Ocular thelaziosis: an emerging human parasitosis in Europe.

Ocular thelaziosis is a parasitosis distributed mainly in East Asia, but increasingly described in Europe in different domestic and wild animals, including dogs, different wild canids and lagomorphs, and exceptionally in humans. In Spain, in some areas, a high infection prevalence rate has been described in domestic canids, which may lead to an increase in human cases. However, the description of human cases is still exceptional, which suggests that they are probably underdiagnosed. A case of ocular thelaziosis in a 2-year-old girl from an urban environment is described.

Social media as a tool for detecting underdiagnosed parasitic infections: the case of spirocercosis.

Spirocercosis is a parasitic disease caused by the nematode Spirocerca lupi that affects several canids around the world. In Costa Rica, few spirocercosis cases have been reported; however, it is suspected that the infection is currently underdiagnosed. As seen during the COVID-19 pandemic, social media has sped up the spread of scientific knowledge, raising practioner's awareness of the epidemiology and signs and manifestations of infections. The aim of this work was to use social media as a tool for increasing awareness of spirocercosis among veterinarians and investigate the frequency of cases occurring in Costa Rica. Infographic material about the infection was disseminated by Whatsapp, Facebook, and Instagram from January 2021 to July 2022 using a public account of the Laboratory of Helminthology of the University of Costa Rica. In addition, Google Forms questionnaires were completed by veterinarians to report the number of spirocercosis cases in their clinics, associated manifestations, diagnosis, treatment, and outcome of the disease. Remarkably, since 2020, a six-fold increase in the number of cases per year was noted. Clinical manifestations matched those reported elsewhere, and one of every three dogs infected with S. lupi died spontaneously or required euthanasia because of the infection. This work suggests that S. lupi infection in Costa Rica may have been underdiagnosed in the last decade, and the knowledge and awareness of clinical personnel play a major role in the detection of this and other infectious diseases.

Human Thelaziosis Caused by Thelazia callipaeda Eyeworm, Hungary.

Ocular infections with Thelazia callipaeda eyeworms in Europe have become more common. We report a case in Hungary caused by T. callipaeda eyeworms in a 45-year-old woman who had no travel history abroad.

Thelazia callipaeda infection during phacoemulsification cataract surgery: a case report.

BACKGROUND: In August 2020, we found one case of thelazia callipaeda infection during phacoemulsification cataract surgery. This maybe the first report for thelazia callipaeda discovered during phacoemulsification cataract surgery in China. CASE PRESENTATION: An 85 years old farmer was found thelazia callipaeda infection during phacoemulsification cataract surgery. The patient admitted whose foreign body sensation was often found in the right eye in recent 2 months. The worm was then taken out with ophthalmic forceps and put into sterile normal saline. The worm was sent to the Eye Institute of Shandong University of Traditional Chinese Medicine for identification. After identification, the worm was regarded as the male thelazia callipaeda. The head is blunt and round, the tail end curls to the abdomen, and the long copulation spines protrudes from the cloaca. The conjunctival sac was washed carefully with a large amount of Sodium Lactate Ringer 's Solution. After operation, antibiotics, pranoprofen eye drops, and tobramycin dexamethasone eye drops were further applied. After continuous examination of conjunctival sac for 2 weeks, the patient's visual acuity maintained 20/20, confirming that there was no residual thelazia. CONCLUSIONS: This report highlights the physician should ask the patient's history carefully before operation and it is necessary to strengthen health publicity and education, maintaining clean environment and keeping personal eye hygiene.

A Second Case of Human Conjunctival Infestation With Thelazia gulosa and a Review of T. gulosa in North America.

We describe a second case of human infection caused by Thelazia gulosa (the cattle eye worm), likely acquired in California. For epidemiologic purposes, it is important to identify all Thelazia recovered from humans in North America to the species level.

First record of the nematode Echinocephalus pseudouncinatus (Gnathostomatidae, Spirurida) in an edible, commercial host, the pen shell Atrina maura (Bivalvia: Pinnidae).

