Imagine being a 28-year-old woman with no prior health issues, presenting with a mysterious mass growing in the corner of your eye. This was the perplexing situation faced by a patient who sought medical care at Cliniques Universitaires Saint-Luc in Brussels. The woman had been on a humanitarian mission in the Democratic Republic of Congo when she noticed the lump, which had been gradually increasing in size over the past two years.
Upon detailed history-taking, healthcare providers discovered that the patient had no history of eye injuries or other symptoms. She denied any contact with snakes but admitted to regularly consuming crocodile meat as part of her diet. A physical examination revealed a foreign body in the inner corner of her eye, prompting further investigation. The medical team decided to perform a conjunctival incision, which led to the extraction of a 10-mm C-shaped larva.
The extracted larva, along with its surrounding exuvia, was sent to the National Reference Center of Tropical Pathogens in Germany for testing. Polymerase chain reaction (PCR) testing targeting the parasite’s nuclear 18S RNA gene revealed the specimen to be Armillifer grandis, a rare zoonotic parasite. This discovery shed light on the rarity of the case, especially considering the limited reports of ocular pentastomiasis in the medical literature.
Pentastomiasis, caused by pentastomid parasites, is a rare disease mainly affecting individuals in tropical and subtropical regions. Infections involving the eye are particularly uncommon, making this case study significant for the field of ophthalmology. The patient’s history of consuming crocodile meat raised suspicions of infection from contaminated meat, possibly obtained from an infected crocodile or through cross-contamination with snake meat.
Surgical removal of the larvae was recommended as the primary treatment approach, considering the risks associated with antiparasitic medication. The potential release of antigens from dying larvae could trigger a robust immune response, making surgery the preferred option. Preventive measures focused on avoiding close contact with parasitized snake hosts, consuming undercooked reptile meat, or ingesting contaminated food or water potentially carrying pentastomid eggs.
Despite the challenges in diagnosing and treating ocular pentastomiasis, this case underscores the importance of considering rare parasitic infections in patients with atypical symptoms, especially those with travel histories to endemic regions. Ophthalmologists and healthcare providers must remain vigilant and proactive in identifying and managing such cases, emphasizing the need for thorough history-taking, clinical examination, and appropriate diagnostic testing. Awareness and education play a crucial role in preventing the spread of zoonotic diseases like pentastomiasis, highlighting the interconnectedness of human health and environmental factors.
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