Intravitreal Angiostrongylus cantonensis: first case report in South America

Abstract

This study reports the first case of intravitreal angiostrongyliasis in South America treated with posterior worm removal via pars plana vitrectomy. This was a retrospective, observational case study. Data from medical charts, wide-field digital imaging, ocular ultrasound, and visual evoked potential studies were reviewed. A 20-month-old boy presented with eosinophilic meningitis and right eye exotropia. Polymerase chain reaction analysis of the cerebrospinal fluid showed a positive result for Angiostrongylus cantonensis. Fundus examination revealed a pale optic disc, subretinal tracks, vitreous opacities, peripheral tractional retinal detachment, and a dead worm in the vitreous cavity. The patient underwent pars plana vitrectomy with worm removal. This case report illustrates the first case of intravitreal angiostrongyliasis in South America, possibly related to the uncontrolled spread of an exotic invasive species of snail.

Magnetic resonance imaging findings and clinical manifestations in cerebral angiostrongyliasis from Dali, China

“…Currently, most reports on A. cantonensis have focused on epidemiology, pathogenesis, and prevention and treatment, and few have summarized the clinical manifestations or imaging characteristics of sporadic cases of A. cantonensis (Andrade et al, ; Eamsobhana, ; Prasidthrathsint, Lewis, & Couturier, ). This study not only analyzed the clinical manifestations, but also analyzed and summarized the imaging characteristics and differential diagnosis of the disease, corresponding to its pathological basis.…”

Case Report: Management of Dead Intraocular Helminth Parasites in Asymptomatic Patients

“…The only case report we identified describing the finding of a dead intraocular Angiostrongylus larva was a 20-month-old child who had just received antiparasitic treatment for Angiostrongylus-related eosinophilic meningitis when additionally unilateral retinal pathologies and a dead larva in the vitreous cavity were discovered. 10 Why in our four cases no local signs of concomitant or past inflammation was present remains unclear. Considering that tissue invasive parasites will only be recognized and diagnosed once they have reached a detectable size (macroscopically or by imaging methods) and/or cause clinical apparent pathology, we speculate that infections with still small and prematurely dying parasites are more likely to remain asymptomatic or oligosymptomatic and thus undiagnosed.…”

Subretinal Angiostrongyliasis: A Case Report

“…9 Another hypothesis is that the larva can reach the eyeball via the bloodstream. 3 The most common site of ocular angiostrongyliasis is in the intravitreous space. 6 However, the presence of helminth in the subretinal space is very rare.…”

“…And its larvae migration into the eyes is found only 1.1% of the Angiostrongyliasis cases. 2,3 Angiostrongylus spp. is a rat lungworm.…”