We describe a nematode infestation of the Atrina maura, the most valuable pen shell fished in Mexico, for the first time. Observations by Mexican authorities indicated that parasites were found encysted in pen shell gonads. The aims of this study included: (i) to identify the parasite morphologically; (ii) to quantify the infestation in different tissues of the pen shell; and (iii) to establish the seasonal variation in gonadal development. During 2015, 10 to 40 pen shells were randomly collected each month from the same commercial bed, and gonads were preserved and processed histologically to establish the seasonal and monthly frequency of infested gonads. A subsample of 35 pen shells was used to identify the parasite and to characterize the infestation of the muscle, mantle, gonad, and digestive gland tissue components. All tissues were dissected, and parasites were collected, photographed, quantified, and adequately preserved for species identification using scanning electron microscopy. Prevalence, intensity of infestation, abundance and crowding data were analyzed by Quantitative Parasitology software and compared monthly and seasonally using a chi test and analysis of means. Results indicated that all parasites were juvenile (second stage) nematodes, Echinocephalus pseudouncinatus. Parasites were found only in muscle and gonad tissues in both male and female pen shells. Hyperpigmentation was observed in the muscle and atretic oocytes with phagocytosis in the gonads. The frequency of infested gonads was significantly higher during winter but was not related to shell size or sex (p > 0.05). A greater number of pen shells were observed to be infested during December and August and during pen shell spawning and development stages. The highest frequency of infested gonads (40%) occurred in December when the lowest temperature and chlorophyll a concentration were recorded. The effects of the biotic and abiotic parameters on this host-pathogen relationship need further research. This nematode species is related to species that are causal agents of gnathostomiasis, which may constitute a health hazard for raw muscle consumers and could affect the reproductive activity of pen shell.

First case of human Gongylonema pulchrum infection in Slovenia.

Nematodes of the genus Gongylonema infect a wide range of mammals worldwide but are only sporadically reported in humans. We describe a case of human infection with Gongylonema pulchrum in a 41-year-old man. The patient extracted the nematode from the submucosa under his tongue and correctly self-diagnosed the infection with the help of the Google search engine. In the laboratory, the collected nematode was confirmed as G. pulchrum microscopically by morphological analysis and genetically by amplifying and sequencing the parasite's rDNA. This is the first report of human G. pulchrum infection in Slovenia.

Thelazia callipaeda infection in a 5-month-old infant.

BACKGROUND: Thelazia callipaeda is the main causative organism in thelaziasis, commonly infecting orbital cavities and associated tissues of carnivores. Thelazia callipaeda infection is rarely reported in humans, especially in infants. CASE PRESENTATION: A 5-month-old male infant presented with 2 weeks of redness and increased secretions in the left eye. On examination, the left eye revealed the presence of one creamy thread-like mobile worm in the conjunctival sac. During surgical exploration, a total of 11 worms were extracted from the left eye. The worms were morphologically identified as seven female and four male T. callipaeda. Ocular symptoms resolved rapidly after the removal of the worms, with no recurrence after the 6-month follow-up. CONCLUSION: We present here detailed clinical and morphological information pertaining to T. callipaeda infection, which is considered to be a probably neglected parasitic disease of the eye. This case illustrates the importance of including thelaziasis into the differential diagnosis of ocular surface diseases, especially in infant patients.

A Pediatric Case of Thelaziasis in Korea.

In the present study, we intended to report a clinical pediatric case of thelaziasis in Korea. In addition, we briefly reviewed the literature on pediatric cases of thelaziasis in Korea. In the present case, 3 whitish, thread-like eye-worms were detected in a 6-year-old-boy living in an urban area and contracted an ocular infection known as thelaziasis incidentally during ecological agritainment. This is the first report of pediatric thelaziasis in Seoul after 1995.

[THE FIRST CASE OF OCULAR THELAZIASIS IN CROATIA].

