Case report of an epidural cervical Onchocerca lupi infection in a 13-year-old boy

Abstract

<jats:p>A 13-year-old boy presented with fever and neck pain and stiffness, which was initially misdiagnosed as culture-negative meningitis. Magnetic resonance images of the brain and cervical spine demonstrated what appeared to be an intradural extramedullary mass at the C1–3 level, resulting in moderate cord compression, and a Chiari Type I malformation. The patient underwent a suboccipital craniectomy and a C1–3 laminectomy with intradural exploration for excisional biopsy and resection. The lesion containing the parasite was extradural, extending laterally through the C2–3 foramina. Inflammatory tissue secondary to <jats:italic>Onchocerca lupi</jats:italic> infection was identified, and treatment with steroids and doxycycline was initiated. At the 6-month follow-up, the patient remained asymptomatic, with MR images demonstrating a significant reduction in lesional size. However, 10 weeks postoperatively, the infection recurred, necessitating a second operation. The patient was treated with an additional course of doxycycline and is currently maintained on ivermectin therapy. This is the second reported case of cervical <jats:italic>O. lupi</jats:italic> infection in a human. In the authors' experience, oral doxycycline alone was insufficient in controlling the disease, and the addition of ivermectin therapy was necessary.</jats:p>

Canine ocular onchocerciasis: a retrospective review of the diagnosis, treatment, and outcome of 16 cases in New Mexico (2011–2015)

“…The importance of O. lupi lies not only in its ability to produce potentially blinding disease in dogs, but also in its role as a zoonotic agent and as a potential animal model for O. volvulus . A better understanding of the life cycle of O. lupi , as well as treatment and prevention strategies, is needed.…”

Onchocerca lupiNematodes in Dogs Exported from the United States into Canada

“…Human cases of infection with O. lupi nematodes have been reported Old World countries, including Albania, Crimea, Iran, Tunisia, and Turkey ( 3 , 8 – 11 ). All case-patients had ocular disease caused by subconjunctival nodules containing nematodes.…”

First detection of Onchocerca lupi infection in dogs in southern Spain

“…In the present study, one of the O. lupi infected dogs showed neurological abnormalities, although previous studies have not reported this clinical sign in dogs positive to O. lupi . However, this condition was described in a 13-year-old boy presenting neurological signs due to aberrant epidural cervical infection, in the spinal canal, by adult nematodes [ 19 ]. However, since an aberrant laryngeal location of O. lupi was previously reported in a dog from Portugal [19], the dog with neurological signs is referred to as (dog 1, Table 1 ) and one without those signs as (dog 4, Table 1 ), were subjected to imaging tests to detect the presence of adults or nodules containing O. lupi adults.…”