RESUMO
Humans are occasionally inadvertently infected with dirofilariae, the zoonotic nematodes. We report two cases of human dirofilariasis in South Africa, an area apparently non-endemic for this infection. Dirofilariasis is frequently misdiagnosed, so increased awareness of this entity in areas that are non-endemic is essential for prevention of inappropriate investigations and invasive therapy.
RESUMO
PURPOSE: To describe the ocular inflammatory manifestations and clinical characteristics of children with Human Immunodeficiency Virus (HIV)-associated arthritis. METHODS: A retrospective review of the charts of children with chronic uveitis and HIV-associated arthritis seen between June 2004 and September 2006 at Inkosi Albert Luthuli Central Hospital, Durban, South Africa. The following data were analyzed: age at presentation, gender, race/ethnicity, rheumatologic problems, uveitic diagnosis, laboratory findings, and ocular complications. RESULTS: Seven black African males with a mean age of 9 years (range, 4 to 13 years) were identified. There were no other significant laboratory findings apart from HIV; all patients were antinuclear antibody negative. Arthritis was polyarticular in 6 patients and pauciarticular in 1. Four patients had intermediate uveitis and 3 patients had nongranulomatous anterior uveitis. Visual acuity ranged from 20/20 to hand movements. Ocular complications included cataract, cystoid macular edema, hypotony, pupillary membranes, band keratopathy, posterior synechiae and optic disk edema. CONCLUSIONS: HIV-associated arthritis and uveitis in children is a clinical syndrome that may be associated with severe sight-threatening intraocular inflammation. Routine eye screening in HIV-positive children, particularly those with arthritis, is warranted to facilitate prompt treatment.
