title: Acute conjunctivitis with episcleritis and anterior uveitis linked to adiaspiromycosis and freshwater sponges, Amazon region, Brazil, 2005.
abstract: We conducted an epidemiologic investigation of an outbreak of ocular disease among children to determine whether the disease was linked to Emmonsia sp., a rarely-reported fungus and an agent of adiaspiromycosis. Using an unmatched case-control study design, we compared case-patients with asymptomatic controls randomly selected from the population. Scleral biopsies were analyzed microscopically. Of 5,084 children examined, 99 case-patients were identified; mean age (+1 SD) was 11.0 +/- 4.4 years. Symptoms included photophobia (57%), ocular pain (42%), and blurred vision (40%). In the multivariate analysis, risk factors included diving in the Araguaia River (odds ratio 5.2; 95% confidence interval 2.4-12.0). Microscopy identified foreign bodies consistent with adiaconidia. This outbreak probably resulted from foreign-body-type reactions to adiaspiromycosis conidia after initial irritation caused by conjunctival contact with spicules of sponges in the river. Symptomatic children responded to corticosteroid treatment. Adiaspiromycosis is a preventable cause of ocular disease in the Amazon region.
authors.affiliation: Ministry of Health, Brasília, Brazil. ooteman@gmail.com
authors.forename: Marcia O
authors.initials: MO
authors.lastname: Mendes
authors.forename: Mario A P
authors.initials: MA
authors.lastname: Moraes
authors.forename: Ernesto I M
authors.initials: EI
authors.lastname: Renoiner
authors.forename: Marta H P
authors.initials: MH
authors.lastname: Dantas
authors.forename: Tatiania M
authors.initials: TM
authors.lastname: Lanzieri
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Fonseca
authors.forename: Expedito J A
authors.initials: EJ
authors.lastname: Luna
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Hatch