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Diffuse unilateral subacute neuroretinitis. Morphometric, serologic, and epidemiologic support for Baylisascaris as a
M A Goldberg1, K R Kazacos, W M Boyce
1Neuro-Ophthalmology Unit, California Pacific Medical Center, San Francisco 94115.
Ophthalmology
|November 1, 1993
Summary
This study identifies Baylisascaris procyonis as a cause of diffuse unilateral subacute neuroretinitis (DUSN). Evidence from a California case and raccoon infections supports this finding for the large nematode variant of DUSN.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Parasitology
Background:
- Diffuse unilateral subacute neuroretinitis (DUSN) is an ocular condition with an uncertain etiology.
- Several nematode species have been implicated, but definitive causal links remain elusive.
- This study investigates a case of DUSN in the western United States, a region not previously considered endemic for relevant parasites.
Observation:
- A patient presented with DUSN, confirmed by the identification of a motile nematode within the retina.
- Morphometric analysis of the nematode and serologic testing (Western blot) were performed.
- Raccoons from the patient's locality were necropsied to assess for Baylisascaris procyonis infection.
Findings:
- The intraocular nematode's dimensions were consistent with Baylisascaris species.
- The patient exhibited serologic evidence of Baylisascaris procyonis infection and had significant raccoon exposure.
- Baylisascaris procyonis infection was confirmed in 8 out of 12 examined raccoons from the area.
Implications:
- This case provides strong evidence implicating Baylisascaris procyonis as the causative agent of the large nematode variant of DUSN.
- The findings expand the known geographic range for DUSN caused by this parasite.
- Highlights the importance of considering Baylisascaris procyonis in DUSN cases, particularly in regions with raccoon populations.