Human Ocular Onchocerca lupi Infection Diagnosed in Norway

Tiril Sandell,Frank Olav Pettersen,Anne Regine Skogen,Tore Lier

doi:10.34172/ijtmgh.2020.29

Abstract

Introduction: Zoonotic Onchocerca lupi infection is a rare but emerging zoonotic disease affecting the eye, subcutaneous tissue and subdural cervical spine. Endemic areas of O. lupi are East and Central Europe, Turkey, Iran and the Northwest of the USA. Thirteen confirmed cases have been published in the world literature. Case Presentation: We present a case of subconjunctival O. lupi infection in the left eye of a Norwegian male. The infection was most likely imported from Turkey. The diagnosis was verified by direct microscopy and molecular analyses with polymerase chain reaction (PCR) with subsequent sequencing. The worm did not contain microfilaria and was surgically removed. The patient was treated with tapering doses of topical steroids. At 6 months follow-up, he was asymptomatic. Conclusion: Increasing numbers of O. lupi infections are reported and it is not clear whether the increasing number of infections is true or due to availability of novel diagnostic tools that correctly identify the cases. Humans cannot eliminate their exposure to vector-borne zoonotic diseases and increasing globalization increases the risk of infection. Both physicians and laboratory staff should be aware of the existence of zoonotic onchocerciasis in their countries.

Highlights

Zoonotic Onchocerca lupi infection is a rare but emerging zoonotic disease affecting the eye, subcutaneous tissue and subdural cervical spine
Human zoonotic disease caused by Onchocerca lupi is rare but increasingly reported in the literature
Case Presentation A 54-year-old male of Turkish origin living in Norway since 1989 was presented to the Eye Clinic, Oslo University hospital (OUH) with a painful left red eye

Summary

Introduction

Human zoonotic disease caused by Onchocerca lupi is rare but increasingly reported in the literature. Extradural masses affecting the spinal cord have been seen in humans.[1,4] Diagnosis is achieved by microscopy of excised adult female worms which exhibit a particular cuticular structure. Case Presentation A 54-year-old male of Turkish origin living in Norway since 1989 was presented to the Eye Clinic, Oslo University hospital (OUH) with a painful left red eye. The patient gave his written and oral consent to publish these data. The patient was treated with topical steroids in tapering doses and seen at regular intervals At 6 months follow-up, the patient was symptom free and the only ophthalmological finding was slight hyperemic vessels in the area of previous worm removal

Discussion

Conclusion