Cases reported "Loiasis"

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1/5. A case of loiasis in Rome.

    BACKGROUND: Owing to the increase of an immigrant population and of Italian citizens travelling for tourism or on business, it is nowadays possible to observe clinical pictures characteristic of tropical regions, often with indistinct symptoms. One of these is loa loa infestation, or loiasis, a form of filariasis caused by loa loa and transmitted by the Chrysops fly. We present the case of a male immigrant from cameroon. Characteristic symptoms were intense xerosis, mostly of the third inferior part of the legs, intensely pruritic, with numerous lesions from scratching. No benefit was obtained by emollient topics, anti-acarus and systemic antihistamines. METHOD: serum samples and Giemsa, haematoxylin, haematoxylin Giemsa concentration-on-membrane stains, have evidenced the presence of loa loa microfilariae. RESULTS: A diagnosis for L. loa (loiasis) infestation was made. CONCLUSIONS: At the beginning of the migration phenomenon, particularly from africa, Italian physicians, especially dermatologists, were eagerly looking for 'tropical' diseases; this approach can be defined as 'Salgari's syndrome' from the name of the Italian novelist who, though never travelling out of italy, had perfectly described environments and habits typical of far away countries. Now, conversely, we have to avoid the opposite approach of considering real tropical diseases as related to social or psychological difficult conditions.
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ranking = 1
keywords = filariasis
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2/5. Five cases of encephalitis during treatment of loiasis with diethylcarbamazine.

    Five cases of encephalitis following treatment with diethylcarbamazine (DEC) were observed in Congolese patients with loa loa filariasis. Two cases had a fatal outcome and one resulted in severe sequelae. The notable fact was that this complication occurred in three patients hospitalized before treatment began, with whom particularly strict therapeutic precautions were taken, i.e., initial dose less than 10 mg of DEC, very gradual dose increases, and associated anti-allergic treatment. This type of drug-induced complication may not be that uncommon in highly endemic regions. It occurs primarily, but not exclusively, in subjects presenting with a high microfilarial load. The relationship between the occurrence of encephalitis and the decrease in microfilaremia is evident. The pathophysiological mechanisms are discussed in the light of these observations and the few other comments on this subject published in the literature.
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ranking = 1
keywords = filariasis
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3/5. loiasis in an expatriate American child: diagnostic and treatment difficulties.

    On the basis of this experience, we recommend the following when faced with possible filariasis in an expatriate from Western Central africa: (1) Attempt a clinical differentiation between L loa and other filarial infections present in West africa. It is important to suspect loiasis because this is the only filarial infection that is readily curable; (2) ophthalmologic assessment to diagnose onchocerciasis; (3) if L loa is suspected, thick blood smears should be obtained from midmorning to midafternoon and stained with Giemsa or hematoxylin stains, after a concentration technique is used. Nighttime blood specimens should be obtained if the patient has been in an area where W. bancrofti is prevalent; (4) skin snip biopsies prepared as follows: Bilateral symmetrical skin snips should be taken. In the case of suspected West African filariasis, the pelvic girdle, iliac crest, and back of scapula are thought to have the highest yield. One snip from each of six different sites should be obtained. Each skin snip should be approximately 2 to 3 mm (a cornealoscleral biopsy forceps can be used). Each skin snip is placed in 100 microL (approximately one drop) of normal saline in a flat-bottomed microtiter plate. The plate is incubated at room temperature and checked periodically for 24 hours under a dissecting microscope (X20 to X40). If present, the small worms will be seen wiggling and squirming in the drop of saline; (5) serologic diagnostic methods are most efficient if human filarial antigens are used; (6) if treatment is with diethylcarbamazine, the initial dose should be small.(ABSTRACT TRUNCATED AT 250 WORDS)
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ranking = 2
keywords = filariasis
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4/5. loa loa: ocular filariasis in an African student in missouri.

    Ocular filariasis was observed in an African student living in missouri. The adult female loa loa worm was seen migrating under the conjunctiva. There was 34% eosinophilia and a high microfilaremia. The patient was successfully treated with diethylcarbamazine (Hetrazan) with no appearance of allergic manifestations.
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ranking = 5
keywords = filariasis
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5/5. thrombosis of the ulnar veins--an unusual manifestation of loa loa filariasis.

    A 49-y-old male, who had travelled in Central africa, was admitted to hospital with oedema of the right forearm. He was diagnosed as having thrombosis of the ulnar veins. Subsequently eosinophilia and positive serology for filariae established the aetiologic agent as loa loa. The patient received antithrombotic and antiparasitic therapy. This is, to our knowledge, the first reported case of thrombosis of the ulnar veins associated with loa loa.
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ranking = 4
keywords = filariasis
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