A rare case of loiasis clinically manifested 9 years after the last epidemiological exposure

Abstract

A 37-year-old Cameroonian patient, residing in Italy for the past nine years without returning to his home country, showed up at the Emergency Department of Cittadella Hospital with acute hyperemia of the conjunctival tissue, tearing, itching, headache in the right hemisphere and transient edema at ankles and wrists. A foreign body suspected to be a parasite was detected while migrating through his right eye. However, primary identification of the worm was hindered due to partial damage during surgical removal. The laboratory team based on the patient’s history and clinical manifestation, suspected blood infection due to microfi- lariae species and collected a blood sample at 12 pm. Microfilariae of Loa loa were identified in May Grunwald- Giemsa (MGG) staining (count of 270 microfilariae/mL) from a K2-EDTA blood sample. Identification of the microfilariae was based on morphological features, patient country of origin, and periodicity of the life cycle of the parasite.

Keywords

• Microfilariae
• Loa loa
• hyperemia
• conjunctiva
• MGG
• blood smear