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Loiasis in a Japanese Traveler Returning from Central Africa.

Kobayashi T, Hayakawa K, Mawatari M, Itoh M, Akao N, Yotsu RR, Sugihara J, Takeshita N, Kutsuna S, Fujiya Y, Kanagawa S, Ohmagari N, Kato Y - Trop Med Health (2015)

Bottom Line: A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin.She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem.She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

View Article: PubMed Central - PubMed

Affiliation: Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo, Japan.

ABSTRACT
We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

No MeSH data available.


Related in: MedlinePlus

Erythematous swelling over the dorsal surface of the left hand (Calabar swellings)
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Related In: Results  -  Collection


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Figure 2: Erythematous swelling over the dorsal surface of the left hand (Calabar swellings)

Mentions: Two weeks after her initial visit to the outpatient clinic, the patient was admitted to our hospital for treatment of suspected loiasis. On admission, her left eyelid was swollen and found to be edematous. Her eye was reddened but no larval body was found upon examination. Treatment with albendazole (200 mg PO) twice daily was initiated upon admission. The eosinophil count remained between 3 and 5%, with white blood cell counts within the normal range throughout the course. The patient noticed linear erythematous cutaneous trail above her right knee on day 3 of albendazole treatment, which spontaneously disappeared within several hours. On day 5 of treatment, she noticed erythematous swelling over the dorsal surface of her left hand (Fig. 2), which disappeared in a few hours. On day 6 of treatment, her left arm became swollen (Fig. 3). The swelling gradually disappeared in 1 week, without any sequelae. She was discharged from our hospital on the 10th day of treatment, and oral administration of albendazole was continued at the outpatient clinic for a total of 21 days. No signs of relapse were observed at the time of follow-up, 5 months after the last day of oral treatment. The anti-filarial IgG antibody levels did not show change until day 3 of the albendazole treatment, but doubled on day 13, peaked on day 21, and decreased thereafter (Fig. 4). She received follow-up care at the outpatient clinic for 10 months after initial presentation, and no signs of relapse were observed.


Loiasis in a Japanese Traveler Returning from Central Africa.

Kobayashi T, Hayakawa K, Mawatari M, Itoh M, Akao N, Yotsu RR, Sugihara J, Takeshita N, Kutsuna S, Fujiya Y, Kanagawa S, Ohmagari N, Kato Y - Trop Med Health (2015)

Erythematous swelling over the dorsal surface of the left hand (Calabar swellings)
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4491493&req=5

Figure 2: Erythematous swelling over the dorsal surface of the left hand (Calabar swellings)
Mentions: Two weeks after her initial visit to the outpatient clinic, the patient was admitted to our hospital for treatment of suspected loiasis. On admission, her left eyelid was swollen and found to be edematous. Her eye was reddened but no larval body was found upon examination. Treatment with albendazole (200 mg PO) twice daily was initiated upon admission. The eosinophil count remained between 3 and 5%, with white blood cell counts within the normal range throughout the course. The patient noticed linear erythematous cutaneous trail above her right knee on day 3 of albendazole treatment, which spontaneously disappeared within several hours. On day 5 of treatment, she noticed erythematous swelling over the dorsal surface of her left hand (Fig. 2), which disappeared in a few hours. On day 6 of treatment, her left arm became swollen (Fig. 3). The swelling gradually disappeared in 1 week, without any sequelae. She was discharged from our hospital on the 10th day of treatment, and oral administration of albendazole was continued at the outpatient clinic for a total of 21 days. No signs of relapse were observed at the time of follow-up, 5 months after the last day of oral treatment. The anti-filarial IgG antibody levels did not show change until day 3 of the albendazole treatment, but doubled on day 13, peaked on day 21, and decreased thereafter (Fig. 4). She received follow-up care at the outpatient clinic for 10 months after initial presentation, and no signs of relapse were observed.

Bottom Line: A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin.She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem.She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

View Article: PubMed Central - PubMed

Affiliation: Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo, Japan.

ABSTRACT
We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred.

No MeSH data available.


Related in: MedlinePlus