Scientific letter
Ocular thelaziosis, an emergent zoonosis in Spain
Thelaziosis ocular, una zoonosis emergente en España
Ramiro López Medranoa, Gloria Guerra Callejab, Carolina Díez Morrondoc, Rosario Panadero Fontánd,
Corresponding author
a Sección de Microbiología, Hospital El Bierzo, Ponferrada, León, Spain
b Servicio de Oftalmología, Hospital El Bierzo, Ponferrada, León, Spain
c Sección de Reumatología, Hospital El Bierzo, Ponferrada, León, Spain
d Departamento de Patología Animal, Facultad de Veterinaria de Lugo, Universidad de Santiago de Compostela, Lugo, Spain
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author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Thelaziosis ocular, una zoonosis emergente en España" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1735 "Ancho" => 1625 "Tamanyo" => 247003 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Specimen of <span class="elsevierStyleItalic">Thelazia callipaeda</span> collected from the conjunctival sac of the patient.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Thelaziosis is a disease caused by nematodes belonging to genus <span class="elsevierStyleItalic">Thelazia</span> described in pet and wild carnivores (dogs, cats, foxes, etc.) and occasionally in humans.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> This infection in Europe is transmitted by the insect vector <span class="elsevierStyleItalic">Phortica variegata</span>,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> which acquires and deposits the parasitic nematode larvae in the host ocular conjunctiva while is nourished from lacrimal secretion.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">This letter reports a case of human ocular thelaziosis in northern Spain (El Bierzo), where cases of canine thelaziosis have also been reported recently; clinical symptoms linked to this parasitism are described and we warn on the inclusion of this infection in the differential diagnosis in cases with conjunctival condition.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient is a 24 year old male who visits the emergency room suffering from a foreign body sensation in his right eye, accompanied by profuse lacrimation. Ophthalmic examination of the right eye showed no corneal injury, with normal anterior chamber and crystalline lens. The conjunctiva was hyperemic, and on the inner side of the lower conjunctival sac there was a white foreign body, threadlike (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The next day, the patient returned with the same feeling of a foreign body in the same eye; in examination another 4 foreign bodies similar to the first one were seen and removed. In an exhaustive search, no further foreign bodies were detected and treatment with topical antibiotic and oral mebendazole was prescribed. After the mechanical extraction of foreign bodies the symptoms disappeared and there were no recurrences.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The collected specimens were identified as parasitic nematodes of <span class="elsevierStyleItalic">Thelazia callipaeda</span> based on morphological features such as serrated cuticle, hexagonal oral capsule with 6 festoons and the position of the vulva, before the junction of the esophagus to the intestine, with a typical flap. The molecular identification was performed by amplification and sequencing of the mitochondrial cytochrome <span class="elsevierStyleItalic">c</span> oxidase subunit 1 gene (689<span class="elsevierStyleHsp" style=""></span>pb). The sequences obtained from nematodes were identical to those of <span class="elsevierStyleItalic">T. callipaeda</span>, haplotype 1 (no. access GenBank<span class="elsevierStyleSup">®</span> AM<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>42549), the only one present in Europe shared by people and animals.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Since diagnosis of cases of canine thelaziosis is increasing significantly in many regions of Spain and prevalence is increasing in northern country,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4,5</span></a> both primary care physicians and ophthalmologists should take into account the differential diagnosis in cases of conjunctivitis and excessive tearing, and avoid inappropriate treatments and possible complications.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally, this case confirms that this nematode has found a good environment to complete their life cycle in northern Spain, which together with the poor knowledge of clinical cases of this nematode might lead to misdiagnosis and inadequate therapy.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,4</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López Medrano R, Guerra Calleja G, Díez Morrondo C, Panadero Fontán R. Thelaziosis ocular, una zoonosis emergente en España. Med Clin (Barc). 2015;145:317–318.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1735 "Ancho" => 1625 "Tamanyo" => 247003 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Specimen of <span class="elsevierStyleItalic">Thelazia callipaeda</span> collected from the conjunctival sac of the patient.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thelazia eyeworm: an original endo- and ecto-parasitic nematode" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. 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