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Background: Thelaziasis is a zoonotic disease mainly caused by Thelazia callipaeda (Spirurida, Thelaziidae, Thelazia), which can cause mild to severe signs and lesions, such as foreign body sensation, itching, tearing, eye pain, conjunctival bleeding, conjunctivitis, corneal ulcers, and even blindness. Thelaziasis cases have been reported mainly in agricultural areas and areas with high potential for contact with domestic animals [1]., Case Presentation: We report a case of Thelazia callipaeda infection in the right eye of a 41-year-old woman working in an office. The patient presented with persistent foreign body sensation, pruritus, and redness despite initial treatment with polyethylene glycol and levofloxacin eye drops. Subsequent examination revealed the presence of multiple Thelazia callipaeda worms, which were successfully removed. Postoperative treatment with gatifloxacin eye ointment resulted in significant symptom relief with no recurrence over two months., Conclusions: This case highlights the thelaziasis in urban settings, emphasizing the need for ophthalmologists to consider parasitic infections in differential diagnosis even in well-maintained environments. Then, we provided an overview of human thelaziasis in China by mining publicly available databases from 2014 to 2023, suggesting a difference in regional distribution that warrants further epidemiological studies., Competing Interests: Declarations. Ethics approval and consent to participate: The study protocol was established, according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of Peking University Third Hospital (approval number: S2024042). Written informed consent was obtained from the patient for the publication of this case report. Consent for publication: Written informed consent was obtained from the patient for the publication of this case report. Competing interests: All authors declare that they have no conflicts of interest., (© 2024. The Author(s).)

Background: For a long time known as the oriental eyeworm, Thelazia callipaeda is a zoonotic nematode that infects the eyes of a wide range of vertebrate hosts including dogs, cats, wildlife carnivores, lagomorphs, and humans. The high occurrence of this infection in Europe and the first cases in the United States have increased scientific interest in the parasite, as it also represents a risk for people living in endemic areas. Therefore, treatment and prevention of thelaziosis in canine population are advocated to reduce the risk of human infection as well. Here, we assessed the efficacy of a formulation containing sarolaner/moxidectin/pyrantel (Simparica Trio ® ) administered orally at monthly intervals, for the prevention of establishment of infection with T. callipaeda in naturally infected dogs. In this formulation, moxidectin is expected to have efficacy against eyeworms, whereas sarolaner and pyrantel are not., Methods: The study was conducted in eyeworm endemic areas of Italy and France, where dogs (n = 125) were assigned into two groups consisting of a negative control group (G1; n = 62), in which animals were treated monthly with a control product (sarolaner; Simparica ® ), and a treatment group (G2; n = 63) in which animals were treated monthly with Simparica Trio (sarolaner/moxidectin/pyrantel) from day 0 to day 150. In total, nine animals were withdrawn from the study (two animals became positive at day 30, and seven for reasons unrelated to eyeworm infection), resulting in 116 animals (n = 58 for G1; n = 58 for G2)., Results: In G1, 16 out of 58 animals (27.6%) were observed with eyeworms during the study, and none of the animals from G2 were ever observed with eyeworms, resulting in 100% efficacy (P < 0.0001) in the prevention of establishment of T. callipaeda infection. Adult nematodes and fourth-instar (L4)-stage larvae were recovered from the eyes of positive animals, counted, and morphologically identified as T. callipaeda. In addition, specimens from Italy were molecularly confirmed as belonging to the haplotype 1 (i.e., the only one circulating in Europe so far)., Conclusions: Data presented herein demonstrated 100% efficacy of Simparica Trio for the prevention of T. callipaeda eyeworm infection in dogs from highly endemic areas of France and Italy. The use of this formulation is advantageous, as it is a licensed product in Europe with a wide efficacy spectrum against other nematodes, multiple tick species, and fleas. In addition, preventing the development of infection in dogs could also be a prophylaxis measure for zoonotic T. callipaeda infection in humans inhabiting endemic areas., (© 2022. The Author(s).)

In November 2021, a 19-year-old medical student was diagnosed with a rabbit-derived Thelazia callipaeda infection in her left eye. She visited her doctor because she removed the white object by herself with a cotton swab 2 days earlier. She explained to the doctor that she rubbed her eyes without washing her hands when rabbit hair got into her eyes during the animal experiment class at school 2 weeks earlier. The other 2 worms were then taken out with ophthalmic forceps and were placed into physiological saline. The worms were sent to the Shandong Academy of Eye Disease Prevention and Therapy for examination. After identification, the worms were regarded as the female T. callipaeda. Ofloxacin eye drops and peranapulin eye drops were administered to control inflammation. No abnormality was found in the follow-up 2 weeks and 1 month later. This report highlights that it is very important to strengthen the health and safety education of medical students during animal experiment classes., Competing Interests: Conflict of interest All authors declare that they have no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In this review, epidemiological features, diagnosis, and treatment processes of Gongylonema pulchrum cases were discussed. G. pulchrum is a spiruroid nematode usually seen in ruminants; it is known to occasionally infect humans. In humans, reports revealed that it is usually located in the oral cavity and that the most common symptom is the sensation of a moving foreign body in the mouth. Although there is no proven treatment approach yet, it is thought that the most effective treatment is surgery. After surgical treatment, it has been observed that albendazole is administered as the drug therapy in almost all cases. Although the conflict about the benefit of albendazole continues, it is claimed that the drug controls the disease and prevents its recurrence. It has been reported that clinicians sometimes experience difficulties in differential diagnosis due to a lack of knowledge and experience on this rare parasite. A better understanding of the etiopathogenesis of Gongylonema infections will facilitate the diagnosis and treatment of this infection.

Objectives: Thelaziosis caused by the nematode Thelazia callipaeda (Spirurida, Thelaziidae) affects the eyes of domestic and wild carnivores, lagomorphs and even humans. The role of cats in spreading thelaziosis remains unclear. The present study assesses the current status of feline T callipaeda infection in Spain and presents the results of the first prophylactic trial conducted in this species., Methods: We retrospectively analysed the occurrence of feline thelaziosis (study 1), examined its prevalence based on cross-sectional sampling of endemic areas (study 2), and assessed the therapeutic/prophylactic benefits of a spot-on (moxidectin) and therapeutic efficacy of an eye drop (ivermectin) formulation (study 3)., Results: In study 1, 69 Thelazia -infected cats were examined. Autochthonous cases were detected in 18/26 municipalities surveyed in Spain, which corresponds to 88.4% (n = 61/69) of the total number of cases. In study 2, 74 cats (20 from La Vera region and 54 from Orense province) were examined from 2011 to 2013. Ten of these cats (13.5%) were infected with T callipaeda . The infection prevalence was 40% (n = 8/20) in La Vera and 3.7% (n = 2/54) in Orense. The therapeutic efficacy of ivermectin was assessed over a summer (2011) in 12 cats, while that of moxidectin was examined over a 17-month period in seven cats. Four of these seven cats were subsequently included in an all-year-round prophylaxis trial. Treatment efficacy ranged from 91.7% (ivermectin) on day 28 after treatment to 100% (moxidectin) on day 14. Moxidectin prevented reinfections in cats., Conclusions and Relevance: Our data confirm the endemic status of T callipaeda infection in Spain, revealing its high prevalence in cats living in known endemic areas. Moxidectin was effective in treating and preventing infection. We strongly recommend the inclusion of thelaziosis in the differential diagnosis of pets and humans presenting with ocular manifestations, along with adequate preventive measures.

