title: Human ocular filariasis: further evidence on the zoonotic role of Onchocerca lupi.
abstract: BACKGROUND
  Among ocular vector-borne pathogens, Onchocerca volvulus, the agent of the so-called "river blindness", affects about 37 million people globally. Other Onchocerca spp. have been sporadically reported as zoonotic agents. Cases of canine onchocerciasis caused by Onchocerca lupi are on the rise in the United States and Europe. Its zoonotic role has been suspected but only recently ascertained in a single case from Turkey. The present study provides further evidence on the occurrence of O. lupi infesting human eyes in two patients from Turkey (case 1) and Tunisia (case 2). The importance of obtaining a correct sample collection and preparation of nematodes infesting human eyes is highlighted.
  
  
  METHODS
  In both cases the parasites were identified with morpho-anatomical characters at the gross examination, histological analysis and anatomical description and also molecularly in case 1.
  
  
  RESULTS
  The nematode from the first case was obviously O. lupi based on their morphology at the gross examination, histological analysis and anatomical description. In the second case, although the diagnostic cuticular characters were not completely developed, other features were congruent with the identification of O. lupi. Furthermore, the morphological identification was also molecularly confirmed in the Turkish case.
  
  
  CONCLUSIONS
  The results of this study suggest that O. lupi infestation is not an occasional finding but it should be considered in the differential diagnosis of other zoonotic helminths causing eye infestation in humans (e.g., D. immitis and Dirofilaria repens). Both cases came from areas where no cases of canine onchocerciasis were previously reported in the literature, suggesting that an in depth appraisal of the infestation in canine populations is necessary. Physicians and ophthalmologists are advised on how to preserve nematode samples recovered surgically, to allow a definitive, correct etiological diagnosis.
authors.affiliation: Dipartimento di Sanità Pubblica Veterinaria e Zootecnia, Università degli Studi di Bari, Bari, Valenzano, Italy. d.otranto@veterinaria.uniba.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Otranto
authors.forename: Filipe
authors.initials: F
authors.lastname: Dantas-Torres
authors.forename: Zafer
authors.initials: Z
authors.lastname: Cebeci
authors.forename: Baris
authors.initials: B
authors.lastname: Yeniad
authors.forename: Nesimi
authors.initials: N
authors.lastname: Buyukbabani
authors.forename: Ozden Buyukbaba
authors.initials: OB
authors.lastname: Boral
authors.forename: Andrea
authors.initials: A
authors.lastname: Gustinelli
authors.forename: Trimèche
authors.initials: T
authors.lastname: Mounir
authors.forename: Yasen
authors.initials: Y
authors.lastname: Mutafchiev
authors.forename: Odile
authors.initials: O
authors.lastname: Bain
mesh_terms: D000328:Adult; D000818:Animals; D002648:Child; D004182:Dirofilaria / Q000145:classification; D004285:Dogs; D005128:Eye Diseases / Q000469:parasitology* / Q000473:pathology; D005368:Filariasis / Q000469:parasitology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D009854:Onchocerca / Q000145:classification*; D009855:Onchocerciasis / Q000662:veterinary*; D014416:Tunisia / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology