title: A five-year-old child with a subcutaneous forehead nodule.
abstract: We describe a case of a 5-year-old girl with onchocerciasis. The patient was recently adopted from Ethiopia and presented with a firm, raised nodule on the midportion of the forehead. Initially, Langerhans cell histiocytosis with bone involvement was suspected; however, histopathologic analysis of the excised nodule revealed the presence of a young-adult, female Onchocerca volvulus worm. This case exemplifies the importance of recognizing the key morphologic characteristics of adult O. volvulus worms isolated from pediatric patients in nonendemic areas to ensure adroit clinical management.
authors.affiliation: 1 Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Lars F
authors.initials: LF
authors.lastname: Westblade
authors.forename: Peter U
authors.initials: PU
authors.lastname: Fischer
authors.forename: Nina
authors.initials: N
authors.lastname: Haghi
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Schniederjan
authors.forename: Bobbi S
authors.initials: BS
authors.lastname: Pritt
authors.forename: John G
authors.initials: JG
authors.lastname: Long
authors.forename: Robert C
authors.initials: RC
authors.lastname: Jerris
authors.forename: Robert E
authors.initials: RE
authors.lastname: Garola
mesh_terms: D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use; D001706:Biopsy; D002675:Child, Preschool; D005260:Female; D005546:Forehead; D006801:Humans; D007150:Immunohistochemistry; D007559:Ivermectin / Q000627:therapeutic use; D009854:Onchocerca / Q000302:isolation & purification*; D009855:Onchocerciasis / Q000175:diagnosis / Q000469:parasitology* / Q000628:therapy; D011237:Predictive Value of Tests; D040521:Subcutaneous Tissue / Q000469:parasitology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin
keywords: Wolbachia; doxycycline; filariasis; ivermectin; onchocerca; onchocerciasis