A rare helminthic infection, most frequently unilateral, presenting in young healthy patients.

The raccoon roundworm, Baylisascaris procyonis, is a gastrointestinal parasite with zoonotic implications. To identify and describe available evidence pertaining to clinical B. procyonis infections in humans. A scoping review of the MEDLINE (via OVID), Web of Science, and CAB Abstracts databases. Sixty infections were identified. Most (38, 75%) were in males and the median age was 2.9 y (range: 9 mo to 73 y). Forty-seven (78%) individuals had neurological disease (9 with concurrent ocular disease), 11 had ocular disease alone, 1 had eosinophilic cardiac pseudotumor, and 1 was an incidental autopsy finding. Clinical signs of neurological disease were highly variable and progressive, with vague initial signs and symptoms. Ocular disease was most often manifested as diffuse unilateral subacute neuroretinitis, retinal lesions, and painless loss of vision and visual acuity. Outcomes were reported for 42 individuals with neurological disease: 8 (19%) died, 4 (10%) fully recovered, and the remaining 30 (71%) had mild to significant neurological residual deficits. Most (7/10, 70%) individuals with solely ocular disease had permanent vision loss. The severity of the disease, poor response to treatment, and widespread presence of the parasite in areas where raccoons are endemic indicate a need for awareness among the public, healthcare providers, and veterinarians. Infections humaines par le ver rond du raton-laveur, Baylisascaris procyonis : recension de la littérature. Le ver rond du raton-laveur, Baylisascaris procyonis, est un parasite gastro-intestinal aux implications zoonotiques. Identifier et décrire les données disponibles concernant les infections cliniques à B. procyonis chez l’humain. Recension de la littérature des bases de données MEDLINE (via OVID), Web of Science et CAB Abstracts. Soixante infections ont été identifiées. La plupart (38,75 %) concernaient des mâles et l’âge médian était de 2,9 ans (intervalle : 9 mois à 73 ans). Quarante-sept personnes (78 %) présentaient une maladie neurologique (dont 9 avec une maladie oculaire concomitante), 11 une maladie oculaire seule, 1 avec une pseudotumeur cardiaque éosinophilique et 1 était une découverte fortuite à l’autopsie. Les signes cliniques de la maladie neurologique étaient très variables et progressifs, avec des signes et symptômes initiaux vagues. Les maladies oculaires se manifestaient le plus souvent par une neurorétinite subaiguë unilatérale diffuse, des lésions rétiniennes et une perte indolore de la vision et de l’acuité visuelle. Les résultats ont été rapportés pour 42 personnes atteintes de maladies neurologiques : 8 (19 %) sont décédées, 4 (10 %) ont complètement guéri et les 30 autres (71 %) présentaient des déficits neurologiques résiduels légers à importants. La plupart (7/10, 70 %) des personnes atteintes uniquement de maladies oculaires ont subi une perte de vision permanente. La sévérité de la maladie, la faible réponse au traitement et la présence répandue du parasite dans les zones où les ratons-laveurs sont endémiques soulignent la nécessité d’une sensibilisation du public, des professionnels de santé et des vétérinaires.(Traduit par Dr Serge Messier).

Ophthalmological conditions in international travelers may be associated with low mortality but high morbidity. Eye involvement in travelers is less frequently reported than febrile, gastrointestinal and respiratory infections, but data probably represent a degree of under-notification. an extensive narrative review of the main viral, bacterial, fungal and parasitic infections affecting the eye in travelers was performed. Common respiratory tract viral infections may cause ocular complications in travelers, human influenza viruses have been associated with conjunctivitis and emerging avian influenza subtypes may also affect the eye. Vector-borne viral infections may affect travelers, usually with systemic symptoms, but eye disease may be the first presenting feature. A spectrum of manifestations have been described with dengue, chikungunya and Zika infections, including conjunctivitis, anterior uveitis, posterior uveitis with chorioretinitis and macular involvement. Staphylococcus spp, Streptococcus spp, and Pseudomonas spp (especially associated with use of contact lenses) are common causes of keratitis, however, resistance patterns to antimicrobials might vary depending on area of travel. Less frequent infections, such as Burkholderia pseudomallei, associated with environmental exposure, and Bartonella spp. may rarely present with ophthalmological involvement in travelers. Fungal ocular infections, especially after ocular trauma caused by plants and contact lens use, should be considered in patients with stromal keratitis not improving with antibiotic eye drops. Parasitic eye infections tend to occur in tropical areas, but some, such as acanthamoebic keratitis or Toxoplasma spp retinitis, are found worldwide. Increasing exposure to animals, undercooked food consumption or poor hygiene during international travels might be leading to the emergence of certain parasitic eye diseases. Clinical features, with identification of risk factors and geographical region of exposure, can assist in the definitive diagnosis of imported ophthalmological infections. Management of imported eye infections requires a multi-disciplinary approach involving ophthalmologists, travel medicine/infectious diseases physicians and other specialists.