoma cayensis n. sp. and Neopolystoma guianensis n. sp. from the bladder and the conjunctival sacs of R. punctularia, respectively, and Neopolystoma scorpioides n. sp. from the conjunctival sacs of K. scorpioides. However the monophyly of Polystomoides and Neopolystoma is still questioned regarding their phylogeny based on a dataset comprising four concatenated genes, namely, 18S, 28S and 12S rRNA genes and cox1. CONCLUSIONS: In addition to these being the first chelonian polystomes to be reported and described from French Guiana, they represent the first polystomes from the hosts K. scorpioides and R. punctularia and the first representatives of Neopolystoma from South America. Chelonian polystomes now require an in-depth morphological study to reconcile the taxonomy of the genera with species evolution.

New Cases of Thelazia callipaeda Haplotype 1 in Dogs Suggest a Wider Distribution in Romania.

Thelazia callipaeda is an emerging vector-borne zoonotic helminth parasitizing the conjunctival sac of a broad spectrum of definitive hosts, such as dogs, cats, rabbits, wild carnivores, and humans. Its presence is associated with mild to severe ocular disease. Here, we report two new clinical cases in dogs originating from western and southern Romania, with no travel history. On clinical examination, the nematodes were retrieved from the conjunctival sac and identified using morphological keys and molecular tools. Twenty-two adult nematodes (8 males, 14 females) were collected and were identified as T. callipaeda by morphology. The molecular analysis revealed a 100% identity with haplotype h1 of T. callipaeda. This study describes the occurrence of new autochthonous cases of thelaziosis in Romania, reinforcing the spreading trend of this zoonotic eyeworm and highlighting the need for increased awareness among medical and veterinary practitioners. Moreover, we provide additional molecular evidence for the exclusive distribution of haplotype 1 of T. callipaeda in Europe.

Miíase na topografia de saco lacrimal / Lacrimal sac topography myiais

RESUMO A miíase é a infestação dos tecidos humanos por larvas Diptera. O comprometimento ocular é raro. Os autores apresentam um caso de miíase na topografia do saco lacrimal e discutem as modalidades terapêuticas para o tratamento desta doença.

ABSTRACT Myiasis is the invasion of human tissues by Diptera larvae. Ocular involvement is rare. The objective of this paper is to report a case of myiasis in the topography of the lacrimal sac and discuss current treatments for this disease.

Pathological Response of Northern Bobwhites to Oxyspirura petrowi Infections.

The effects of Oxyspirura petrowi infections in northern bobwhites ( Colinus virginianus ) are not well understood. While studies have reported O. petrowi infections, none has histopathologically examined the eye surface and intraorbital glands to assess cellular-level impacts associated with infection. This study is the first to document the histopathology associated with O. petrowi infections. Oxyspirura petrowi occurred on the eye surface as well as in the conjunctiva, lacrimal ducts, lacrimal glands, and Harderian glands. Histopathology showed infections of O. petrowi caused cellular damage to these tissues, scarring and interstitial keratitis of the cornea, and acinar atrophy of the Harderian gland.

Unusual presentation of Enterobius vermicularis in conjunctival sac.

We report an unusual case of extraintestinal infection with adult Enterobius vermicularis worms in the conjunctival sac of a two-and-a-half year old boy from Alipurduar, West Bengal, India. Only two other similar cases have been reported in the English literature, one from Assam, India in 1976, and the other from Illinois and California in 2011.

Lacrimal sac rhinosporidiosis: clinical profile and surgical management by modified dacryocystorhinostomy.

PURPOSE: To describe the clinical profile and surgical management of patients with lacrimal sac rhinosporidiosis. METHODS: This is a retrospective interventional case series. Eighteen patients, who were clinically diagnosed as isolated lacrimal sac rhinosporidiosis between October 2009 to January 2012, were included in the study. Detailed history, including whether there was exposure to stagnant bathing water, was noted. All patients underwent modified dacryocystorhinostomy (DCR) under general anaesthesia. RESULT: Out of 18 patients, 14 were male and 4 were female. Rhinosporidiosis was more prevalent in the 25 to 34 years age group. The most common clinical presentation was a doughy swelling over the lacrimal sac area, present in all cases. Twelve patients (66.67%) had a history of bathing in stagnant water. After modified DCR operation, all patients were followed for one year and only two patients had recurrence of their disease. CONCLUSION: Patients with lacrimal sac rhinosporidiosis usually present with a soft, doughy swelling in the lacrimal sac area. Bathing in stagnant water is a common risk factor. A modified DCR yields excellent outcomes.