Background: The present clinical field trial was conducted to assess the efficacy of a broad-spectrum parasiticide spot-on formulation containing eprinomectin (Broadline ® ) against Thelazia callipaeda eyeworm in naturally infected cats., Methods: Fifteen privately owned cats harboring at least one live adult T. callipaeda were included in the study. Cats were randomly allocated to an untreated control group of seven cats or to a Broadline ® -treated group of eight cats. Cats were treated on Day 0; ocular examinations were performed at inclusion and on Days 7 and 14; eyeworms were recovered and counted on Day 14. The primary efficacy assessment was based on group comparison of number of T. callipaeda on Day 14., Results: Seven days after treatment, six of eight treated cats were negative for eyeworm infection per visual examination, and on Day 14 no eyeworms were found in the treated cats while the seven untreated cats were still infected (geometric mean: 1.97). All cats had inflammatory ocular signs at inclusion; on Day 14, five of eight treated cats had recovered while all untreated control cats were still symptomatic. All collected parasites were confirmed to be T. callipaeda by morphology and molecular characterization., Conclusions: A single treatment with Broadline ® provided 100% efficacy against feline thelaziosis and improved related ocular inflammation signs., (© 2021. The Author(s).)

Objective: This study aimed to evaluate the efficacy of eprinomectin, moxidectin and fenbendazole for treating Dentostomella translucida infections in naturally infected Mongolian gerbils ( Meriones unguiculatus )., Methods: A total of 28 gerbils were placed in individually numbered cages to determine the individual animal parasite load. Eggs per gram (EPG) counts were used to estimate the efficacy of the drugs. The day before the anthelmintic administration was denoted as day 0, and the EPG counts were determined by the McMaster technique from the stool removed from the cage bottom on days 7, 14, 21 and 28. The animals were assigned to one of four treatment groups according to their day 0 EPG counts. The orally administered drugs in the treatment groups were eprinomectin (15 mg/kg), moxidectin (0.4 mg/kg) and fenbendazole (12 mg/kg) for groups 1-3, respectively. The fourth group served as the control (without any drug administration)., Results: Treatment efficacy was evaluated based on weekly EPG counts. The values decreased to zero in the fenbendazole group at 4 weeks of follow-up after treatment, and no parasite was found in any of the repeated examinations. The eprinomectin and moxidectin groups exhibited a fluctuating EPG state on both individual and group basis., Conclusion: D. translucida , which is known as the specific parasite of gerbils, can easily affect other members of the animal colony; thus, the control of its presence in gerbil breeding units is necessary. Therefore, the reported effective drug treatments are important for the fight against the investigated parasitic infection.

This study examines the therapeutic and year-round prophylactic efficacy of different formulations used in dogs in three Spanish areas where canine thelaziosis is endemic. The study was conducted as a Good Clinical Practice, multicentre, randomised field study in privately owned outdoor dogs naturally infected with Thelazia callipaeda. The active pharmaceutical ingredients tested were: an oral formulation of milbemycin oxime 12.5 mg combined with praziquantel 125 mg (A), a subcutaneous sustained-release formulation of moxidectin 10 g (B), a moxidectin 2.5% weight/volume (w/v) spot-on formulation combined with imidacloprid 10% w/v (C), and an eye drop formulation (6 µg) of ivermectin 10 mg/ml diluted 10% in propylene glycol (D). Infected dogs were randomly allocated to treatment Groups A, B, C and D. Dogs testing negative for T. callipaeda inspection in two visits (Day 7/Day 14 and D30) were enrolled in the prophylaxis trial and reallocated to the corresponding study group (A, B, C or D). Treatment efficacy ranged from 70.4% recorded in Group A 1 week after treatment, to 100% recorded in Group C on Day 30 and in Group B on Day 60. Treatment was more efficacious in Group D (85.7% 1 week after treatment) than A, but was never 100% efficacious as in Groups B and C. Year-round prophylactic efficacy was 83.3% in Group A, 100% in Group B, 93.5% in Group C and 87.5% in Group D. In conclusion, products containing moxidectin were highly efficacious both in treating and preventing canine thelaziosis. Milbemycin also emerged as a good option. However, the off-label use of topical or subcutaneous ivermectin should be avoided due to possible adverse reactions such as pruritus, irritation or redness. In endemic areas, monthly prophylaxis to limit the spread of T. callipaeda to new areas across Europe and reduce zoonotic risks is essential., (Copyright © 2020 Australian Society for Parasitology. Published by Elsevier Ltd. All rights reserved.)

The first case of feline ocular Thelazia callipaeda infection and two new canine imported infections in West Germany are here described. The three animals had a history of recent travel to/from other countries. The young adult cat imported from Spain presented an intermittent unilateral ocular discharge. During in-depth ophthalmic examination, a single alive nematode was removed from the conjunctival compartment of the affected eye. Referring to the canine cases, an adult female dog originated from Kenya presented epiphora and mucous whitish-grey discharge of the right eye. During flushing of the nasolacrimal duct two small, thin and long nematodes were removed. Furthermore, a male Borzoi racing dog with regular visit to racing tracks in different countries presented ocular mucous discharge. At ophthalmologic examination, two transparent-whitish vital nematodes were removed. All nematode specimens of the three cases were morphologically identified as adult T. callipaeda parasites. The animals were treated orally with milbemycin oxime (2.0 mg/kg; cat) or milbemycin oxime/praziquantel (0.5 mg/kg and 5.0 mg/kg; dogs) twice with 1-week interval resulting in complete resolution of symptoms. The repeated introduction of patent T. callipaeda-infected animals, especially from southern and eastern endemic countries, will ease the establishment of ophthalmic thelaziosis in Northern Europe. The male fruit fly, Phortica variegata, an intermediate host of T. callipaeda, is endemic within European countries. Considering the clinical and zoonotic relevance of ophthalmic thelaziosis, enhanced disease awareness of European medical and veterinarian doctors and in-depth eye examination for proper detection of T. callipaeda are crucial for appropriate anthelmintic treatments and to limit spreading of the infection.

