RESUMEN
We conducted an epidemiologic investigation of an outbreak of ocular disease among children to determine whether the disease was linked to Emmonsia sp., a rarely-reported fungus and an agent of adiaspiromycosis. Using an unmatched case-control study design, we compared case-patients with asymptomatic controls randomly selected from the population. Scleral biopsies were analyzed microscopically. Of 5,084 children examined, 99 case-patients were identified; mean age (+1 SD) was 11.0 +/- 4.4 years. Symptoms included photophobia (57%), ocular pain (42%), and blurred vision (40%). In the multivariate analysis, risk factors included diving in the Araguaia River (odds ratio 5.2; 95% confidence interval 2.4-12.0). Microscopy identified foreign bodies consistent with adiaconidia. This outbreak probably resulted from foreign-body-type reactions to adiaspiromycosis conidia after initial irritation caused by conjunctival contact with spicules of sponges in the river. Symptomatic children responded to corticosteroid treatment. Adiaspiromycosis is a preventable cause of ocular disease in the Amazon region.
Asunto(s)
Chrysosporium/patogenicidad , Enfermedades Transmisibles Emergentes/epidemiología , Conjuntivitis/epidemiología , Infecciones Fúngicas del Ojo/epidemiología , Poríferos/microbiología , Uveítis Anterior/epidemiología , Adolescente , Animales , Brasil/epidemiología , Estudios de Casos y Controles , Niño , Preescolar , Chrysosporium/aislamiento & purificación , Enfermedades Transmisibles Emergentes/diagnóstico , Enfermedades Transmisibles Emergentes/microbiología , Conjuntivitis/diagnóstico , Conjuntivitis/microbiología , Brotes de Enfermedades , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/microbiología , Femenino , Agua Dulce , Humanos , Lactante , Masculino , Uveítis Anterior/diagnóstico , Uveítis Anterior/microbiología , Adulto JovenRESUMEN
In a recent outbreak of human ocular injuries that occurred in the town of Araguatins, at the right bank of Araguaia river, state of Tocantins, Brazil, along the low water period of 2005, two patients (8 and 12-year-old boys) presented inferior adherent leukoma in the left eye (OS), and peripherical uveites, with snowbanking in the inferior pars plana. The third one (13-year-old girl) showed posterior uveites in OS, also with snowbanking. Histopathological analysis of lensectomy material from the three patients and vitrectomy from the last one revealed several silicious spicules (gemmoscleres) of the freshwater sponges Drulia uruguayensis and D. ctenosclera. This work brings material evidences, for the first time in the literature, that freshwater sponge spicules may be a surprising new etiological agent of ocular pathology.
Asunto(s)
Humanos , Animales , Masculino , Femenino , Niño , Adolescente , Catarata/parasitología , Poríferos , Agudeza Visual , Baja Visión/parasitología , Extracción de Catarata , Catarata/diagnóstico , Fondo de Ojo , Lentes Intraoculares , Ríos , Vitrectomía , Baja Visión/diagnóstico , Baja Visión/cirugíaRESUMEN
In a recent outbreak of human ocular injuries that occurred in the town of Araguatins, at the right bank of Araguaia river, state of Tocantins, Brazil, along the low water period of 2005, two patients (8 and 12-year-old boys) presented inferior adherent leukoma in the left eye (OS), and peripherical uveites, with snowbanking in the inferior pars plana. The third one (13-year-old girl) showed posterior uveites in OS, also with snowbanking. Histopathological analysis of lensectomy material from the three patients and vitrectomy from the last one revealed several silicious spicules (gemmoscleres) of the freshwater sponges Drulia uruguayensis and D. ctenosclera. This work brings material evidences, for the first time in the literature, that freshwater sponge spicules may be a surprising new etiological agent of ocular pathology.