Lagochilascariasis leading to severe involvement of ocular globes, ears and meninges

Abstract

SUMMARYA case report of a 31 year-old woman from Paraíba State (North-Eastern Brazil) that presented severe involvement of ocular globes, ears and meninges. Diagnosis was established after enucleation of her left eye, when adult worms were seen in the midst of a granulomatous inflammatory process. Her response to the initial treatment with levamisole and cambendazole was good, but there was a relapse after the fifth month of treatment even with maintenance doses of both medications. She later received ivermectin and albendazol and responded well.

A Case of Lagochilascariasis in Suriname with the Involvement of the ENT System and the Skull Base

“…Especially after treatment with anthelmintic drugs like albendazole, recurrences are frequent, maybe as a result of ineffectiveness against the eggs of the parasite. 9,[13][14][15] Resection of the mass is often performed, although the benefit is unknown.…”

“…9,13 In an animal experiment with experimentally infected cats, a 100% drug efficacy was observed with ivermectin treatment. 16 A regimen of repeated doses is often prescribed based on the possibility of autoinfection and possible ineffectiveness against larval stages.…”

Human lagochilascariasis—A rare helminthic disease

“…Human lagochilascariasis has been recorded in Trinidad and Tobago [1,2,18,23], Surinam [14,20,24,25], Mexico [9,26], Costa Rica [27], Venezuela [6,15,28], Colombia [11,12], Bolivia [29], Ecuador [30], Paraguay [7], Brazil [3–5,10,13,16,21,31–35] and Peru [36] (Fig 1). As for its geographic distribution by country, the highest concentration is found in Brazil, representing 78.1% (100/128) of the total number of cases reported in the literature [36].…”

“…Several drugs, such as benzimidazole derivatives, ivermectin, and diethylcarbamazine (Table 1), have been used in the treatment of lagochilascariasis [9,10]. Treatment generally starts with thiabendazole, followed by diethylcarbamazine or followed by mebendazole and, finally, levamisole [11,32,33].…”

“…L . minor has been found in subcutaneous abscesses in the cervical region [1–5], mastoid [4–9], rhino-oropharynx [4,5,9,10], tonsils [4,5,11,12], auditory meatus [4,5,10,13], nasal sinuses [9,13–15], lungs [4,5,16], central nervous system [6,13,17] , sacral region [4], eyes [10,18], and dental alveoli [5,9,19] of humans. Different stages of the life cycle (eggs, larvae, and adult worm) have also been found [5,14,20,21].…”