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Sonalika Mehta

Sonalika Mehta

Department of pediatrics,AIIMS RISHIKESH, uttarakhand India

Title: Subconjunctival cysticercosis- Is surgery always indicated? Role of medical management – Literature review and a case report

Biography

Biography: Sonalika Mehta

Abstract

Case report-

Introduction: One of the most important parasites which frequently causes blindness in humans is the cysticercus cellulosae which is the larval form of the pork tapeworm Taenia solium .Humans are the intermediate hosts in the life cycle. Cysticercus cellulosae may become encysted in various bodily tissues, usually the eyes, central nervous system, and subcutaneous tissues leading to an immunologic reaction with  intense inflammatory signs and symptoms. Acquired strabismus, diplopia, recurrent redness, and painful proptosis are some of the clinical signs in patients with orbital cysticercosis. Diagnosis of cysticercosis is based mainly on orbital imaging.

Case report: 8 year old girl presented to pediatric department of AIIMS rishikesh with a large cystic swelling in the upper part of the right eye which was gradual in onset and constant in size for the past 6 months. On examination, the visual acuity was 6/5, N6 in both the eyes. On examination of right eye  a large 1.5 × 1.5 cm firm and mobile mass was present at the 10 o’clock meridian. B-scan ocular ultrasonography revealed a well-defined cystic lesion with clear contents and a hyperechoic area suggestive of a scolex. A-scan USG showed high amplitude spikes corresponding to the cyst wall and scolex.MRI brain revealed associated neuro-cysticercosis. The child was started on oral steriods followed by albendazole at 15 mg/kg. Steroids tapering was started after 14 days while albendazole was continued for six weeks till complete resolution of the swelling which was monitored by serial ocular USG scans. Medical management is the standard of care for extraocular  cysticercosis1.To the best of out knowledge there has been no case report on complete resolution of subconjunctival cysticercosis by medical management alone2,3 and surgical management has been used early in the course of disease with associated complications of invasive management4,5,6.Thus our case adds to the existing literature in the management of subconjunctival cysticercosis.

 

BIBLIOGRAPHY:

  1. Patel D, Trivedi H, Murade S, et al. Ocular cysticercosis: a review. Bombay Hosp J. 2011;53:420–5.
  2. Gupta C. and Alam S. A case of non-resolving subconjunctival cysticercosis managed by surgical excision, Sci J Med & Vis Res Foun 2016;XXXIV:67–69.
  3.  S. Giriyan S, Kumar Nirala N. Subconjunctival Cysticercosis: Case Report and Review of Literature. International Journal of Science and Research (IJSR). 2016;5(8):1939-42.
  4. Dhiman R, Devi S, Duraipandi K, Chandra P, Vanathi M, Tandon R, Sen S. Cysticercosis of the eye. Int J Ophthalmol. 2017 Aug 18;10(8):1319-1324. doi: 10.18240/ijo.2017.08.21. PMID: 28861361; PMCID: PMC5554854.
  5. Kaliaperumal S, Rao VA, Parija SC. Cysticercosis of the eye in South India--a case series. Indian J Med Microbiol. 2005;23:227–30.
  6. Bodh SA, Kamal S, Kumar S, Goel R, Nagpal S, Aditya KOrbital Cysticercosis. DJO 2012;23:99-103.