Trematodal granulomatous uveitis in paediatric Egyptian patients: a case series

Abstract

In Egypt, a unique pattern of granulomatous anterior uveitis in rural children attributable to a waterborne helminthic infection is reported. The River Nile and its fresh water fauna are implicated in our series, and the need for an environmental investigation to further outline best management options in the given endemic areas is highlighted.

Anterior chamber granuloma: conservative treatment versus surgical intervention

“…Lesions were almost always recognized in young boys, as girls in these localities are not allowed to bathe or play in canal waters due to the conservative nature of the countryside. Similarly, other studies in both India and Egypt have reported that the majority of patients with anterior chamber granuloma were males and all were reporting bathing in local canal waters (Rathinam et al 2002;Arya et al 2016;Amin et al 2017;Amin et al 2019).…”

“…Unlike other studies, we have not encountered patients with either lid or subconjunctival nodules. (Rathinam et al 2002;Arya et al 2016;Amin et al 2017) Amin and colleagues reported that complications at presentation, such as cataract, glaucoma, corectopia, phthisis or retrocorneal scarring, were present in 16% of their study eyes. (Amin et al 2017).…”

“…Anterior chamber granuloma, referred to as pearl-like ocular granuloma (Amin et al 2017), is a common cause of uveitis in Egyptian children living alongside the River Nile. The River Nile is the main source of water supply in Egypt.…”

“…It seems that the disease shows a predilection towards paediatric eyes causing the characteristic single or multiple anterior chamber nodules with anterior uveitis. Some of anterior chamber granulomas are big enough to be recognized with naked eye in most of the cases and were the main concern irritating the parents (Amin et al 2017).…”

“…Several attempts have been made to identify the aetiology of such lesions. A molecular evidence of digenetic trematode has been reported as a cause of such peculiar inflammation in recent studies (Rathinam et al 2012;Arya et al 2016;Amin et al 2017;Amin et al 2019).…”