Complete agenesis of major salivary glands.

A 4 year-old female patient was treated for persistent right-sided dacryocystitis and xerostomia. MRI was performed to screen for a dry syndrome; which resulted in the diagnosis of agenesis of the parotid and submandibular glands as well as lacrimal duct malformation. An MRI of each parent was normal. The mother's history revealed 4 days of pyrexia during the 8th week of amenorrhea. This was an isolated case, with no family history, characterized by a febrile episode during pregnancy at the period of main salivary gland genesis. Epigenetic mechanisms could be implicated.

Ocular and adnexal rhinosporidiosis : the clinical profile and treatment outcomes in a tertiary eye care centre.

INTRODUCTION: Rhinosporidiosis may mimic a burst chalazion or a simple conjunctival polyp. OBJECTIVE: To study the demography, histopathological evaluation, treatment modalities, their outcomes and recurrence rates in patients clinically and histopathologically diagnosed as ocular and adnexal rhinosporidiosis. PATIENTS AND METHODS: The study was conducted in the Department of Orbit, Oculoplasty and Oncology at a tertiary eye care centre in South India. Fifty patients were included who were diagnosed with ocular and adnexal rhinosporidiosis. The conjunctival and lid mass underwent complete excision. All patients with rhinosporidiosis of the lacrimal system under went dacryocystectomy (DCT) with care taken to avoid spilling the spores. Diagnosis was confirmed histopathologically. RESULTS: The mean age at presentation was 30.42 years, standard deviation( SD) being 16.89 (1 - 70 years). The mean follow-up was 14.2 months (12 months - 18 months) . The most common site was conjunctiva (n = 26 eyes, 52 %), followed by the lacrimal sac ( n = 13, 26 %) and lids (n = 11, 22 %). All the cases were treated by surgical excision with cautery at the base. There was a single recurrence (2 %) involving the lacrimal sac. Endonasal polypectomy combined with exploration in the sac region was done. There were no further recurrences during subsequent follow-up. CONCLUSION: Rhinosporidiosis is an ocular disorder with high recurrence rates reported. We recommend histopathological examination in every case following excision biopsy for conclusive diagnosis. Recurrence rates can be very low if a complete meticulous excision coupled with cauterization of the lesion is performed.

Evaluation of the presence of Leishmania spp. by real-time PCR in the lacrimal glands of dogs with leishmaniosis.

Leishmania infantum infection is highly prevalent in endemic areas. Dogs with leishmaniosis may develop keratoconjunctivitis sicca (KCS). The goals of this study were (1) to quantify Leishmania amastigotes in the Meibomian glands (MG), main lacrimal gland (MLG) and nictitating membrane gland (NMG) from dogs with leishmaniosis; (2) to compare these results to immunohistochemistry (IHC), and (3) to explore the association between the Leishmania parasite load and the presence of ocular clinical signs. Twenty-five dogs diagnosed with leishmaniosis were included. MG, MLG and NMG from both eyes were collected. Histopathology, IHC and real-time PCR were performed. All specimens yielded positive real-time PCR results. For all three glands, samples from dogs with ocular clinical signs had mean ΔCt (cycle threshold) values significantly lower (higher parasite loads) than those from dogs without signs. Cut-off values of ΔCt<0, ΔCt<4 and ΔCt<4.9 for MG, MLG and NMG, resulted in a likelihood ratio of positives of 5.9, 6.38 and 6.38, respectively. Samples with ΔCt values below the reported cut-off were significantly more likely to display clinical signs related to KCS than those with results above the cut-off, for all three glands. Similarly, ΔCt values below the cut-off were significantly associated with positive IHC. In this study real-time PCR has been standardised for use in MG, MLG and NMG. A cut-off value established for each of these tissues may aid the clinician in the discrimination between ocular signs related to Leishmania from those associated with other causes of KCS.

Oculosporidiosis in a tertiary care hospital of western Orissa, India: a case series.

The authors present a case series of 54 subjects of Rhinosporidium. They were reported in two years at a tertiary care hospital of Western Orissa. The clinically diagnosed cases by ophthalmologists were confirmed by histopathological samples following surgery. In our series, we noted Rhinosporidium seeberi organisms as the main causative agent. Males were affected three times more than females. Children less than 10 years of age comprised more than 50% of our series. In 91% of cases, the conjunctiva was the site of this infection. Total excision of fungal mass was carried out in all cases and two cases had recurrence between 9 and 12 months following intervention. Although this is an endemic area for such infestation, unilateral manifestation observed in all cases is interesting to note. Low recurrence rate in limited follow-up period could be due to early detection and standard management.

