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CASE REPORT
Year : 1954  |  Volume : 2  |  Issue : 2  |  Page : 51-52

Dracunculus medinensis (guinea worm) in the orbit


Christian Medical College, Ida S. Scudder Eye Dept., Vellore, India

Correspondence Address:
Anna Thomas
Christian Medical College, Ida S. Scudder Eye Dept., Vellore
India
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How to cite this article:
Thomas A, Rambo V. Dracunculus medinensis (guinea worm) in the orbit. Indian J Ophthalmol 1954;2:51-2

How to cite this URL:
Thomas A, Rambo V. Dracunculus medinensis (guinea worm) in the orbit. Indian J Ophthalmol [serial online] 1954 [cited 2020 Apr 4];2:51-2. Available from: http://www.ijo.in/text.asp?1954/2/2/51/33595

The Dracunculus Medinensis (guinea worm) in 80% of cases is found in the lower extremities. They are found in the remaining 20% of patients in other parts of the body. Craig & Faust (1943) make the following comment. "These lesions are most common between the metatarsal bones on the soles of the feet or on the ankles, but may be found on hands or arms, trunks, buttocks, scrotum or even at the angle of the jaw bone." Noronha ( 1932) found the worm in an inflamed fronto-nasal tumour which may be mistaken for a dermoid cyst. Chatterjee ( 1952) mentions that the tongue and eyelids can be involved, but very rarely.

A young man aged 20 of village Kariyathum came to the Christian Medical College Ida. S. Scudder Eye Department, 17th August 1953 complaining of a swelling of the area just above and nasal to the left eye ball. He said that the swelling had been first noticed six months ago. It did not cause pain but he was conscious of its presence from the first. He said it would become larger on rubbing it. For the last six weeks there had also been a slight oedema of the orbit.

Examination showed a healthy looking young Indian. Vision of the right eye was 6/6 and of the left eye 6/12. The movements of the eyes were normal throughout. The pupils were normal and equal in size and reacted well to light. His fundii showed no abnormality. There was no exophthalmos.

As one observed the left lids open and close there was visible a swelling extending from the nasal side to the junction of the outer and middle third of the upper area of the upper lid. On palpation this tumour was found to be non­cystic, moderately firm in consistency, not particularly movable. Asking the patient to rub it to make it larger, as he had said, we found no difference in size. In the lower nasal portion of the orbit there was a horizontally placed 3 mm. wide thickening more palpable than visible.

Operation

Under local and deep infiltration with procain and adrenalin a 18 mm. incision was made through skin and subcutaneous tissues 11 mm. above the upper medial left lid margin. - Continuing in a horizontal plane by blunt dissection search for a line of demarkation was made. As the dissection passed through the orbital septum of the upper lid, immediately there appeared loops of a creamy yellow tape which kept on coming out with only a slight resistance. Then one end appeared. One of us then started rolling it around on a small stick. Gradually the other end came out. [Figure - 1]

The family of the young man stated that such worms were a common occurrence in the dwellers of their village. Neither they nor we had ever seen the dracunculus in the orbit.

The worm measured 105 cm. in length. It was sent to the department of public health and hygiene, Christian Medical College, Vellore, for identification. Apparently due to the looseness of the tissue in which the worm found itself, it developed much more a tape shape of its body than ordinarily seen in such worms. There was doubt in Vellore as to the exact verification of the worm. However, this matter was cleared by Dr. Shrivastava of the pathology department, Medical College, Nagpur, who verified the worm as Dracunculus Medinensis.


  Summary Top


A case of Dracunculus Medinensis ( guinea worm) in the orbit is presented.[3]

 
  References Top

1.
Chatterjee, K. D. ( 1952) Human Parasites and Parasitic Diseases, p. 618, Chatterjee, Calcutta.  Back to cited text no. 1
    
2.
Craig & Faust Clinical Parsitology, p. 330, Henry Kimpton, London.   Back to cited text no. 2
    
3.
Noronha as quoted in 2.  Back to cited text no. 3
    


    Figures

  [Figure - 1]



 

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