The first case of ocular thelaziasis in a human male patient in Croatia is presented. Thelaziasis is a zoonosis caused by nematodes of the genus Thelazia, parasites of the conjunctival bags or tear ducts of mammals and birds. Two types of the genus Thelazia (T.) have been described as causes of infection in humans, T. callipaeda and T. californiensis. To date, less than 300 thelaziasis cases in humans have been reported. This zoonosis is very rare in humans in European countries, with a high incidence in Asian countries, especially in China, Thailand and Japan. Because of the high prevalence of the parasites in the Far East, T. callipaeda is called 'Oriental eye worm'. The first case of thelaziasis in Europe was described in 2008 in Italy and France, where cases in animals had already been reported. Seasonal occurrence of thelaziasis in Europe depends on the presence of the vector, fruit flies of Drosophilidae family, Phortica variegate as the most common type. Adult worm is milky white, females grow to 20 mm and males up to 12 mm. Dogs and cats are the most common sources of infection for humans, which occurs as unilateral ocular infection. The clinical picture of infection is similar to bacterial and allergic conjunctivitis with tearing and foreign body sensation. After removal of worms, clinical signs quickly disappear and there is no need for anthelmintic treatment. In the treatment of secondary infections, local antibiotics and corticosteroids can be applied. The 82-year-old male patient presented to outpatient ophthalmology clinic for occasional sensation of pain, itching, redness and tearing in his left eye during the last few days. His left eye was blind due to previous retinal detachment and had severe conjunctival and ciliary infection with large corneal abscess. Worm-like movement in the lateral canthus was observed. After topical anesthesia, seven worms were removed. Upon surgical extirpation of the parasite, the diagnosis of thelaziasis was verified by microbiological identification. Only two cases of Thelazia in dogs were reported in Croatia, in December 2013 and January 2014. It is important to bear in mind this cause of eye infections, especially when caused by larval stages that are difficult to identify. Untimely diagnosis and inadequate treatment lead to extended illness and complications. The appearance of this parasite in Croatian patients suggests the need for inclusion of the pathogen in the differential diagnosis of bacterial or allergic conjunctivitis.

Spirocerca lupi infection in a dog from southern Italy: an "old fashioned" disease?

Canine spirocercosis caused by Spirocerca lupi is a life-threatening helminthic disease featured by severe clinical signs and potential development of oesophageal neoplasia. This infection is considered fairly frequent in Europe but almost unknown in Italy, from where only few reports have been published in local journals at the beginning of the XXI century. In the present study, an autochthonous case of canine spirocercosis in a 2-year-old dog from southern Italy is described. The animal was admitted to a private veterinary clinic in the municipality of Potenza (Basilicata region) due to persistent dyspnoea, vomiting, and regurgitation. At the abdominal ultrasound, a mass (1.3 × 2 cm) was observed and, thereafter, surgically removed from the apical part of the stomach. A female specimen of S. lupi was morphologically identified during the histological examination of the nodule and its eggs were detected in the faeces. In addition, the morphological identification was confirmed by molecular amplification and sequencing of partial cox2 gene sequence of S. lupi. Veterinarians should be aware of the potential risks derived from infection with this spirurid, which requires specific diagnostic and preventive measures.

Fatal verminous pharyngitis and esophagitis caused by Streptocara incognita in mute swans (Cygnus olor).

Streptocara spp. infections are reported to cause gastritis, proventriculitis, esophagitis, and pharyngitis in various waterfowls, especially diving ducks. In the present paper, we describe severe fatal diphtheritic pharyngitis and esophagitis caused by Streptocara incognita in three female mute swans (Cygnus olor) in Bosnia and Herzegovina. Prior to death, the swans were showing signs of lethargy, anorexia, and reluctance to move. At necropsy, in all swans severe diphtheritic pharyngitis and esophagitis with deep, dark red hemorrhagic ulcerations were observed. Numerous thin, white, up to 1-cm-long nematodes, identified as S. incognita, were observed embedded in the pharyngeal and esophageal mucosa under the diphtheritic membranes. Histopathology revealed severe fibrinonecrotic inflammation with numerous cross-sections of the parasites. To the authors' knowledge, this is the first report of severe, fatal streptocariasis in mute swans.

Computed tomographic and radiographic characteristics of aortic lesions in 42 dogs with spirocercosis.