Background: The present study evaluated the therapeutic effectiveness of moxidectin 1.0% (w/v) and imidacloprid 10% (w/v) (Advocate® spot-on solution for cats, Bayer Animal Health) against natural infections with the eyeworm Thelazia callipaeda in cats. This study was conducted as a GCP, negative-controlled, blinded and randomised field study in privately owned cats living in an area in southern Italy where T. callipaeda is enzootic., Methods: The study was carried out in 30 cats (19 females and 11 males, aged from 8 months to 5 years, weighing 1.2-5.2 kg) of different breeds, naturally infected by T. callipaeda. At study inclusion (Day 0), animals were physically examined and the infection level was assessed by examination of both eyes for clinical score and live adult T. callipaeda count. Each cat was weighed and randomly assigned to one of the treatment groups (G1: Advocate, G2: untreated control). Clinical assessments and T. callipaeda adult counts were performed on Day 14. At the study completion visit on Day 28, clinical assessments and counts of T. callipaeda adults and larvae were performed. All cats were daily observed by their owners and general health conditions were recorded during the entire period of the study., Results: The primary effectiveness variable was the percentage of animals in G1 group (Advocate) showing a complete elimination (parasitological cure) of adult eye worms at Day 14 and Day 28 . The effectiveness of the treatment in the G1 group was 93.3 and 100% at Day 14 and Day 28 , respectively, when compared to group G2. Total worm count reduction from both eyes for Advocate was 96.3% on Day 14 and 100% on Day 28. Clinical data were confirmed by the examination of conjunctival pouch flushing. An overall reduction in the number of cats with lacrimation and conjunctivitis was observed following treatment despite the fact that in a few cats treated with Advocate clinical signs persisted due to the chronic nature of the disease., Conclusions: Based on the results of the present trial, a single dose of Advocate was found to be safe and highly effective in the treatment of natural T. callipaeda infection in cats.

In the past decade, canine thelaziosis due to Thelazia callipaeda has been diagnosed in an increasing number of European countries, with endemic areas being identified. A multi-center field trial was conducted in endemic areas in France and Spain to evaluate the efficacy of monthly administrations of the oral milbemycin oxime/afoxolaner combination (NexGard Spectra ® ) for the prevention of T. callipaeda infection in at-risk dogs. A total of 79 dogs negative for T. callipaeda and with a clinical history of eyeworm infection in the past two years completed the study. Dogs were randomly allocated either to a negative control group (42 dogs) or to the NexGard Spectra ® treated group (37 dogs). All dogs were followed up for a 6-month period and assessed monthly for the presence of nematodes on the eyes and for the signs of ocular thelaziosis (e.g., conjunctivitis, keratitis, and ocular discharge). When the presence of nematodes was confirmed, the conjunctival fornix was flushed with a saline solution for parasite recovery and counting, and the dogs were treated appropriately. Recovered parasites were stored in 70% alcohol for subsequent morphological identification. During the course of the study, 57.1% (24/42) of the control dogs were diagnosed positive for Thelazia infection, which illustrates a high incidence rate of parasite infection. Conversely, no eyeworm was recovered from any of the 37 dogs that received NexGard Spectra ® . All parasites sampled were confirmed to be T. callipaeda. This clinical field study demonstrated that monthly administrations of NexGard Spectra ® provided 100% preventive efficacy against canine thelaziosis., (© W. Lebon et al., published by EDP Sciences, 2019.)

Background: Dogs are the definitive hosts of Spirocerca lupi. Spirocercosis is treated by prolonged avermectin administration by injection or daily oral doses. In this prospective, double-blinded, placebo-controlled, clinical trial, the efficacy of imidacloprid and moxidectin spot-on formulation (Advocate®) was compared to injectable doramectin (Dectomax®). Dogs diagnosed with benign esophageal spirocercosis were divided randomly into doramectin (400 μg/kg IM) or moxidectin and imidacloprid spot-on (2.5-6.25 mg/kg and 10-25 mg/kg, respectively) groups and treated weekly for 12 consecutive weeks. Dogs were followed for 20 weeks by physical examination, owners' questionnaire, blood work, fecal floatation, PCR and endoscopy., Results: All the doramectin group dogs (n = 10) completed the treatment and follow-up, and the disease had completely resolved in all by week 12. Of the Advocate® group (n = 10), four had complete resolution at week 12, four had partial resolution, one dog did not respond to treatment, and one dog was switched to the doramectin protocol on week 5 due to persistent severe clinical signs. PCR analysis was more sensitive in detecting S. lupi eggs compared to fecal floatation. Discrepancies were detected on 22 occasions, of which on 20 occasions, the PCR was positive while fecal floatation was negative, and only on two occasions the PCR results were negative while fecal flotation was positive., Conclusions: The present results indicate that weekly Advocate® spot-on administration may be effective for treating benign esophageal spirocercosis, but is less effective than the currently used injectable doramectin therapy at the dose and duration used herein.

Thelazia callipaeda (Spirurida, Thelaziidae), the so-called oriental eyeworm, has been increasingly reported as an agent of infection in animals and humans from many European countries. Clinical signs range from subclinical to moderate or severe ocular disorders (e.g., epiphora, photophobia, conjunctivitis, keratitis, ulcers). The disease has been also diagnosed in animals from countries of the Balkan area (e.g., Croatia, Bosnia and Herzegovina and Serbia), but only a single case of canine thelaziosis, presumably autochthonous, was reported in Northern Greece. In this study, we provide robust information of the occurrence of thelaziosis in Greece by reporting autochthonous cases of thelaziosis in dogs (n = 46), cats (n = 3) and in one rabbit (Oryctolagus cuniculus) living in Northern and Central regions of Greece. The occurrence of a single haplotype of the cytochrome oxidase subunit 1 gene confirms that the same zoonotic haplotype of the parasite circulating in Europe is also spreading in Greece. The increased awareness of this parasitosis is crucial to limit the risk of further infections in both humans and animals in European countries., (© 2017 Blackwell Verlag GmbH.)

Infection with Serratospiculum species was identified in a captive peregrine falcon (Falco peregrinus) in Switzerland. Pathologic and parasitologic examination results revealed generalized severe granulomatous airsacculitis, with intralesional adults, larvae, and eggs of Serratospiculum species. Subsequently, an individual coprological analysis of the remaining 15 falcons (peregrine falcons and gyrfalcons [Falco rusticolus]) from the same owner was performed. Eggs of Serratospiculum species (4 birds) and Capillaria species (11 birds), and oocysts of Caryospora species (1 bird) were detected. Treatment with ivermection (2 mg/kg SC) was effective, as none of the falcons excreted Serratospiculum species eggs 10 days after one dose. To our knowledge, this is the first report of infection with Serratospiculum species in captive falcons in Europe.

