RESUMEN
PURPOSE: To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis. METHODS: 11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique). RESULTS: In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity. CONCLUSION: The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.
Asunto(s)
Endoftalmitis/diagnóstico por imagen , Infecciones Parasitarias del Ojo/diagnóstico por imagen , Granuloma/diagnóstico por imagen , Toxocariasis/diagnóstico por imagen , Uveítis/diagnóstico por imagen , Adolescente , Animales , Anticuerpos Antihelmínticos , Niño , Preescolar , Diagnóstico Diferencial , Perros , Endoftalmitis/parasitología , Infecciones Parasitarias del Ojo/parasitología , Femenino , Granuloma/parasitología , Humanos , Larva Migrans , Masculino , Toxocara canis/inmunología , Ultrasonografía , Uveítis/parasitologíaRESUMEN
The parasitic nodules are part of the cutaneous manifestations of the parasitic diseases, fundamentally affect children. We report the clinic history, study by images and parasitological results of three infrequent parasitic cases in the pediatric age, which were studied with images, specially ultrasound, and this contributed somehow to the diagnosis. The final parasitological diagnoses were dirofilaria, toxocara and myiasis. The epidemiology, clinical and dermatológica! manifestations are discussed of each one.
Los nodulos parasitarios forman parte de las manifestaciones cutáneas de las enfermedades parasitarias, las cuales afectan fundamentalmente a niños. Se da a conocer la historia clínica, el estudio por imágenes y los resultados histopatológicos y parasitarios de tres casos poco frecuentes en la edad pediátrica, los cuales fueron estudiados con ultrasonido que contribuyó de alguna manera al diagnóstico. Los parásitos encontrados fueron dirofilaria, toxocara y una larva de mosca. Se discute la epidemiología, manifestaciones clínicas y dermatológicas de cada una de estas parasitosis.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Niño , Adolescente , Enfermedades Cutáneas Parasitarias/diagnóstico por imagen , Toxocariasis/diagnóstico por imagen , Dirofilariasis/diagnóstico por imagen , Miasis/diagnóstico por imagen , UltrasonografíaRESUMEN
Our aim was to study optical coherence tomographic findings in a case of Toxocara granuloma. A patient with a cicatricial macular lesion, diagnosed as ocular toxocariasis, was examined with optical coherence tomography. In optical coherence tomography images, the macular granuloma appeared as a highly reflective round mass protruding above the retinal pigment epithelium with two other surrounding masses. Optical coherence tomography may increase understanding of the pathophysiology of the retinal Toxocara granuloma and help in the clinical diagnosis and management of its macular complications.
Asunto(s)
Granuloma/parasitología , Enfermedades de la Retina/parasitología , Toxocara/inmunología , Toxocariasis/diagnóstico por imagen , Animales , Anticuerpos Antihelmínticos/análisis , Preescolar , Ensayo de Inmunoadsorción Enzimática , Granuloma/diagnóstico por imagen , Humanos , Masculino , Radiografía , Enfermedades de la Retina/diagnóstico por imagen , Tomografía de Coherencia ÓpticaRESUMEN
PURPOSE: To describe the morphologic alterations in ultrasound biomicroscopy (UBM) present in peripheral vitreoretinal toxocariasis. METHODS: An observational prospective study of case series. Fifteen eyes of 15 patients with clinical and laboratory diagnosis of peripheral vitreoretinal toxocariasis were enrolled. The patients were submitted to UBM examination of the region corresponding to the pars plana of the affected eye. RESULTS: The most common morphologic alterations found by UBM in patients with peripheral vitreoretinal toxocariasis were as follows: vitreal membranes (13 cases), toxocara granuloma (11 cases), and pseudocysts (8 cases). Other less frequent findings were thickening of the ciliary body (6 cases), cystic formation (2 cases), peripheral retinal detachment (2 cases), rectification of the iris root (1 case), and posterior synechiae (1 case). CONCLUSIONS: UBM allows detection of well-defined morphologic alterations associated with peripheral vitreoretinal toxocariasis, being useful to reinforce the clinical diagnosis.
Asunto(s)
Infecciones Parasitarias del Ojo/diagnóstico por imagen , Enfermedades de la Retina/diagnóstico por imagen , Toxocariasis/diagnóstico por imagen , Cuerpo Vítreo/diagnóstico por imagen , Adolescente , Adulto , Anticuerpos Antihelmínticos/sangre , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Infecciones Parasitarias del Ojo/sangre , Infecciones Parasitarias del Ojo/inmunología , Femenino , Humanos , Masculino , Microscopía/métodos , Estudios Prospectivos , Enfermedades de la Retina/parasitología , Toxocariasis/sangre , Toxocariasis/inmunología , Ultrasonografía , Agudeza Visual , Cuerpo Vítreo/parasitologíaRESUMEN
PURPOSE: To evaluate abdominal ultrasound (US) findings in children infected with Toxocara canis. MATERIALS AND METHODS: Eighteen children, 18 months to 7 years of age, with serological diagnosis of T.canis infection underwent abdominal US. Eosinophil counts, hemoglobin levels and immunoglobulin E titers were measured for all patients. RESULTS: Abdominal ultrasound revealed multiple hypoechoic areas in the livers of 15 patients (83.3%). Hepatohilar lymph-node enlargement was present in 14 patients (77.7%), 2 of whom also showed peripancreatic lymph-node enlargement. Hepatomegaly was present in 13 patients (72.7%) and splenomegaly in 9 (50%). CONCLUSION: The most prevalent findings of abdominal ultrasound examination of children with T.canis infection are hepatic granulomas and abdominal lymph-node enlargement. This infection should be considered in the differential diagnosis of any children who exhibit these findings on abdominal US examination, especially for those with eosinophilia.