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Image 18:
Six months after arrival from Bangladesh she presented with (R) parotitis and peripheral eosinophilia (1.1x109/L) that resolved on antibiotics over a week. One month later she developed new (R) painful periorbital and facial swelling with a normal eye examination and vision. Antibiotics did not help. Her vision deteriorated over the following week with (R) anterior uveitis, keratic precipitates and 3+ cells and after 10 days a wiggling object was seen emerging from the iris.
Diagnosis:
The worm was removed and was identified as Ganthostoma spinigerum (for details see Can J Opthalmol 2000;35:35-9). A serum sample was positive, by Western Blot, for Gnathostoma antibodies, at the Dept. Micro. Immunol., University of Mahidol, Thailand.