Scanning electron microscopy (SEM) was used to study the morphological alteration occurring in Habronema muscae adult female worms after in vitro exposure to different doses of Verbesina alternifolia oil extract. The half maximal lethal concentration (LC50) was reached 400 ppm after 24hrs, while LC100 was reached 600 ppm after 48hrs. Irreversible degenerative changes were recorded such as shrinking, detachment and distortion of the cuticle, cephalic and distal region. The cuticular surface had a wrinkled, corrugated appearance with longitudinal ridges and transverse thick folds. The lips and papillae were deformed and aggregated over each other. There is a direct relation between the level of the recorded degenerative changes and the increase in the dose and exposure time. In the same time no degen'erative changes were recorded in the control worm exposed to PBS till the end of the exposure period.

Thelazia callipaeda (Spirurida, Thelaziidae) has been documented as agent of ocular infection in domestic animals (dogs and cats), wildlife (e.g., foxes, hares, rabbits), and humans. In the last two decades, this parasitosis has been increasingly reported in several European countries. Both adult and larval stages of the eyeworm are responsible for symptoms ranging from mild (e.g., lacrimation, ocular discharge, epiphora) to severe (e.g., conjunctivitis, keratitis, and corneal opacity or ulcers). The present study evaluated the clinical efficacy and safety of imidacloprid 10% and moxidectin 2.5% spot on (Advocate(®), Bayer Animal Health) in comparison to milbemycin oxime/praziquantel tablets (Milbemax(®), Novartis-Animal Health), as positive control, in the treatment of canine thelaziosis in naturally infected dogs and, a third group was used as an untreated control. Forty-seven dogs (27 females and 20 males) harbouring at least one live adult worm of T. callipaeda in one eye were enrolled from an endemic area of southern Italy. Each dog was then weighed and assigned in accordance with a random treatment allocation plan to one of the treatment groups (G1: imidacloprid 10% and moxidectin 2.5% spot on, G2: Untreated control and G3: milbemycin oxime/praziquantel tablets). On Day (D) 7, 14, 28 and 35 dogs were physically examined and the infection level was assessed by examination of both eyes, including conjunctival pouch and third eyelid for live adult T. callipaeda count and clinical scores. Dogs in G1 were treated on D0 and D28, whereas those in G3 on D0 and D7. Efficacy in G1 was 100% at each day post treatment (p<0.01). For the G3 group efficacy was 57.39% on D7 (p<0.05), 92.79% on D14 and 100% on D28 and D35 (p<0.01). The application of the spot on formulation moxidectin 2.5% and imidacloprid 10% was highly effective in the treatment of canine thelaziosis caused by T. callipaeda. Advocate(®) spot on can be recommended for the control of T. callipaeda infection, considering that this formulation is currently licensed in Europe for the treatment of a wide range of parasites affecting dogs., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

The nematode Spirocerca lupi (Rudolphi, 1809) is widely distributed but mostly occurs sporadically with stable populations only in certain geographic areas. This helminth mainly infects dogs and wild canids. Primary pathology relates to migration of third stage larvae (L3) damaging the thoracic aorta and establishment of adults in nodules in the oesophagus. The objective of the present study was to evaluate the efficacy of milbemycin oxime in combination with afoxolaner (NexGard Spectra(®), Merial), administered monthly, in preventing establishment of adult worms after experimental infection. Two groups consisting of eight animals each were experimentally infected with 15 L3 on Days -28, -14 and -2, respectively (45 L3 per animal in total). Group 1 dogs served as untreated (negative) control, whereas animals in group 2 were treated with NexGard Spectra(®) at a minimum dose of 0.5mg/kg milbemycin oxime on Day 0 and from then onwards every 28 days up to Day 140 (six treatment occasions). Endoscopy was performed on Day 112 and for some animals also Day 140. Necropsy for worm recovery and nodule/lesion scoring was performed on Day 168. All eight animals in the control group (group 1) presented with 1-3 nodules and worm counts ranging from 9 to 41. Six animals in the NexGard Spectra(®) group presented with 1-4 nodules and worm counts ranging from 1 to 5. Significantly (p<0.05) fewer worms were collected from treated animals in the treated group (geometric mean 1.7) versus the negative control group (geometric mean 22.0) with 92.3% efficacy calculated. There was no significant (p>0.05) difference between groups with reference to number of nodules in the oesophagus. However, nodules in the control group were significantly (p<0.05) larger than those in the treated group. Number and size of lesions in the dorsal aorta did not differ statistically between groups 1 and 2. Because NexGard Spectra(®) was administered 28 days after onset of inoculation, migrating and developing L3 caused damage to the aorta wall of animals in the treated group. Milbemycin oxime (administered as NexGard Spectra(®)) demonstrated effectiveness in reducing infection with adult Spirocerca lupi worms in the oesophagus., (Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.)

The eyeworm Thelazia callipaeda has been reported in different European countries, i.e. Italy, France, Germany, Switzerland, Spain, Portugal, Bosnia and Herzegovina, Croatia and Romania. The present article describes the first autochthonous case of ocular thelaziosis in a dog from Greece, thus revealing a new spot of infection in Europe. The dog in this case report, most likely infected at the northern borders of Greece, was referred to a private veterinary practice with conjunctivitis, oedema, keratitis, epiphora and mucoid discharge in both eyes. Seventy-seven nematodes were removed from both eyes, and the dog was treated with two subcutaneous injections of ivermectin 14 days apart, in combination with a topical antimicrobial medication. The parasites were morphologically and molecularly identified as T. callipaeda. Although in Greece there is no information about the presence and distribution of the fruit fly Phortica variegata, i.e. the intermediate host of T. callipaeda, the location where the dog was infected is environmentally suitable for its development. The present report of this zoonotic parasitosis indicates that in Greece, along with endemic areas in Spain and Italy, T. callipaeda is currently reaching its southernmost distribution limit in Europe.

Gongylonema pulchrum is an important parasite of captive primates. Twelve rabbits were infected with 30 third-stage larvae of G. pulchrum. At 4-7 months post-infection, animals were administered levamisole at a single dose of 12 mg/kg, levamisole at 8 mg/kg three times at 2-day intervals, levamisole at a single dose of 8 mg/kg after administration of mebendazole at 70 mg/kg for 3 days or 8 ml of distilled water for 3 days (control). Necropsy at 14 days after treatment revealed that single and multiple dosages of levamisole reduced nematode burdens by 68.4% and 89.5%, respectively. The combined regimen of mebendazole and levamisole exhibited high efficacy for treating G. pulchrum located widely within the upper digestive tract, with a reduction of 98.2%. These results suggest that this combined chemotherapy treatment may be effective against G. pulchrum infection, including buccal and lingual gongylonemiasis in primates.