A case of lacrimal gland dirofilariasis.

A patient with a diagnosis of chronic and idiopathic unilateral dacryoadenitis was submitted to our clinic for diagnostic reasons from a regional hospital. Within a period of 1 year, this was the second onset of a swelling in the region of the lacrimal gland which - unlike the first time - showed resistance to antibiotic treatment. The patient's general and ophthalmic condition was good, and his only complaint was of cosmetic nature because of the disfiguring swelling in the lateral part of the left upper eyelid. Basic laboratory findings showed no abnormalities and radiographic imaging showed enlargement of the left lacrimal gland without bony destruction. Guided by epidemiological data for noninfectious dacryoadenitis we decided to perform excisional biopsy of the left lacrimal gland. To our surprise, the pathologist verified the presence of a worm of the genus Dirofilaria, which is, to the best of our knowledge, the second reported case of lacrimal gland dirofilariasis in the literature and the second reported case of such a disease in Croatia.

Anatomical route of invasion and protective mucosal immunity in Trypanosoma cruzi conjunctival infection.

Trypanosoma cruzi is a protozoan parasite that can initiate mucosal infection after conjunctival exposure. The anatomical route of T. cruzi invasion and spread after conjunctival parasite contamination remains poorly characterized. In the present work we have identified the sites of initial invasion and replication after contaminative conjunctival challenges with T. cruzi metacyclic trypomastigotes using a combination of immunohistochemical and real-time PCR confirmatory techniques in 56 mice between 3 and 14 days after challenge. Our results demonstrate that the predominant route of infection involves drainage of parasites through the nasolacrimal duct into the nasal cavity. Initial parasite invasion occurs within the ductal and respiratory epithelia. After successive waves of intracellular replication and cell-to-cell spread, parasites drain via local lymphatic channels to lymph nodes and then disseminate through the blood to distant tissues. This model of conjunctival challenge was used to identify immune responses associated with protection against mucosal infection. Preceding mucosal infection induces mucosal immunity, resulting in at least 50-fold reductions in recoverable tissue parasite DNA in immune mice compared to controls 10 days after conjunctival challenge (P < 0.05). Antigen-specific gamma interferon production by T cells was increased at least 100-fold in cells harvested from immune mice (P < 0.05). Mucosal secretions containing T. cruzi-specific secretory immunoglobulin A harvested from immune mice were shown to protect against mucosal parasite infection (P < 0.05), demonstrating that mucosal antibodies can play a role in T. cruzi immunity. This model provides an important tool for detailed studies of mucosal immunity necessary for the development of mucosal vaccines.

Dacryoadenitis associated with Acanthamoeba keratitis.

OBJECTIVE: To report the incidence of dacryoadenitis as a symptom associated with Acanthamoeba keratitis. METHODS: We investigated all cases of Acanthamoeba keratitis (20 patients and 21 eyes) diagnosed and treated at Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Japan, between May 1, 1994, and November 30, 2005. We recorded the incidence of dacryoadenitis diagnosed using clinical signs of lacrimal gland swelling and pain on pressure, computed tomography, magnetic resonance imaging, and histopathologic analysis. RESULTS: Eight eyes (38%) of 8 patients had dacryoadenitis simultaneously with Acanthamoeba keratitis. Dacryoadenitis was diagnosed using histopathologic analysis and computed tomography in 1 patient, histopathologic analysis and magnetic resonance imaging in 1, magnetic resonance imaging in 2, and clinical signs alone in 4. Histopathologic examination in 2 patients revealed moderate infiltration of lymphocytes and plasma cells in the lacrimal gland compatible with dacryoadenitis. No Acanthamoeba organisms were found in the lacrimal gland. The standard protocol for Acanthamoeba keratitis was performed without particular treatment of dacryoadenitis in all patients. Lacrimal gland swelling improved after a mean of 10 weeks (range, 4-17 weeks) in conjunction with symptoms of keratitis; however, 1 patient (patient 1) required levator muscle surgery and blepharoplasty for residual ptosis. CONCLUSION: Dacryoadenitis is a clinical finding associated with Acanthamoeba keratitis.