title: Baylisascaris procyonis and Herpes Simplex Virus 2 Coinfection Presenting as Ocular Larva Migrans with Granuloma Formation in a Child.
abstract: Ocular Baylisascaris procyonis infection results from ingestion of infective eggs of B. procyonis, the raccoon ascarid. Herpes simplex virus type 2 (HSV-2) infection of the retina is the result of either primary infection or reactivated disease. Herein, we report a case of a 12-year-old female resident of the Bronx in New York City, who presented with pan-uveitis and vision loss. Initial evaluation for etiologic causes was nondiagnostic. Serology for anti-Baylisascaris procyonis antibodies in serum and vitreous fluid were both positive. Polymerase chain reaction (PCR) of vitreous fluid was positive for HSV-2. Treatment with vitrectomy, albendazole, and acyclovir resulted in mild improvement of visual acuity. The atypical presentation of B. procyonis in this case, as ocular larva migrans with a peripheral granuloma and retinal detachment, underscores the importance of maintaining a high degree of suspicion for this pathogen even in non-diffuse unilateral subacute neuroretinitis (DUSN) patients in urban areas. This case further illustrates that it is possible to have coexisting infections in cases of posterior uveitis.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Grace
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Glenn
authors.initials: G
authors.lastname: Fennelly
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Kazacos
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Charles
authors.initials: C
authors.lastname: Grose
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Joanna
authors.initials: J
authors.lastname: Dobroszycki
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Norman
authors.initials: N
authors.lastname: Saffra
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Coyle
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Louis M
authors.initials: LM
authors.lastname: Weiss
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa.
authors.forename: Moshe M
authors.initials: MM
authors.lastname: Szlechter
authors.affiliation: Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York; Department of Pediatrics, Albert Einstein College of Medicine, New York City, New York; Department of Pathology, Albert Einstein College of Medicine, Bronx, New York; Department of Medicine, Albert Einstein College of Medicine, and Jacobi Medical Center, Bronx, New York; Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, Indiana; Virology Laboratory, University of Iowa Children's Hospital, Iowa City, Iowa herbert.tanowitz@einstein.yu.edu.
authors.forename: Herbert B
authors.initials: HB
authors.lastname: Tanowitz
mesh_terms: D000818:Animals; D017191:Ascaridida Infections / Q000150:complications* / Q000175:diagnosis; D001199:Ascaridoidea; D002648:Child; D060085:Coinfection; D003937:Diagnosis, Differential; D015822:Eye Infections, Parasitic / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005654:Fundus Oculi; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology / Q000469:parasitology / Q000821:virology; D018258:Herpesvirus 2, Human; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D007815:Larva Migrans / Q000175:diagnosis*