Canine spirocercosis caused by Spirocerca lupi is a life-threatening helminthic disease featured by severe clinical signs and potential development of oesophageal neoplasia. This infection is considered fairly frequent in Europe but almost unknown in Italy, from where only few reports have been published in local journals at the beginning of the XXI century. In the present study, an autochthonous case of canine spirocercosis in a 2-year-old dog from southern Italy is described. The animal was admitted to a private veterinary clinic in the municipality of Potenza (Basilicata region) due to persistent dyspnoea, vomiting, and regurgitation. At the abdominal ultrasound, a mass (1.3 × 2 cm) was observed and, thereafter, surgically removed from the apical part of the stomach. A female specimen of S. lupi was morphologically identified during the histological examination of the nodule and its eggs were detected in the faeces. In addition, the morphological identification was confirmed by molecular amplification and sequencing of partial cox2 gene sequence of S. lupi. Veterinarians should be aware of the potential risks derived from infection with this spirurid, which requires specific diagnostic and preventive measures.

Ocular thelaziosis by Thelazia callipaeda is an emerging disease that affects primarily dogs, but also cats, foxes and other wild carnivores, as well as humans. Three clinical cases of unilateral conjunctivitis caused by Thelazia nematodes were detected in Border Collie, a dog breed intolerant to the macrocyclic lactones. Animals came from southwestern Spain, on the border with Portugal. Eight worms were collected and identified molecularly as T. callipaeda by amplification and sequencing of partial cytochrome c oxidase subunit 1 gene. Oral treatment with mebendazole 20mg/kg (Telmin(®)) was effective in curing the infection., (Copyright © 2013 Elsevier B.V. All rights reserved.)

A 13-year-old female Labrador Retriever presented with chronic regurgitation. Radiography and computed tomography (CT) revealed nodules in the caudal esophagus. Upper gastrointestinal endoscopy followed by histopathological examination revealed esophageal granulomas caused by Spirocerca lupi. The infection was treated with milbemycin oxime. The therapy was successful, and a remarkable reduction in granulomas was observed. This case report describes the diagnostic imaging findings and treatment outcome of a dog with S. lupi infection in Japan.

Equine habronematidosis has a global distribution and is caused by three spirurid species, Habronema muscae, Habronema microstoma and Draschia megastoma. A case of cutaneous habronematidosis in a stallion in a stable in Dubai, UAE gave occasion to investigate the parasite situation on the farm. Patent H. muscae infections were diagnosed in 18 out of 49 horses in a stable in Dubai, UAE with a xenodiagnostic test using houseflies as indicator host. All horses in the stable were treated with a single dose of moxidectin administered orally as 2% gel in a dosage of 0.4 mg/kg body weight and the efficacy of this targeted treatment was studied. Habronema infection was terminated in all horses. A fly survey conducted at the farm prior and after treatment revealed two muscid species: Musca domestica and Stomoxys calcitrans. Only M. domestica caught at the farm showed a natural infection with Habronema larvae prior and shortly after anthelmintic treatment. Later, examination of flies caught at the farm in monthly intervals up to the end of observation (8 months after treatment) gave negative results. The absence of infection in the intermediate host was an indication of the eradication of stomach worms. The described xenodiagnostic test is a useful tool to diagnose H. muscae infections and can be used to evaluate the efficacy of nematocides in equines., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Thelazia callipaeda (Spirurida, Thelaziidae) is a nematode that lives in the conjunctival sac of domestic and wild carnivores, rabbits and humans causing mild to severe symptoms (e.g., conjunctivitis, lacrimation, epiphora, blepharospasm, keratitis and even corneal ulceration) in infected animals. This report describes an autochthonous case of thelaziosis in a cat from the central region of Portugal, representing the most occidental record of thelaziosis in Europe. Adult nematodes recovered from alive animal were morphological identified as T. callipaeda. A portion of the mitochondrial cytochrome c oxidase subunit 1 gene (cox 1) from nematode specimens was amplified by PCR. Cox1 sequences of all specimens were identical to T. callipaeda haplotype 1. Additionally to these findings, a recent description of thelaziosis in the northern region of Portugal suggests that T. callipaeda has successfully established in Portugal., (Copyright © 2013 Elsevier B.V. All rights reserved.)

This study investigated the efficacy and safety of an imidacloprid 10 %/moxidectin 2.5 % spot-on combination (Advocate®, Advantage® Multi, Bayer) against immature and mature stages of Spirocerca lupi in experimentally infected dogs. 24 dogs were allocated to 3 groups and infected with approximately 10 L3 larvae of S. lupi orally on study day (SD) +2, +14, +28 and +42. Group 1 remained as untreated control group. Group 2 dogs were treated on SD –28, 0, and thereafter monthly until Day 280 (12 treatments). Group 3 dogs were treated weekly on 19 occasions starting on SD +170. The dosage for all treatments was the licensed dose of 10–25 mg imidacloprid/2.5–6.25 mg moxidectin per kg body weight. All dogs were examined on SD +169 or +176 by endoscopy. Group 3 dogs were additionally examined approximately every two weeks up to Day 296. On Day +308 or +310, all dogs were necropsied to recover S. lupi worms and to quantify lesions in the thoracic aorta and oesophagus. Dogs in the control group were adequately infected with S. lupi, demonstrated by the extensive damage to the thoracic aorta, the nodules in the oesophagus and the large numbers of worms recovered. In total 144 worms were collected (geometric mean of 16.8 worms per dog). Dogs in group 2 had no or very slight damage to the thoracic aorta and no nodules or worms in the oesophagus, indicating 100 % efficacy of the monthly treatments. Dogs in group 3 were also adequately infected, showing nodules in the oesophagus before initiation of weekly treatment, and at necropsy extensive damage was seen in the thoracic aorta. After treatment, three dogs of 8 still had a few nodules and in total three worms (GM of 0.25 per dog) were recovered, demonstrating an efficacy of 98.5 % against adult S. lupi. All dogs tolerated the treatment well and no treatment- related adverse events occurred.

This paper reports the diagnosis and treatment of one patient infected with Thelazia callipaeda, which suggests that in the diagnosis, the ophthalmologists should combine the epidemiological contact history with the examination so as to avoid misdiagnosis.

The purpose of this study was to evaluate the effect of a daily oral dose of doramectin in dogs with spirocercosis. Twenty naturally infected dogs were treated with 0.5 mg/kg doramectin administered orally once daily for 42 days. In 13 of the dogs there was resolution of the nodules after 42 days. Nodules were eliminated in five of the remaining seven dogs following treatment for an additional 42 days. In the remaining two dogs, treatment continued for a further 42 days (total 126 days), resulting in complete resolution. No adverse events associated with treatment were observed. This study concluded that doramectin at 0.5 mg/kg once a day is effective in the elimination of Spirocerca lupi nodules in dogs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Oxyspiruriasis caused by the bird eyeworm, Oxyspirura mansoni, a thelaziid nematode, in three species of pheasants, 3 Chrysolophus pictus (golden pheasant), 7 Lophura nycthemera (silver pheasant) and 9 Phasianus colchicus (common pheasant) in Zoo Negara Malaysia are reported. Birds with the disease were treated with a solution of 0.5% iodine or 0.5% lysol. Antistress powder for 4 days in water and non-strep vitamin powder in water was also provided. Control measures included removal of the cockroach intermediate host, Pycnoscelus surinamensis (Surinam cockroach) from the vicinity of the birds. The golden pheasant is a new host for O. mansoni in peninsular Malaysia.

