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Toxocariasis in childhood: progression, treatment and outcome

Poster Details

First Author: T.Valadao BRAZIL

Co Author(s):    N. Maes   R. Souza   B. Mota   W. Lima   M. Mendes   I. Cunha     

Abstract Details

Purpose:

To describe a clinical case of ocular toxocariasis with presented posterior pole granuloma, focusing on complementary diagnostic exams, treatment and outcome.

Setting:

Bonsucesso Federal Hospital, Rio de Janeiro, Brazil

Methods:

A male patient, 11 years old, complaining of visual loss for the last 2 months. Visual Acuity in right eye was 20/20 (1.0), left eye CD. The fundus exam was also normal in the right eye, and the left eye presented blurred margins of the optic nerve, regular vessels, and granuloma mass around macular region, measuring 1.5 optic disc diameter, and mild vitritis. General uveitis screening laboratory was requested and the patient was evaluated by a Retina specialist, who presumed a toxocariasis diagnosis. The treatment was immediately initiated with Albendazole 400mg/day for 30 days, associated with anti-inflammatory doses of prednisone

Results:

Laboratory exams excluded cytomegalovirus and Syphilis, toxoplasmosis IgG was positive, and IgM negative and blood count showed 10% eosinophilia. Specific toxocara antibody tests were, unfortunately, not available in the public health system. There was a history of close contact with dog puppies during the presentation of the clinical symptoms. At the end of the treatment there was reduction of the vitritis and the granuloma size, that became well delimitated, with a scaring halo, measuring 1.0 optic disc diameter and we could observe a pre-retinal membrane development around the lesion and the final visual acuity remains the same

Conclusions:

Despite its unusual frequency, ocular toxocariasis is still an important cause of childhood uveitis and must always be remembered in the leukocoria differential diagnosis. Antibody testing is not always reliable, which makes the epidemiology and clinical manifestations essentials to confirm its diagnosis. Although still controversial, antihelminthic agents seemed to be useful to delimitate the subretinal granuloma in this case.

Financial Disclosure:

NONE

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