Cases reported "Onchocerciasis"

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11/26. Cutaneous onchocerciasis.

    onchocerciasis was diagnosed when a skin biopsy specimen immersed in saline revealed microfiliariae. The patient was a 22-year-old student from cameroon, West africa, complaining of small, recurrent, pruritic papules on his thighs. Chemotherapy with ivermectin, an established antiparasitic agent with newly recognized anti-onchocercal potential, was well tolerated, and microfilariae were not detected in post-therapy skin biopsy specimens. The diagnosis of onchocerciasis should be entertained in individuals returning or emigrating from endemic areas.
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12/26. lymphadenitis in Sowda.

    Sowda is a form of onchocerciasis in yemen characterized by unilateral dermatitis of one limb, with enlargement of the regional lymph nodes. Previous pathologic studies of lymph nodes from cases of Sowda describe only follicular hyperplasia without microfilariae in the lymph nodes. This contrasts with African onchocerciasis, where the lymph nodes tend to be atrophic and microfilariae are usually present. In the present report, a case of Sowda with microfilariae in the lymph nodes is described and the implications of this finding are discussed.
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13/26. upper extremity swelling and hyperpigmentation due to onchocerciasis in an American.

    An American woman who had lived in equatorial guinea was seen in the united states with intermittent swelling, pruritus, hyperpigmentation, and mild cutaneous atrophy of the right arm. Filarial diseases were considered in the differential diagnosis; skin snips subsequently revealed onchocerca volvulus microfilariae. There was no evidence of ocular involvement. The case illustrates the importance of obtaining a history of international travel, the need to consider "exotic" parasitic diseases in travelers returning from the tropics, and several of the presenting features of onchocerciasis. In the past, onchocerciasis was treated with diethylcarbamazine and suramin, both of which have appreciable toxicity. A major recent advance has been the introduction of ivermectin, which appears to be more effective and less toxic, and is currently undergoing clinical evaluation in the united states and abroad.
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14/26. Conjunctival nodules associated with onchocerciasis.

    A 14-year-old native of ethiopia with previously treated onchocerciasis moved to california where he was examined for evidence of persisting nematode infestation. skin and conjunctival biopsy specimens initially disclosed no abnormalities. Subsequently, conjunctival nodules developed, and a biopsy specimen of one of these revealed microfilariae of onchocerca volvulus lying adjacent to a necrotic eosinophilic granulomatous inflammatory nodule. To our knowledge, nodules of this type have not heretofore been reported to be a notable feature of ocular onchocerciasis. This type of inflammation has a relationship to degenerating microfilaria in onchocerciasis and in other nematode infestation.
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keywords = onchocerciasis
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15/26. Sowda-type onchocerciasis in guatemala.

    The usual pattern of onchocercal dermatitis in Africans and Guatemalans is a generalized and symmetrical dermatitis located on legs, arms and trunk. These patients appear to be anergic, with depressed immune responses and numerous microfilariae in the skin. In contrast, "sowda" is an unusual type of onchocercal dermatitis found in Yemenites and in a minority of African patients. Here the dermatitis is localized and asymmetrical - typically confined to one limb or one region of the body. patients with sowda appear to be hypergic, with active humoral and cellular immune responses; microfilariae are rare or absent. This study describes two Guatemalan patients with sowda-type dermatitis. The diagnosis in these two patients is based on the asymmetrical papular pruritic dermatitis, rare or absent microfilariae, a positive Mazzotti reaction, and histopathologic changes characteristic of the sowda-type onchocercal dermatitis.
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16/26. onchocerciasis in expatriates on the Ivory Coast.

    Six cases of onchocerciasis were diagnosed in expatriates working on a hydroelectric dam project in Taabo (Ivory Coast) between 1977 and 1978. Taabo is in the forest area of the Bandama River, where onchocerciasis is hyperendemic. The six patients had lived in the area from 20 months to four years. In the early 1970s four of them had worked at the Kossou Dam, a similar project 125 miles up the Bandama River. Diagnoses were confirmed by demonstrating microfilariae in biopsy specimens taken from the skin overlying the iliac crest. A seventh case was diagnosed clinically as tropical filarial pulmonary eosinophilia. The six patients with microfilariae in the skin were treated successfully with diethylcarbamazine (Notezine, Hetrazan) and suramin (Moranyl). The patient with pulmonary involvement responded dramatically to treatment with diethylcarbamazine. The overall effects of onchocerciasis are poorly understood, though it is now one of the major tropical diseases, affecting millions of people living in central and western africa, yemen, and central america. Medical treatment is successful, but few preventive measures are available for the disease; larvicides are subject to resistance, and their effects are transient.
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keywords = onchocerciasis
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17/26. Pigmented basal cell epithelioma arising in the scar of an onchocerciasis nodule.

    Pigmented basal cell epithelioma (BCE) arose in the scar of an onchocercoma nodule in a 45-year-old white man. There were extensive fibrosis, inflammation, epidermal hyperplasia, and nests of basal cancer cells. The authors believe that the development of epithelioma in this case was more than a chance occurrence. There is little doubt that the malignant change was subsequent to the scarring-proliferative process of the disease. To the authors' knowledge, this complication has not been reported previously.
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ranking = 0.8
keywords = onchocerciasis
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18/26. Ocular onchocerciasis with living microfilariae in the anterior chamber in two Dutch boys.

    In 2 Dutch boys, 15 and 12-year-old brothers, living microfilariae were observed in the anterior chamber. Both boys had returned 4 years before from a hyperendemic onchocerciasis region where they had lived for 5 years. The pathogenesis and treatment of onchocerciasis are discussed.
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ranking = 1.2
keywords = onchocerciasis
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19/26. onchocerciasis in israel.

    A 15-year-old boy with onchocerciasis had severe generalized pruritus of five months' duration. He had been born and raised in ethiopia and had emigrated to israel one year earlier. A biopsy specimen of an area of depigmentation on the right thigh disclosed microfilaria of onchocerca volvulus in the dermis. The discovery of an unusual disease in a nonendemic area is an example of the increased complexity of differential diagnosis resulting from the ease of travel from one geographic region to another.
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ranking = 0.2
keywords = onchocerciasis
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20/26. An onchocercal nodule appearing during diethylcarbamazine therapy.

    We describe the appearance of an onchocercal nodule in a patient during treatment with diethylcarbamazine (DEC). This is a unique occurrence. DEC has been employed in the treatment of onchocerciasis for many years, but there have been no reports of any effects of DEC on nodules. Histopathological studies in which nodules have been examined before and after treatment of patients with DEC have not revealed any changes induced by such treatment. The histological appearance of this nodule is described, and the probable mechanism of its enlargement is discussed.
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