Background: Over the last few decades, canine and feline thelaziosis caused by Thelazia callipaeda eye worms has gained the attention of the veterinary community due to the spread of this ocular infestation in geographical areas previously regarded as non endemic. The therapeutic efficacy of milbemycin oxime/praziquantel tablets (Milbemax®) against T. callipaeda was tested in naturally infested dogs and cats., Methods: From January 2009 to July 2011 a placebo controlled and randomized field study was conducted in T. callipaeda endemic areas of Switzerland (CH) and Italy (ITA) involving client-owned animals. Dogs (n = 56) and cats (n = 31) were physically examined at enrolment Day 0 (D0) and twice afterwards (D7 and D14). Infested animals were orally treated with Milbemax® or with placebo tablets on D0 and, if an animal was found still infested with T. callipaeda, also on D7. On D14 nematodes were flushed from the conjunctiva, identified and counted., Results: Out of 56 dogs, 43 were included in the statistical analysis, whereas 13 were excluded because the products under investigation were not administered with food, as required by the label. On D7 and D14, 72.7% and 90.9% of treated dogs were eye worm free, whereas in the placebo group 95.2% and 76.2% still harbored nematodes, resulting in a mean percentage worm count reduction for the Milbemax® group of 86.1% and 96.8%, respectively. Both results were significantly higher (p = 0.0001) than the placebo group. Out of the 31 cats included in the study at D7 and D14, 53.3% and 73.3% treated with Milbemax® were free of T. callipaeda, while 81.3% and 73.3 in the placebo group were still harbouring eye worms, resulting in a mean percentage worm count reduction for the treated group of 62.2% and 80.0%, respectively. Both results were significantly higher (p = 0.0106 and p = 0.0043) than the placebo group., Conclusions: The commercial formulation of milbemycin oxime at the minimal dose of 0.5 mg/kg and 2 mg/k in dogs and cats, respectively, showed a high therapeutic efficacy in curing T. callipaeda infestations. The advantages of an oral application are additionally increased by the large spectrum of activity of praziquantel and milbemycin oxime against Cestodes and Nematodes infesting dogs and cats.

The aim of this investigation was to determine the efficacy of milbemycin oxime in preventing the oesophageal encapsulation of Spirocerca lupi, following the experimental infection of dogs. Two studies were conducted which involved a total of 21 purpose-bred Beagles. Each dog was infected with approximately 40, third stage infective S. lupi larvae. The larvae were dissected from scarabaeid beetles that had been collected from areas endemic for spirocercosis. In the first study, milbemycin oxime (minimum dose 0.5mg/kg body weight) was administered to seven dogs on day 30 post-infection. Seven other dogs served as untreated controls. In the second study, milbemycin oxime (also at a minimum dose of 0.5mg/kg body weight) was administered to four of seven infected dogs on day 28 post-infection. Treatment was repeated at 14- or 28-day intervals. All of the dogs, from both studies, were euthanized 168 or 169 days after infection. All S. lupi were recovered, and lesions in the thoracic aorta and oesophagus were described and quantified. A single treatment with milbemycin oxime was 79.8% effective in preventing the establishment of S. lupi in the oesophagus. This treatment significantly (p<0.05) reduced both the number of S. lupi within the oesophagus and the size of the oesophageal nodules. The efficacy of anthelmintic treatment was increased to 100% when repeat doses of milbemycin oxime were administered at 14- or 28-day intervals. These repeat treatments completely prevented the establishment of S. lupi within the oesophagus and thereby averted the development of oesophageal nodules. As expected, none of the treatment protocols reduced S. lupi related damage within the aorta because the administration of milbemycin oxime only began after the larvae had completed their first stage of migration., (Copyright © 2010 Elsevier B.V. All rights reserved.)

We report 2 cases of Thelazia rhodesii infection in the African buffaloes, Syncerus caffer, in Zambia. African buffalo calves were captured from the livestock and wildlife interface area of the Kafue basin in the dry season of August 2005 for the purpose to translocate to game ranches. At capture, calves (n=48) were examined for the presence of eye infections by gently manipulating the orbital membranes to check for eye-worms in the conjunctival sacs and corneal surfaces. Two (4.3%) were infected and the mean infection burden per infected eye was 5.3 worms (n=3). The mean length of the worms was 16.4 mm (95% CI; 14.7-18.2 mm) and the diameter 0.41 mm (95% CI; 0.38-0.45 mm). The surface cuticle was made of transverse striations which gave the worms a characteristic serrated appearance. Although the calves showed signs of kerato-conjunctivitis, the major pathological change observed was corneal opacity. The calves were kept in quarantine and were examined thrice at 30 days interval. At each interval, they were treated with 200 µg/kg ivermectin, and then translocated to game ranches. Given that the disease has been reported in cattle and Kafue lechwe (Kobus lechwe kafuensis) in the area, there is a need for a comprehensive study which aims at determining the disease dynamics and transmission patterns of thelaziasis between wildlife and livestock in the Kafue basin.

Gnathostomiasis is a food-borne zoonosis caused by the late-third stage larvae of Gnathostoma spp. It is being seen with increasing frequency in countries where it is not endemic and should be regarded as another emerging imported disease. Previously, its foci of endemicity have been confined to Southeast Asia and Central and South America, but its geographical boundaries appear to be increasing, with recent reports of infection in tourists returning from southern Africa. It has a complex life cycle involving at least two intermediate hosts, with humans being accidental hosts in which the larvae cannot reach sexual maturity. The main risks for acquisition are consumption of raw or undercooked freshwater fish and geographical exposure. Infection results in initial nonspecific symptoms followed by cutaneous and/or visceral larva migrans, with the latter carrying high morbidity and mortality rates if there is central nervous system involvement. We review the literature and describe the epidemiology, life cycle, clinical features, diagnosis, treatment, and prevention of gnathostomiasis.

Infection with Gnathostoma spinigerum has been generally confined to Southeast Asia and Central and South America. However, gnathostomiasis was recently found in British tourists who had visited Botswana. Consequently, travel to Africa should now be considered a risk factor for gnathostomiasis.

