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ARTICLES
Year : 1980  |  Volume : 28  |  Issue : 1  |  Page : 31-32

Sub-conjunctival cysticercus cellulosae (spontaneous expulsion)


Gandhi Eye Hospital and A.M. U. Institute of Ophthalmology Aligarh, India

Correspondence Address:
U S Shrivastava
Gandhi Eye Hospital and A.M. U. Institute of Ophthalmology Aligarh
India
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Source of Support: None, Conflict of Interest: None


PMID: 7203594

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How to cite this article:
Shrivastava U S, Gogi R, Johri A. Sub-conjunctival cysticercus cellulosae (spontaneous expulsion). Indian J Ophthalmol 1980;28:31-2

How to cite this URL:
Shrivastava U S, Gogi R, Johri A. Sub-conjunctival cysticercus cellulosae (spontaneous expulsion). Indian J Ophthalmol [serial online] 1980 [cited 2020 Oct 21];28:31-2. Available from: https://www.ijo.in/text.asp?1980/28/1/31/31044

Taenia solium or pork tapeworm is an important parasite which causes blindness in human beings. Cysticercus cellulosae is the bladder worm stage of Taenia solium. It is characterized by scolex with its suckers and crown hooks. Source of infection in human is taking of infected pork, water contaminated with ova or an autoinfection.[7]

The ocular cysticercus is a rare disease and the first case report was made by Sommering.[9] Since then a number of reports have been published. The most common site for this parasite is subretinal space followed by sub­conjunctival tissue. We could not find a report describing a spontaneous expulsion of this parasite from the conjunctival tissue. We report here a case of sub-conjunctival cyst presenting with spontaneous expulsion.


  Case report Top


A Hindu, 10 years old boy reported in the out patient department of Gandhi Eye Hospital, Aligarh, with the complaint of a swelling near the inner side of left eye for the last four weeks. It had increased suddenly during the last 24 hours. There was no pain or redness or diminution of vision. There was no history of trauma.

On examination right eye was normal. The left eye had visual acuity of 6/6. There was a cystic swelling between the plica semilunaris and limbus of the left eye. The swelling was greyish-white in colour with dense white spot in the centre and was bulging into the palpe­bral aperture. It was approximately 3 x 5 mm in size. There was slight congestion in the conjunctival blood vessels in the adjacent area. Rest of the eye was normal. On examination under surface anaesthesia swelling could be mobilised with the help of cotton swab.

It was found that the cyst was partly prolapsed out of the sub-conjunctival tissue and was partly attached to the conjunctiva. It was gently picked up and sent for pathological examination. There was a gap in the conjunc­tiva corresponding to the size of the cyst which was allowed to heal under the cover of antibiotics.

On pathological examination the cyst was oval in shape and measured 6 x 4 mm. It was translucent and position of scolex was marked by a dense white spot in the cyst cavity. The histopathological examination showed the presence of body canal of cysticer­cus lined by epithelium [Figure - 1]. The diagnosis of cysticercus cellulosae was confirmed on the basis of its gross and microscopic morphology.


  Discussion Top


Ocular and adnexal dissemination of cysticercus cellulosae is well established. A large number of such reports are available in literature (> 1003)[4]. The favourite site being vitreous-subretinal space followed by sub­conjunctival tissue, anterior chamber, orbit, subhyloid space, iris, optic nerve, sclera and subcutaneous tissue in the region of lacrimal sac.[1],[2],[3],[4],[5],[6],[7],[8],[9]. However, to the best of our knowledge we did not come across a case of sponteneous expulsion of cysticercus cellulosae. It is very difficult to account for such an expulsion in the absence of any history of trauma. There was an associated inflammatory reaction in the adjacent area of of the cyst which could cause softening of conjunctiva. Mechanical streching due to the presence of a cyst in the weak area of conjunctiva could possibly explain the spontaneous expulsion.

The lesion in the present case was localised in the left eye which can have anatomical reasons as the left common carotid artery arising directly from arch of aorta can disse­minate the parasite more towards the left eye.[3],[5] Furthermore, medial side of the ocular and orbital tissues are more prone to this parasite which may be due to the fact that ophthalmic artery after giving off lacrimal branches runs along the medial side of the orbital tissue.


  Summary Top


A case of sub-conjunctival cysticercus presenting with spontaneous expulsion has been reported.

 
  References Top

1.
Laignier-Terrase, P., 1932, cited by Duke­Elder, S., 1945, Text Book of Ophthalmology, Vol. III, P. 3439, Kimpton, London.  Back to cited text no. 1
    
2.
Lech, J. 1949, Amer. J. Ophthalmol., 32, 523.  Back to cited text no. 2
    
3.
Malik, S.R.K., Gupta, AX and Chaudhri, S.K. 1968, Amer Jour. Ophthalmol., 66:1168.  Back to cited text no. 3
    
4.
Nath, K., Gogi, R. and Gopal Krishna, 1977, Ind. J. Ophthalmol., 25:24.  Back to cited text no. 4
    
5.
Rao, A.U.N., Satyendran O.M. and Sood, N.N., 1967, Orient. Arch. Ophthalmol., 15:249.  Back to cited text no. 5
    
6.
Reddy, P.S., and Satyendran O.M., 1964, Amer. J. Ophthalmol., 57:664.  Back to cited text no. 6
    
7.
Swatz, W.G , Medical Parasitology, p. 127, Me Graw Bill, New York.  Back to cited text no. 7
    
8.
Sen, D.K., Mathur, R.N. and Thomas, A., 1967, Brit. J. Ophthalmol., 5;630.  Back to cited text no. 8
    
9.
Duke Elder. S., 1976, System of Ophthalmo­logy. vol. XV. Page 40 Kimpton, London.  Back to cited text no. 9
    


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