Spirocerca lupi is a common cause of vomiting, regurgitation, and sudden death in dogs that live in tropical or subtropical regions. Sudden death due to aortic rupture may occur with no preceding clinical signs. The purpose of this prospective study was to compare radiographic and computed tomographic (CT) characteristics of aortic lesions in a cohort of 42 dogs with endoscopically confirmed spirocercosis. Dorsoventral and right lateral recumbent thoracic radiographic findings were compared with pre- and postcontrast thoracic CT findings. Aortic mineralization was detected using CT in 18/42 dogs (43%). Three dogs had faint diffuse aortic wall mineralization. Using CT as the reference standard, radiographs had a sensitivity and specificity of 6% and 96%, respectively, for detecting aortic mineralization. A total of 20 aortic aneurysms were detected using CT in 15/42 dogs (36%). Using CT as the reference standard, radiographs had a sensitivity and specificity of 86% and 56%, respectively, for detecting aortic aneurysms. Respiratory motion, aortic displacement by esophageal masses and Spirocerca nodules adjacent to the aorta mimicked aneurysm formation on radiographs. Aortic thrombi were seen in two dogs in postcontrast CT images. Findings from this study indicated that aortic mineralization and aneurysm formation are common in dogs with spirocercosis. Findings also supported the use of pre- and postcontrast CT as effective methods for detecting and characterizing these lesions.

Thelazia callipaeda infestation in Bangladesh: a case report.

A 5 years old girl was admitted to Ophthalmology department of Mymensingh Medical College Hospital, Mymensingh with excessive watering, redness and movement of something in her right eye for last 2 months. She had unaided visual acuity- 6/6, matted eye lashes and mucoid discharge in right eye. Follicles were present on the fornices and lower palpebral conjunctiva of the same eye. On eversion of the right upper lid there were silicon tube like coiled moving structures seen at the lateral part of the upper fornics. Six nematodes were seen in the upper fornics around the duct of lacrimal glands. After removing the nematodes, one specimen was sent to parasitology department of Bangladesh Agriculture University for species identification. They reported that sending specimen is an adult "Thelazia Callipaeda". By the present study, the presence of human ocular T. callipaeda infestation is second reported case in Bangladesh. Ophthalmologists should be aware about parasitic infestation of conjunctiva.

[Buccal infection with Gongylonema pulchrum: an indigenous case in France]. / Infection buccale à Gongylonema pulchrum : un cas autochtone.

BACKGROUND: Although long known, infestations of the buccal mucosa by nematodes of the Gongylonema genus are rare, particularly in France. Herein we report a new case. PATIENTS AND METHODS: A 48-year old man consulted for itching in various parts of the buccal mucosa over the preceding weeks. The patient lived in a rural region in southern Alsace and had never visited Africa. His work comprised overseeing the unloading of flour at the port of Basel. The initial clinical examination was negative. However, the patient managed to photograph a filament previously present in his buccal mucosa, and to ultimately extract a worm. The latter was identified at the Strasbourg Institute of Parasitology by Pr Pesson as a nematode of the genus Gongylonema sp. pulchrum. No other treatment was considered necessary. DISCUSSION: It is important for dermatologists to be aware of this type of parasitosis. Its stereotyped clinical presentation allows ready diagnosis, but the possible absence of the parasite at the time of the visit may lead to a misdiagnosis of Ekbom syndrome (delusional parasitic infestation).

Spirocercosis and Parvovirus in an Imported Dog: Implications for Biosecurity and Foreign Infectious Disease Risk.

Increased international travel and importation of animals brings with it the potential for spread of infectious diseases. This report details a case in which an 8-month-old male mixed breed dog died shortly after arrival to the United States from complications secondary to spirocercosis, despite having been deemed healthy and approved for international travel. Four weeks following arrival, the dog developed mild tachypnea and diarrhea. Physical examination revealed moderate pyrexia with generalized cerebellar ataxia, moderate anemia, a mature neutrophilia, and severe panhypoproteinemia. Packed red blood cells were administered. The dog was diagnosed with pyothorax and decompensated with septic shock shortly thereafter. Necropsy revealed severe transmural esophagitis with intralesional Spirocerca lupi. Evaluation of the brain revealed cerebellar hypoplasia, and polymerase chain reaction of brain tissue was positive for canine parvovirus. Despite receiving a clean bill of health in its country of origin, this patient ultimately had evidence of 2 different infectious processes that pre-dated its arrival into the United States. While neither of these diseases posed a significant public health risk, this case highlights the role veterinarians play before and after international travel as important barriers against the spread of exotic diseases, and emphasizes that maintaining vigilance is paramount to that task.

[Epidemiological and clinical characteristics of human ocular helaziasis in China from 2011 to 2022 based on bibliometrics].

