CPC 2018 03 08 PinPen Hsieh MD Department

CPC 2018 03 08 Pin-Pen Hsieh, MD Department of pathology and laboratory medicine, KSVGH

cornea

Retina

Retina

Choroid

Inflammatory exudate(H&E 40 X)

Parasite, 200 um(H&E, 400 X)

• Consultation to Prof. Chuan-Min Yen

Differentail diagnosis of ocular parasite • 1. Onchocerca volvulus (蟠尾絲蟲病, microfilaria 150~350 um): Primarily found in patients with travel history, especillay have been to Africa. • Skin lesion with itching, river blindness

Onchocercal ocular disease Clinics in Dermatology (2006) 24, 176– 180

• 2. Trichinella spiralis (旋毛蟲. larvae 80~120 um): Especillay in patients with history of taking undercooked meat products

D. M. Abou Rayia et al. / Parasitology International 66 (2017) 56– 63

• 3. Toxocara canis(larvae 350 um~): The length of Toxocara canis is not compatible with the parasite of this case.

• 4. Hookworm(filariform larvae 590 um~): The length of Hookworm is not compatible with the parasite of this case. • Please check stool sample for ova. • Rhabditiform larva: soil, 250 um

• 5. Strongyloides stercoralis (糞小桿 線蟲, filariform larvae 550 um~, rhabditiform larvae about 250 um) • It may be possible if the patient lives in non-urban and has immunocompromised status. • Suggest check the stool sample for larvae.

Skin Haematol 2011; 126: 63– 67

• 6. Thelazia callipaeda (結膜吸吮線蟲 , adult worm female 0. 7~1. 9 cm, male 0. 4~1. 3 cm) • Larvae?

Conclusion • Trichinella spiralis (旋毛蟲) • Strongyloides stercoralis (糞小桿線蟲) • Thelazia callipaeda, larvae? (結膜吸吮線蟲)

Thank you