Epidemic of unilateral panuveitis in children from Brazilian Amazonia: clinical and etiological aspects in seven patients.
OBJECTIVE
To describe clinical presentation and results of diagnostic and therapeutic procedures in seven children from an epidemic of panuveitis in the Brazilian Amazonia, as well as environmental analysis and etiological aspects involved.


METHODS
Patients underwent full pediatric and ophthalmic examinations, B-scan, ultrasound biomicroscopy, and serological tests. Ocular samples were thoroughly analyzed, including two enucleation specimens. Environmental investigation encompassed water, soil, and river fauna.


RESULTS
All patients had bathed in the waters of a regional river, the Araguaia. Six of them presented with intermediate uveitis, with snowbanking. Five had cataract and four showed inferior endothelial opacity, with localized anterior synechiae. One showed total leukoma, with flat anterior chamber. Only two had active uveitis, one of them with anterior chamber nodule. Serology revealed high prevalence of anti-Toxocara canis immunoglobulin G (IgG) antibodies. In three cases, vitreous and lens samples disclosed spicules of freshwater sponges Drulia uruguayensis and D. ctenosclera, also detected in the waters of the river.


CONCLUSIONS
Freshwater sponge spicules could be potential new etiological agents of ocular pathology, but further studies are needed, considering the heterogeneity of the ocular lesions and results of serological and environmental studies.
Vasconcelos-Santos
Daniel Vítor
DV
Hospital São Geraldo/HC - Universidade Federal de Minas Gerais - UFMG, Rua Espírito Santo, 1634/102, Belo Horizonte, MG, 30.160-031, Brazil.
Oréfice
Fernando
F
Fonseca
Carlos Franklin
CF
Alencar
Leandro Moulin
LM
Almeida
Priscilla Jane Ayres
PJ
Lenzi
Henrique Leonel
HL
Pelajo-Machado
Marcelo
M
Volkmer-Ribeiro
Cecília
C
Batista
Twiggy Cristina Alves
TC
Chieffi
Pedro Paulo
PP
Lescano
Susana Zevallos
SZ
Caldeira
Roberta Lima
RL
Carvalho
Omar Dos Santos
Odos S
Pavesio
Carlos Eduardo
CE
D000293:Adolescent; D000818:Animals; D000909:Antibodies, Helminth / Q000276:immunology; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007908:Lens, Crystalline / Q000469:parasitology; D008297:Male; D015864:Panuveitis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D011161:Porifera; D045483:Rivers / Q000469:parasitology; D017166:Toxocara canis / Q000276:immunology; D015354:Vision, Low / Q000175:diagnosis / Q000469:parasitology; D014822:Vitreous Body / Q000469:parasitology
D000909:Antibodies, Helminth