1/26. onchocerciasis presenting with lower extremity, hypopigmented macules.onchocerciasis, or river blindness, is a parasitic infection caused by the filarial nematode, onchocerca volvulus. It infects 18 million people worldwide, but is rarely seen in the united states. It is one of the leading causes of blindness in the developing world. Although onchocerciasis is also known as river blindness, it is not just a disease of the eyes, but rather a chronic multisystem disease. Clinically, onchocerciasis takes three forms: 1) eye disease; 2) subcutaneous nodules; and 3) a pruritic hypopigmented or hyperpigmented papular dermatitis. We present an 18-year-old African female with a 5-year history of asymptomatic, hypopigmented, slightly atrophic macules on her anterior tibiae. pathology revealed a scant perivascular inflammatory infiltrate with mononuclear cells, eosinophils, and rare microfilariae in the papillary dermis. ivermectin is the treatment of choice for onchocerciasis and was initiated in this patient. We present this interesting patient with onchocerciasis to expand our differential of hypopigmented macules, especially in the African population. In addition, we discuss both the diagnosis and the treatment of onchocerciasis in expatriate patients living in nonendemic areas.- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |
2/26. Misidentification of onchocerca volvulus as guinea worm.Over the past 10 years, the status of human infection with guinea worm (Dracunculus medinensis) in the central african republic (CAR) has been difficult to ascertain. It is unclear if indigenous cases are occurring and whether cases are migrating into the CAR from surrounding countries. A team of investigators visited the CAR in July-August 2000, to attempt to ascertain the presence of indigenous transmission. No cases of true guinea-worm infection (i.e. dracunculiasis) were detected, but three cases of human infection with onchocerca volvulus, each of which had been misidentified as dracunculiasis, were detected. The unusual presentation of skin blisters and extraction of an intact female O. volvulus are described. As a result of this investigation, and the confusion of onchocerciasis being misidentified as dracunculiasis, the presence of endemic transmission of guinea worm in the CAR remains in question.- - - - - - - - - - ranking = 0.2keywords = onchocerciasis (Clic here for more details about this article) |
3/26. A new focus of onchoceriasis in the sudan.A new focus of onchocerciasis is reported from Upper Atbara River area in the sudan. This river is a known seasonal breeding place of Simulium damnosum. The area was sparsely populated in the past but now, following agricultural development, is inhibited mainly by immigrants from Northern nigeria and chad. Clinically the common features are skin changes of the legs, thighs buttocks, arms and trunk. Other features are corneal opacities and small often deeply placed subcutaneous nodules. Choroido-retinal degeneration, genital elephantiasis and hydrocoele, commonly associated with onchocerciasis in other parts of the sudan, are absent.- - - - - - - - - - ranking = 0.4keywords = onchocerciasis (Clic here for more details about this article) |
4/26. Worldwide blindness.blindness affects approximately 42 to 52 million people worldwide. This article examines the major causes of blindness, including cataract, trachoma, glaucoma, onchocerciasis, nutritional deficiencies, and ocular trauma. Numerous case studies supplement the text.- - - - - - - - - - ranking = 0.2keywords = onchocerciasis (Clic here for more details about this article) |
5/26. Zoonotic onchocerciasis caused by a parasite from wild boar in Oita, japan. A comprehensive analysis of morphological characteristics of the worms for its diagnosis.Histological examination of a nodule removed from the back of the hand of a 58-year-old woman from Oita, Kyushu, japan showed an Onchocerca female sectioned through the posterior region of the worm (ovaries identifiable) and young (thin cuticle). Six Onchocerca species are enzootic in that area: O. gutturosa and O. lienalis in cattle, O. suzukii in serows (Capricornis crispus), O. skrjabini and an Onchocerca sp. in Cervus nippon nippon, and O. dewittei japonica in wild boar (sus scrofa leucomystax). Diagnostic characters of female Onchocerca species, such as the cuticle and its ridges, change along the body length. tables of the histologic morphology of the mid- and posterior body-regions of the local species are presented. In addition, it was observed that transverse ridges arose and thickened during the adult stage (examination of fourth stage and juvenile females of O. volvulus). The specimen described in this report, with its prominent and widely spaced ridges, was identified as O. d. japonica. Four of the 10 zoonotic cases of onchocerciasis reported worldwide were from Oita, three of them being caused by O. d. japonica, the prevalence of which in local wild boar was 22 of 24 (92%).- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |
6/26. Cutaneous onchocerciasis in an American traveler.A case report of cutaneous onchocercias acquired during travels to Africa is presented. The salient epidemiologic, clinical, diagnostic, and therapeutic aspects are reviewed. Clinical and laboratory differences between onchocerciasis patients who are inhabitants of endemic areas and those who are occasional visitors to such areas are discussed. Parasitic infections, including onchocerciasis, should be considered in the differential diagnosis of pruritic eruptions in patients with a history of foreign travel to africa, central and south america.- - - - - - - - - - ranking = 1.2keywords = onchocerciasis (Clic here for more details about this article) |
7/26. onchocerciasis-associated limb swelling in a traveler returning from cameroon.Travelers to West Central Africa are at risk for infection with onchocerca volvulus. We describe the case of an adventurous traveler who became infected with O volvulus after a 10-day stay in rural cameroon. Two years after his return, he was diagnosed with a 3-month history of limb swelling with pruritus and fixed edema of the right arm. He was successfully treated by a single dose of ivermectin, with an additional treatment with doxycycline. The patient was followed-up during 1 year after therapy without relapse. Such travelers experiencing unusual dermatitis syndromes should prompt evaluation for onchocerciasis.- - - - - - - - - - ranking = 0.2keywords = onchocerciasis (Clic here for more details about this article) |
8/26. suramin and the time it takes to kill onchocerca volvulus.The paper records the numbers of 1-2 mm shotty papules developing in the author's skin after 2-day courses of diethylcarbamazine (DEC) repeated every 16 days before, during and after a 7.1 G suramin course for cutaneous onchocerciasis. Assuming, from biopsy evidence, that each papule represented a dead onchocerca volvulus microfilaria (mf), the number of mfs reaching the skin every 16 days did not begin to fall until 96 days after the first full dose of suramin; and only reached zero by day 224. The histopathology of nodules excised from Cameroonian patients before, and at intervals of 56-335 days after, the start of a 7.1 G suramin course, revealed changes in the worms that correlated over time with the disappearance of mfs from the skin. suramin sterilized and killed the male worms between days 77 and 105 and, in the females, it adversely affected the staining and subsequent development of small morulae from about day 56. It was estimated that new embryogenesis ceased about 56-77 days after the first full dose; development of the last viable embryos to mfs was complete by about 136 days; and the last mfs, perhaps having reduced vitality, emerged from the females by 160 days and reached the skin within 16-32 days.- - - - - - - - - - ranking = 0.2keywords = onchocerciasis (Clic here for more details about this article) |
9/26. Possible transplacental transmission of onchocerca volvulus.In a recent epidemiological study on onchocerciasis on the lower Jos Plateau in nigeria, a 7-month-old baby delivered by a mother suffering from onchocerciasis showed early clinical signs of the disease: pruritus was present all over the body. The infant's skin snip on incubation revealed microfilariae of onchocerca volvulus. These findings were confirmed 3 months later when the child was re-examined. No onchocercal nodule was found, but pruritus persisted.- - - - - - - - - - ranking = 0.4keywords = onchocerciasis (Clic here for more details about this article) |
10/26. A human case of zoonotic onchocerciasis in japan.A 2-year-old girl living in southwestern japan had a nodule of 2 months' duration on the left foot. A biopsy from the lesion showed transverse sections of a worm surrounded by granulomatous tissue. The worm was identified as an Onchocerca sp. from the morphological characteristics such as relatively thick cuticles, annular ridges on the cortical layer, and high somatic muscles. Positive serological tests using ELISA for Onchocerca gutturosa and onchocerca volvulus supported the diagnosis. This was the first case of zoonotic Onchocerca infection detected in japan. The clinicopathological aspects of zoonotic onchocerciasis of this case were discussed.- - - - - - - - - - ranking = 1keywords = onchocerciasis (Clic here for more details about this article) |
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