Hospital, Costa Rica
Santiago, Chile
Se presenta un caso de queratitis ulcerativa y glaucoma agudo recidivante, cuyo decurso clínico pudo seguirse durante más de nueve años. El edema angioneurótico facial, la rinitis y el asma hicieron sospechar la naturaleza alérgica del proceso que quedó demostrada y definitivamente ligada al parasitismo por Ascaris lumbricoides y Entamoeba histolytica.El uso de adrenalina acuosa, como preventivo o abortivo de las reacciones oculares, demostró ser la más eficaz entre las drogas empleadas.Los autores insisten en que la capacidad alergénica de los parásitos intestinales, debe tenerse muy en cuenta en casos clínicos como el presente.
A case of ulcerative keratitis and relapsing acute glaucoma is reported, whose clinical course was followed for over 9 years. The recurrent paroxysmal character of the case, with the coincidence of ocular manifestations with facial angioneurotic edema, rhinitis and asthma, led to the investigation of a possible allergic etiology. No common allergen was found to be involved; but the concomitance of intestinal symptoms with presence of Ascaris lumbricoides eggs and Entamoeba histolytica cysts and trophozoites in the feces suggested investigation of the nexus between the above parasitoses and the ocular and extraocular manifestations.During treatments there were, consistently, allergic manifestations; but inclusion of intramuscular aqueous addrenaline among the drugs used proved effective as a preventive or abortive factor of the ocular reactions.fter the antiparasitic treatments the symptoms disappeared completely; however, reinfection of either of the two parasites caused new allergic manifes tations. The permanent cure of ocular (keratitis and glaucoma) and extraocular (angioneurotic edema, rhinitis, asthma) mallifestations corresponded to perma nent eliminatioll of the parasites.Having revised the literature available on the subject, the authors believe the present case to be the first report on ulceral keratitis alld allergic glaucoma in relatioll to Ascaris lumbricoides and Enlamoeba bistolytica. They recommend, moreover, that the allergenic nature of intestinal parasites not well studied immunologically should be suspected in cases such as the present one.
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