Abstract
Diffuse unilateral subacute neuroretinitis (DUSN) secondary to raccoon roundworm (Baylisascaris procyonis) infection has been reported in rural and suburban areas of North America and Europe with extant raccoon populations. Here, we present a case of Baylisascaris-induced DUSN from the densely populated borough of Brooklyn in New York City and alert urban ophthalmologists to consider this etiology even in areas not typically thought to be associated with endemic risk factors. Infected raccoons also occur in urban settings, and urban patients may be exposed in surrounding areas. Most patients with Baylisascaris ocular larva migrans-DUSN will not have concomitant neurologic disease; this fact and larval neurotropism are both misconceptions regarding this infection.
Highlights
Diffuse unilateral subacute neuroretinitis (DUSN) is a progressive inflammatory and degenerative disease affecting the retina, retinal vessels, and optic nerve head, secondary to infection with nematode and possibly other helminth larvae [10,11]
As first proposed in the mid-1980s, DUSN is a multi-etiologic syndrome, being caused by several possible species of nematodes whose larvae fall into different size ranges [10,13,15]
B. procyonis is the primary cause of the large nematode variant (1500–2000 μm) and is the most common cause of DUSN in the northern and midwestern United States and Canada, with cases reported from Europe [16]
Summary
Cases of Baylisascaris DUSN are usually observed in regions where raccoons, the definitive host, are found such as rural and suburban communities in the northern and Midwestern United States [10,13,15]. This entity has been less often reported within densely urban communities, even though raccoons are known to occur in this setting [13]. A New York City Department of Health public health advisory was released, in response to this case as well as another of our urban patients, an infant with B. procyonis-induced neural larva migrans (NLM), who suffered permanent severe neurological impairment [21]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
