Human Ocular Thelaziasis: A Case Report.

Thelaziasis is a zoonotic disease which affects the eye of domestic and wild carnivores caused by the nematode Thelazia. It is transmitted to humans by secretophagous arthropod-borne zoophilic nonbiting flies of the family Drosophilidae. Human thelaziasis is rare and occurs in poor socio-economic families of the rural locations where people live in close proximity with animals. A one and halfyear-old was presented to the outpatient ophthalmology clinic after her mother noticed a whitish, thread-like worm in her right eye. A total of four worms were mechanically removed from her right eye. All the collected worms were gravid female nematodes of Thelazia species. The present case of human ocular thelaziasis from Palpa, Nepal is presented for its rarity.

Etiology of Central Nervous System Infections in a Rural Area of Nepal Using Molecular Approaches.

The etiology of infections of the central nervous system (CNS) in Nepal often remains unrecognized because of underdeveloped laboratory facilities. The aim of this study was to investigate the etiology of CNS infections in a rural area of Nepal using molecular methods. From November 2014 to February 2016, cerebrospinal fluid (CSF) was collected from 176 consecutive patients presenting at United Mission Hospital in Tansen, Nepal, with symptoms of possible CNS infection. After the CSF samples were stored and transported frozen, polymerase chain reaction (PCR) was performed in Sweden, targeting a total of 26 pathogens using the FilmArray® ME panel (BioFire, bioMerieux, Salt Lake City, UT), the MeningoFinder® 2SMART (PathoFinder, Maastricht, The Netherlands), and an in-house PCR test for dengue virus (DENV), Japanese encephalitis virus (JEV), and Nipah virus (NiV). The etiology could be determined in 23%. The bacteria detected were Haemophilus influenzae (n = 5), Streptococcus pneumoniae (n = 4), and Neisseria meningitidis (n = 1). The most common virus was enterovirus detected in eight samples, all during the monsoon season. Other viruses detected were cytomegalovirus (n = 6), varicella zoster virus (n = 5), Epstein-Barr virus (n = 3), herpes simplex virus (HSV) type 1 (HSV-1) (n = 3), HSV-2 (n = 3), human herpes virus (HHV) type 6 (HHV-6) (n = 3), and HHV-7 (n = 2). Cryptococcus neoformans/gatti was found in four samples. None of the samples were positive for DENV, JEV, or NiV. Of the patients, 67% had been exposed to antibiotics before lumbar puncture. In conclusion, the etiology could not be found in 77% of the samples, indicating that the commercial PCR panels used are not suitable in this setting. Future studies on the etiology of CNS infections in Nepal could include metagenomic techniques.