Gnathostomiasis is increasingly reported among travelers returning from endemic areas. Between 2000 and 2004, thirteen patients were diagnosed with imported gnathostomiasis and followed for at least 6 months after treatment. Nine patients presented with cutaneous signs, two with gastrointestinal signs, and two with neurological signs. The median age was 38 years and the female/male sex ratio was 1.6. The patients had visited South East Asia or Central America. The median interval between symptom onset and treatment (with albendazole in 12 cases and ivermectin in one case) was 3.5 months. Post-treatment follow-up lasted a median of 15 months. Eight patients relapsed, a median of 2 months (1-7 months) after initial treatment. These eight patients had a total of 13 relapses, the last occurring a median of 16 months (2-26 months) after initial treatment. Thus patients with imported gnathostomiasis should be monitored for at least 6 months to detect late treatment failure.

Six medium sized mixed breed dogs treated with milbemycin oxime (11.5mg on days 0, 7 and 28 and then monthly) stopped shedding Spirocerca lupi ova after 3-44 days. There was no evidence of subsequent shedding in repeated tests (about 5/dog) carried out from 31 to 133 days after initiation of treatment. Esophageal nodules disappeared in all dogs within 95-186 days and radiographic signs resolved within 85-127 days in the five dogs that were studied. This preliminary data shows milbemycin oxime deserves further evaluation for the treatment of spirocercosis.

A 16-year-old Thai male presented with sudden onset severe epigastric and right upper quadrant pain, fever (39 degrees C), chills and malaise. He gave no history of underlying disease, migratory swelling or urticarial skin rash. He had a history of frequently eating raw pork. Physical examination revealed a soft abdomen with markedly tender hepatomegaly. His blood count showed extreme leukocytosis with hypereosinophilia. After admission he developed a non-productive cough with left sided chest pain, a chest x-ray showed a left pleural effusion. Serological findings were positive for Gnathostoma larval antigen but not Fasciola antigen. The patient recovered completely after albendazole treatment. His clinical presentation is compatible with abdominopulmonary hypereosinophilic syndrome or visceral larva gnathostomiasis. The presented case is interesting not only for physicians who work in endemic areas of gnathostomiasis but also for clinicians who work in travel medicine clinics in developed countries, to consider abdominopulmonary gnathostomiasis when patients present with the signs and symptoms of visceral larva migrans.

A 4-year-old boy presented with fever, myalgia followed by progressive quadriparesis and urinary retention. Spinal fluid from a lumbar puncture showed 42 WBC/microl with 100% lymphocytes, no RBC, a glucose of 54 mg/dl (blood glucose 107 mg/dl), and a protein of 39 mg/dl. The cerebrospinal fluid culture was negative. His white blood cell count was 10,860 cells/microl with a normal differential count. An MRI of the brain was negative. An MRI of the whole spine showed fusiform dilatation of the cervical cord from the cervicomedullary junction to the T4 level. The tentative diagnosis was acute hemorrhage of an intrinsic cord tumor versus acute myelitis. Intravenous dexamethasone was administered which resulted in a slight improvement in strength. One week later, he deteriorated precipitously and became flaccidly quadriplegic. Since the patient deteriorated rapidly and no definitive diagnosis was made, the patient underwent cervical cord biopsy. Intraoperatively, after the cervical cord had been opened, a living Gnathostoma spinigerum was found in the spinal cord parenchyma. The nematode was removed. Following the operation the patient was placed on albendazole 400 mg/d and metronidazole 250 mg three times per day for 3 weeks. He gradually improved over the next several weeks.

Two trials were conducted to evaluate the therapeutic and prophylactic activity of milbemycin oxime (Interceptor, Novartis Animal Health) against the eye-worm Thelazia callipaeda (Spirurida, Thelaziidae) infection. In Trial 1, the therapeutic efficacy of milbemycin oxime was evaluated in 55 naturally infected dogs treated with min. 0.5mg/kg milbemycin oxime. The dogs were clinically examined for the presence of eyeworms before and again 7 days after treatment. Dogs still positive were given a second treatment and re-checked again a week later. Forty-eight of the 55 dogs tested negative 1 week after treatment (87.3% reduction of infection rate). Following the second treatment 6 of these 7 dogs tested negative 1 week later resulting, after two treatments, in a reduction of infection rate of 98.2%. In Trial 2, the prophylactic efficacy of milbemycin oxime was evaluated in 60 uninfected dogs. Thirty dogs were treated with milbemycin oxime monthly from June to November with the recommended dose rate for the prevention of heartworm disease (> or =0.5mg/kg), 30 dogs served as untreated controls. At the end of the trail 1 dog in the treated group and 10 dogs in the control group became infected during the trial. The incidence of infection differed significantly between treated and control dogs (p=0.0056). The efficacy of the prophylactic use of a monthly treatment with milbemycin oxime showed 90% efficacy in reducing T. callipaeda infection rate.

Spirocercosis (Spirocerca lupi) in dogs has been mostly associated with the presence of esophageal granulomas that may transform to sarcomas; aortic aneurysms; mid-thoracic spondylitis; hypertrophic osteopathy; salivary gland necrosis; and pyothorax. Although the disease is frequently subclinical, esophageal dysphagia manifested by regurgitation, odynophagia, and hypersalivation is considered the clinical hallmark. Diagnosis should combine fecal analysis, thoracic radiography, and esophagoscopy to look for parasite ova, spondylitis or posterior mediastinal masses, and parasite nodules or tumors, respectively. Two avermectins, doramectin and ivermectin, have been effective in the treatment of canine spirocercosis, resulting in clinical remission, regression, or elimination of esophageal granulomas and cessation of egg shedding.

In vitro and in vivo studies were conducted to evaluate the effects of thiabendazole, mebendazole, levamisole and ivermectin against Gongylonema pulchrum. For in vitro assays, third-stage larvae (L3) incubated with the drugs were administered orally to mice and the ability of larvae to invade the gastric mucosa of the animals was examined. After incubation, only those larvae treated with high concentrations of levamisole (1 and 10 microg/ml) were tightly coiled with intestines exhibiting morphological abnormalities. Good dose-response data for the drugs tested was observed at the time of worm recovery from mice, with no worms recovered at the two highest concentrations of levamisole. In vivo efficacy of the drugs against adult worms was evaluated in six groups of three rabbits, each of which was infected with 30 L3 of G. pulchrum and treated with thiabendazole at 100 mg/kg for 3 days, mebendazole at 70 mg/kg for 3 days, levamisole as a single dose of 8 mg/kg, and subcutaneously injected ivermectin as a single dose of 0.2 mg/kg or vehicles of the drugs (control) at 4 months post-infection. Necropsy 14 days after treatment revealed that levamisole, mebendazole and ivermectin reduced worm burdens by 63.2%, 22.8% and 25.8%, respectively, with no reductions in worms observed with thiabendazole. The surviving worms were principally found in the esophagus with the remainder distributed among the buccal mucosa, the tongue, and/or pharyngeal mucosa in all groups. A number of morphologically abnormal eggs were observed within the uterus and ovijector in female worms recovered from the thiabendazole-treated group. These findings suggest that levamisole exhibits in vivo efficacy against G. pulchrum infection and that the larval invasion tests using mice could be used to screen for anthelmintic susceptibility of nematodes.

