Zoonotic Onchocerca lupi Infection in a 22-Month-Old Child in Arizona: First Report in the United States and a Review of the Literature

Mark L. Eberhard Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Gholamabbas Amin Ostovar Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Kote Chundu Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Dan Hobohm Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Iman Feiz-Erfan Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Blaine A. Mathison Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Henry S. Bishop Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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Paul T. Cantey Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Pathology and Neurosurgery, Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix, Arizona

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A 22-month-old girl presented with neck pain and stiffness and magnetic resonance imaging showed an extradural mass extending from C2 through the C4 level with moderate to severe compression of the cord. A left unilateral C2–C4 laminectomy was performed revealing an extradural rubbery tumor; a small biopsy was obtained. Examination of stained tissue revealed the presence of a parasitic worm that was identified as a gravid female Onchocerca lupi. A magnetic resonance imaging at 7 weeks follow-up showed a significantly decreased size of the enhancing lesion and the patient's symptoms gradually resolved. This is the first report of zoonotic O. lupi in the United States. The parasite has been reported in dogs and cats in the western United States, and from people in four cases reported from Europe. A great deal more needs to be learned, including full host range and geographic distribution, before we fully understand O. lupi infections in animals and man.

Author Notes

* Mark L. Eberhard, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, Atlanta, GA 30333. E-mail: mle1@cdc.gov

Authors' addresses: Mark L. Eberhard, Blaine A. Mathison, Henry S. Bishop, and Paul T. Cantey, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: mle1@cdc.gov, gqa4@cdc.gov, hsb2@cdc.gov, and gdn9@cdc.gov. Gholamabbas Amin Ostovar and Kote Chundu, Department of Pediatrics, Maricopa Medical Center, Phoenix, AZ. Dan Hobohm, Department of Pathology, Maricopa Medical Center, Phoenix, AZ. Iman Feiz-Erfan, Division of Neurosurgery, Maricopa Medical Center, Phoenix, AZ, E-mails: Amin_Ostovar@dmgaz.org, Kote_Chundu@dmgaz.org, Dan_Hobohm@dmgaz.org, and Iman_Feiz-Erfan@dmgaz.org.

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