Loa loa in the Vitreous Cavity of the Eye: A Case Report and State of Art

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  • 1 Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro,” Bari, Italy;
  • | 2 Section of Ophthalmology, Department of Medical Science, Neuroscience and Senso Organs, Bari Policlinico Hospital University of Bari, Bari, Italy;
  • | 3 Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro,” Bari, Italy

Loa loa is a filarial nematode responsible for loiasis, endemic to West–Central Africa south of the Sahara and transmitted by flies. This study reports a case of L. loa in the vitreous cavity of the eye of a young patient, along with an in-depth literature review. A 22-year-old woman from Cameroon who migrated from Cameroon to Italy was referred to the Emergency Ophthalmology Department at Policlinico di Bari in July 2021 with the presence of a moving parasite in the subconjunctiva of the left eye. A recent onset of a papular lesion on the dorsal surface of the right wrist and a nodular lesion in the scapular region were detected. L. loa filariasis was diagnosed based on anamnestic data, clinical and paraclinical signs, and a parasitological test confirming the presence of microfilariae in two blood samples collected in the morning of two different days. Because of the unavailability of diethylcarbamazine (DEC), albendazole (ALB) 200 mg twice daily was administered for 21 days. A mild exacerbation of pruritus occurred during treatment, but resolved with the use of an antihistamine. A single dose of 12 mg ivermectin was prescribed at the end of the treatment with albendazole. Unlike other endemic parasite infections, L. loa is not included in the Global Program to Eliminate Lymphatic Filariasis, because it is not mentioned in the WHO and CDC list of neglected tropical diseases. This can result in an overall risk of lack of attention and studies on loiasis, with lack of data on global burden of the disease.

Author Notes

Address correspondence to Elisabetta Pallara, Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro,” Piazza G. Cesare, 11, 70124 Bari, Italy. E-mail: etta.pallara@gmail.com

Authors’ addresses: Elisabetta Pallara, Sergio Cotugno, Giacomo Guido, Elda De Vita, Aurelia Ricciardi, Valentina Totaro, Michele Camporeale, Luisa Frallonardo, Roberta Novara, Gianfranco G. Panico, Michele Mariani, Giuseppina De Iaco, Eugenio Milano, Davide F. Bavaro, Rossana Lattanzio, Giulia Patti, Roberta Papagni, Carmen Pellegrino, Annalisa Saracino, and Francesco Di Gennaro, Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro,” Bari, Italy, E-mails: etta.pallara@gmail.com, sergio.cotugno@gmail.com, giacguido@gmai.com, devitaelda@gmail.com, aurelia.r.92@gmail.com, valentinatotaro11@gmail.com, mickdorian91@gmail.com, luisana.frallonardo@gmail.com, robertanovara@gmail.com, panico.gianfranco@gmail.com, mca90@hotmail.it, giusideiaco@gmail.com, eugeniomilano@gmail.com, davidebavaro@gmail.com, rossana.lattanzio@gmail.com, giuliapatti22@gmail.com, robertapapagni0@gmail.com, karmenpellegrino@gmail.com, annalisa.saracino@uniba.it, and cicciodigennaro@yahoo.it. Pasquale Puzo and Giovanni Alessio, Section of Ophthalmology, Department of Medical Science, Neuroscience and Senso Organs, Bari Policlinico Hospital University of Bari, Bari, Italy, E-mails: puzopasquale@gmail.com and giovanni.alessio@uniba.it. Sara Sablone, Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro,” Bari, Italy, E-mail: sarasabloneml@gmail.com.

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