Objective: To determine if monthly ivermectin was efficacious in reducing the observed incidence of eyeworms over a period of 2 months as compared with normal husbandry practices in a population of Republic of Korea Army military working dogs (MWDs)., Methods: Prospective observation of 114 German Shepherd MWDs in a randomized, double-blind, controlled clinical trial. MWDs were randomly assigned to either a treatment group receiving a monthly dose of 0.2 mg/kg BW ivermectin orally, or to a control group given an equivalent dose volume and frequency of a saline placebo. A quantitative numerical count of eyeworms found in the eyes of MWDs was conducted at 25-day intervals., Results: The prevalence of eyeworms in the treatment group went to zero at 25 days and remained lower at 50 days (5%) than baseline (24%). Prevalence in the controls remained approximately constant over all treatment times (14% to 18%)., Conclusion: Although ivermectin does not prevent dogs from being infected with eyeworms, the study suggests that ivermectin administered orally at a dose of 0.2 mg/kg every 3 weeks significantly reduces the prevalence of Thelazia species eyeworms in dogs.

Spirocerca lupi is a nematode mainly affecting dogs but has been found in other animals, particularly carnivores. Anatomical areas of typical and aberrant migration vary. This report describes four cases of Spirocerca lupi causing neurological symptoms, similar to thoracolumbar disc syndrome, as a result of aberrant migration of the nematode into the spinal canal. In two of the cases, the nematode could be demonstrated intraoperatively. The third was discovered on post-mortem examination, while the fourth case displayed compelling evidence of Spirocerca lupi involvement. Surgical removal of the Spirocerca lupi nematode would be the treatment of choice in cases of spinal migration, with therapeutic and preventive treatment with doramectin instituted to treat remote sites and prevent re-infection. In areas endemic for spirocercosis, Spirocerca lupi should be considered as an important differential diagnosis in cases that are presented with clinical signs suggestive of a spinal cord lesion.

Numerous cases of Gongylonema spp. infection with associated pathological lesions and clinical signs were identified in a collection of Goeldi's monkeys (Callimico goeldii) (GMs) at a zoological park during a 3-yr period. An increase in the incidence of clinical signs in the GMs and other callitrichid species prompted an investigation to determine the prevalence of infection within the collection and evaluate treatment protocols. Twenty-one callitrichids [nine GMs, four golden lion tamarins (Leontopithecus rosalia), six cotton-top tamarins (Saguinus oedipus), and two golden-headed lion tamarins (Leontopithecus chrysomelas)] were included in this study. Many of the animals had been positively diagnosed on past examinations. Repeated cytological evaluations of scrapings taken from the mucosa of the tongue were performed to diagnose infection. The animals were randomly divided into two groups and treated with either ivermectin (290 microg/kg p.o., q7 days for four doses) or mebendazole (70 mg/kg p.o. q24 hr for three doses). Follow-up scrapings were performed on all animals at days 35, 64, and 156. Numerous animals displayed clinical signs (facial pruritus, inflammation, and ptyalism) before and throughout the investigation; however, Gongylonema spp. infections were only confirmed by tongue scrapings in two animals. Fecal floatation by using a sodium nitrate solution for recovery of spirurid eggs also was performed, but it yielded no positive results. The low number of confirmed cases precluded comparative evaluation of the efficacy of the anthelmintic treatment protocols. However, both regimes seemed subjectively similar in decreasing clinical signs and were safe with no adverse effects. Diagnosis of Gongylonema spp. infection is challenging, even when severe clinical signs are present. This investigation further demonstrates the lack of a reliable ante-mortem test for the parasite and underscores the importance of treatment based on clinical signs. Until a more sensitive test is available, further comparison studies on treatment regimes will be difficult and likely unrewarding.

All dermatologists worldwide should have at least passing familiarity with various tropical maladies that generate cutaneous manifestions. In addition to the standard infectious ailments associated with tropical environs, the authors have described herein five "emerging" illnesses that are gaining increasing attention for their capacity to cause human disease in those immigrating from, or traveling to, the tropical and subtropical world.

Purpose: To describe a patient with isolated monocular optic neuritis caused by an identified Gnathostoma spinigerum infestation., Case Report: A 21-year-old man developed a swollen eyelid and painful monocular visual loss of his left eye which did not improve after treatment by intravenous steroid and albendazole. A remarkable eosinophilia in his peripheral blood count was demonstrated. The patient subsequently found a live parasite emerged from his lower eyelid and it was successfully removed by himself. Gross and histopathology examinations of the obtained parasite was undertaken. The parasite was identified as Gnathostoma spinigerum. His blood test for Gnathostoma antibody was positive., Discussion: The etiology of isolated optic neuritis in this patient was Gnathostoma spinigerum which was confirmed by the histopathology of the obtained parasite and the positive serologic test., Conclusions: We could identify the exact parasite that was proven to cause an isolated optic neuritis. The immediate removal of a causative parasite maynot result in an improvement of the injured tissue but is beneficial in preventing further destruction as well as future complications.

Cysteine proteinases from the fruit and latex of plants, including papaya, pineapple and fig, were previously shown to have a rapid detrimental effect, in vitro, against the rodent gastrointestinal nematodes, Heligmosomoides polygyrus (which is found in the anterior small intestine) and Trichuris muris (which resides in the caecum). Proteinases in the crude latex of papaya also showed anthelmintic efficacy against both nematodes in vivo. In this paper, we describe the in vitro and in vivo effects of these plant extracts against the rodent nematode, Protospirura muricola, which is found in the stomach. As in earlier work, all the plant cysteine proteinases examined, with the exception of actinidain from the juice of kiwi fruit, caused rapid loss of motility and digestion of the cuticle, leading to death of the nematode in vitro. In vivo, in contrast to the efficacy against H. polygyrus and T. muris, papaya latex only showed efficacy against P. muricola adult female worms when the stomach acidity had been neutralized prior to administration of papaya latex. Therefore, collectively, our studies have demonstrated that, with the appropriate formulation, plant cysteine proteinases have efficacy against nematodes residing throughout the rodent gastrointestinal tract.

We report a case of cutaneous gnathostomiasis acquired in Myanmar where this parasitic zoonosis was considered as non-endemic until a recent outbreak. Myanmar must be added to the list of countries where the infection can be acquired in Southeast Asia. Despite a treatment with ivermectin the patient relapsed after an apparent cure. A double-dose of ivermectin is now recommended for the treatment of gnathostomiasis.