OBJECTIVE: To understand the clinical and epidemiological characteristics of human ocular thelaziasis patients in China. METHODS: Case reports regarding human ocular thelaziasis cases in China were retrieved in international and national electronic databases, including CNKI, VIP, CBM, Traditional Chinese Medical Literature Analysis and Retrieval System, Wanfang Database, PubMed and Web of Science from 2011 to 2022. Patients' gender, age, clinical symptoms, treatment, recurrence, site of infections, time of onset, affected eye, affected sites, number of infected Thelazia callipaeda, sex of T. callipaeda and source of infections were extracted for descriptive analyses. RESULTS: A total of 85 eligible publications were included, covering 101 cases of human ocular thelaziasis, including 57 males (56.44%) and 44 females (43.56%) and aged from 3 months to 85 years. The main clinical manifestations included foreign body sensation (56 case-times, 22.49%), eye itching (38 case-times, 15.26%), abnormal or increased secretions (36 case-times, 14.46%), tears (28 case-times, 11.24%) and eye redness (28 case-times, 11.24%), and conjunctival congestion (50 case-times, 41.67%) was the most common clinical sign. The most common main treatment (99/101, 98.02%) was removal of parasites from eyes using ophthalmic forceps, followed by administration with ofloxacin and pranoprofen. In publications presenting thelaziasis recurrence, there were 90 cases without recurrence (97.83%) and 2 cases with recurrence (2.17%). Of all cases, 51.96% were reported in four provinces of Hubei, Shandong, Sichuan, Hebei and Henan, and ocular thelaziasis predominantly occurred in summer (42.19%) and autumn (42.19%). In addition, 56.45% (35/62) had a contact with dogs. CONCLUSIONS: The human thelaziasis cases mainly occur in the continental monsoon and subtropical monsoon climate areas such as the Yellow River and the Yangtze River basin, and people of all ages and genders have the disease, with complex clinical symptoms and signs. Personal hygiene is required during the contact with dogs, cats and other animals, and individual protection is required during outdoor activities to prevent thelaziasis.

Diversity of Thelazia spp. in domestic cattle from Romania: epidemiology and molecular diagnosis by a novel multiplex PCR.

BACKGROUND: Thelaziosis is a neglected vector-borne disease caused by parasitic nematode worms of the genus Thelazia which affects various hosts. Limited attention has been given to ungulate-associated Thelazia species. Current diagnosis of thelaziosis and the identification/differentiation of species heavily relies on morphological features. Therefore, we conducted an epidemiological study in Romanian cattle, with the aim to obtain morphological and molecular data that can be used for species identification. METHODS: The eyes of 705 slaughtered cattle were sampled and subjected to morphological identification, morphometric analysis, and molecular characterization. PCR amplification and sequence analysis were performed based on the cytochromec oxidase subunit 1 (COI) gene. Statistical tests assessed the correlations between infection parameters and ecological or biogeographical factors. A novel PCR method was developed based on the consensus sequence from each species. Specific forward primers were designed for each of the three species, and a reverse primer (COIintR) was used for all reactions. A consensus thermal profile was established by gradient PCR amplification of each species separately. RESULTS: Of the sampled cattle, 19.3% were infected with Thelazia spp. Prevalence varied significantly with ecogeographical factors. A total of 585 Thelazia nematodes were recovered, with T. rhodesi being the most abundant, followed by T. skrjabini and T. gulosa. Morphometric and molecular analyses supported the morphological identification, yielding unique sequences for each species. From the 59 T. rhodesi specimens sequenced, 29 unique sequences were obtained, with a 99.1-99.85% nucleotide identity to the only other COI sequence present in GenBank®. All nine T. gulosa isolates were unique (99.37-100% nucleotide identity to other sequences), while T. skrjabini specimens displayed 98.47-100% nucleotide identity to the sole available sequence. CONCLUSIONS: Bovine thelaziosis is prevalent in Romania, raising concerns for animal welfare and potential economic impacts. Infected cattle grazing alongside vulnerable wild ruminants, such as the European bison, may affect conservation efforts. Our newly developed multiplex PCR shows promise as a valuable surveillance tool, enabling the detection of occult infections in apparently healthy animals through lachrymal secretion testing.