Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005
Published Date:Apr 2009
Source:Emerg Infect Dis. 15(4):633-639.
Communicable Diseases, Emerging
Eye Infections, Fungal
Fresh Water Sponges
Description: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.
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