Diagnostic dilemma: A woman had something in her eye — and it turned out to be parasitic worms
The patient: A 41 -year -old woman in Beijing
Symptoms: The patient went to the hospital because she felt like there was something right. When the doctors looked at his eye, they noted that its external surface, the corneaseemed damaged, but they found no foreign bodies. They prescribed the patient’s eye drops, one type to treat eye irritation and another with antibiotics to help prevent infection.
What happened next: The drops of the eyes did not facilitate the symptoms of the woman, and she returned to the hospital the following month with the same feeling that something was stuck in her eyes. She also reported redness and persistent itching.
When the doctors re -examined his eye, this time, they noticed that the fabric under his upper eyelid looked inflamed and wore “significant” bumps, they wrote in a Case report. They used a device called retractor for the eyelid to remove the eyelid and examine the fabric more closely.
The diagnosis: There, the doctors found four small white worms weoring. The medical team applied topical anesthesia – a medication to numb the area – then removed the worms with pliers, and sent the extracts to the laboratory. A microscopic and genetic analysis of the worms revealed that they were a species called Thelazia callipaedaalso known as OrientedThis can cause a parasitic infection called theater.
Treatment: After extracting the worms of the woman’s eyelid, the doctors rinsed the eye with a solution to “make sure that no verse remained”, they wrote in the report. He was also prescribed an eye ointment containing an antibiotic to use several times a day, which has helped reduce the risk of a subsequent bacterial infection.
“A week later, the patient’s symptoms were significantly relieved and no recurrence was reported in the following two months,” his doctors wrote.
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Which makes the case unique: The theater is relatively rare in humans. It is seen more often in animals, including cattle, dogs, cats, foxes and rabbits. The worms are transmitted to these animals via flies which carry the parasite. The flies feed on the tears of animals and place the larvae of worm in their eyes as they do. The larvae then matured inside the eye – often in the eyelid, in particular – before being picked up by another passing fly, continuing their life cycle. A variety of Thelazia species can cause infection, but T. Callipaeda is the most common culprit.
Historically, most cases of theater in humans have been reported in Asia, China reporting the greatest number overall. In more than 100 years – between the first known human cases in the country in 1917 and 2018 – Just over 650 cases have been reported.
“Théaziasis cases have been reported mainly in agricultural areas and areas with high contact with pets,” noted the authors of the report. In addition, many people affected by the disease report that farming and / or they specifically remember having been recently exposed to flies.
In this case, however, the source of women’s infection was not 100%certain. The patient was an office worker based in an urban center, and she did not remember recent exposure to flying insects. However, she said she had a pet cat who had recently had an eye infection. “The pathological examination of the cat was not carried out as the patient refused it,” noted her doctors. Thus, while the cat was the likely source of the worms, it was not officially confirmed.
The authors of the report concluded that, even in urban centers, doctors should be aware of the symptoms of theater and consider it as a potential diagnosis. Symptoms can go from light to serious, including the feeling of something in your eye, itching, eye pain, bleeding or inflammation of the fabric covering the eyes and eyelids, ulcers in cornea and vision changes. Parasite infection can also be complicated by secondary bacterial infections, which aggravate these symptoms. Doctors should wonder if patients have pets or have had recent contacts with flying insects, they added.
This article is for information only and is not supposed to offer medical advice.
