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Strongyloidiasis
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Robert M. Genta, Peter D. Walzer
The pathological lesions with the cutaneous migration of larvae (larva currens) have been described as allergic (136), with dermal edema and a sparse eosinophilic exudate. It is remarkable, however, that no cases are reported in which the parasites have been identified in tissue sections. In some cases, multiple biopsies were taken from and around the tip of the progressing serpiginous lesion, but even serial sections failed to demonstrate larvae (136). In disseminated disease, S. stercoralis larvae have been found in the skin associated with purpura and a mononuclear infiltrate (137). Recently, we observed a patient with severe disseminated strongyloidiasis and bone marrow depression. Biopsies of serpiginous purpuric lesions on the abdomen revealed numerous filariform larvae in the dermis and within the vessels. No cellular responses were present in association with the parasites (Fig. 5d).
Varicella zoster virus infection
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Don Gilden, Randall J. Cohrs, Dallas Jones, Maria A. Nagel
VZV myelopathy may also present as an insidious, progressive and sometimes fatal myelitis, mostly in immunocompromised individuals. MRI reveals longitudinal serpiginous enhancing lesions. Diagnosis is confirmed by the presence of VZV DNA or anti-VZV IgG or both in CSF. Pathological and virological analyses of the spinal cord from fatal cases have shown frank invasion of VZV in the parenchyma. An early search for VZV DNA or VZV antibody in CSF is essential for diagnosis, particularly since aggressive treatment with acyclovir, even in AIDS patients, may produce a favorable response. The benefit of steroids in addition to antiviral agents is unknown.
Parasitoses
Published in Giuseppe Micali, Francesco Lacarrubba, Dermatoscopy in Clinical Practice, 2018
Elvira Moscarella, Bakos Renato, Giuseppe Argenziano
CLM is caused by accidental percutaneous penetration and subsequent migration of larvae of various animal hookworms (helmints). Ancylostoma braziliense is the most common parasite implicated in the development of CLM.2 Its length and width are approximately 650 and 20 µm, respectively. Eggs are shed in feces of infested dogs and cats, hatch in the superficial layer of the soil, and then develop into larvae.1–2 Upon close contact, the larvae penetrate human skin. The larvae cannot penetrate the basement membrane of human skin and remain confined to the epidermis. This results in the development of serpiginous skin lesions.
Multifocal Serpiginoid Choroiditis Due to Mycobacterium Mageritense following Laparoscopic Hysterectomy in an Immunocompetent Host
Published in Ocular Immunology and Inflammation, 2023
Shrey Maheshwari, Shweta Parakh, Shrutanjoy M Das, Alok Ahuja, Shashi Nath Jha, Rupesh Agrawal, Vishali Gupta, Saurabh Luthra
Serpiginous choroiditis (SC) is an idiopathic, chronic entity that shows a geographic serpentine pattern with centrifugal spread and active advancing edge.1 It is a bilateral, asymmetric inflammation of noninfective or autoimmune etiology affecting the choriocapillaris, retinal pigment epithelium (RPE), and photoreceptor cells.2 SC is mediated by autoreactivity of circulating lymphocytes to retinal S antigen.3 Serpiginous like choroiditis (SLC) or serpiginoid choroiditis is a subtype of SC with infectious etiology. The most common organism implicated in SLC etiopathogenesis is Mycobacterium tuberculosis.2 The first description of tubercular SLC which presented either as a multifocal progressive choroiditis or a diffuse plaque-like choroiditis with an amoeboid pattern and a leading edge resembling SC was given by Gupta et al.4
Co-occurrence of incontinentia pigmenti and down syndrome: examining patients’ potential susceptibility to autoimmune disease, autoinflammatory disease, cancer, and significant ocular disease
Published in Ophthalmic Genetics, 2021
David C. Gibson, Natario L. Couser, Kayla B. King
Over the next few weeks, the patient’s skin findings progressed into hyperpigmented macules and with thin verrucous papules in a serpiginous distribution present on the left lower extremity, anterior shoulders, axillae, scalp, middle back. This progression is characteristic of the skin lesions found in IP, and a diagnosis was made based on these clinical findings and the patient’s family history. Management included follow-up with a dermatologist, neurologist, and ophthalmologist to monitor the patient for possible complications. The patient was also followed by human genetics, otolaryngology, and pediatric cardiology for the management of Down syndrome and its comorbidities.
Treatment of Serpiginous Choroiditis with Chlorambucil: A Report of 17 Patients
Published in Ocular Immunology and Inflammation, 2018
Nazanin Ebrahimiadib, Bobeck S. Modjtahedi, Samaneh Davoudi, C. Stephen Foster
The exact etiology of serpiginous chorioretinitis is not known, although autoimmune and infectious causes have been proposed.8 Mononuclear cell infiltration of the choroid with lymphocytic aggregation in the lesions indicates that inflammation plays a role in pathogenesis.9 Pharmacologic treatment aims for preserving vision by preventing recurrence, lesion extension, and scar progression.