Loa Loa in Montgomery County by Dr. Martinez
1. Loa Loa In Montgomery CountyJ. Alberto Martinez, MDApril 22, 2012 2. Demographics: Patient FM Gender: maleNovember 5th 2010 Race: African Country: Cameroon Age: 30 History of present illness: Two days history of FBS and itching Referred as anemergency by Dr.Suzanne Carducci O.D. for evaluation of a possible worm OS. 3. History 3o Y.O African male with two days history ofitching and FBS OS. Patient looked at the mirror and saw somethingmoving. Went to work regardles, and coworkersaw something moving in his eye, urged him tosee eye doctor. Patient works at Lake Forest Mall, went to seeDr. Carducci 4. Past Ocular History Two years previously, in Cameroon had twoepisodes of FBS, itching and red eye. Was told byhis parents it was filaria and prescribed theusual treatment: Cut an onion in half and placeit in front of the eye for 10 minutes. Both timesthe symptoms went away and the eye got whiteand stopped itching. 5. Social History Drinks socially Denies smoking Student and sales associates at JCPenneys No family history noted No systemic meds No known allergies Arrived in United States two yearspreviously 6. Orientation, Mood and Affect: Alert and oriented Vision: Corrected VA OD: 20/25 +0.50 +0.25 X103Exam: Corrected VA OS: 20/20 +0.75 SPHER Slit-Lamp Exam: +2 injection of conjunctiva OS. A worm-like creature actively moving in the subconjunctival space inferotemporally. 7. Prescription: Zylet 0.5% Instructions:Plan: 1 drop TID left eye Patient referred to LOASISunit at NIH/NIAID 8. Patient AN April 22, 2012 Demographics: Gender: female Race: African Country: Cameroon Age: 20 Occupation: Student 9. History of Present Illness Two day history of itching, FBS, eye pain OS. Symptoms worsened when she went to the sun Looked in the mirror, never saw anythingmoving Began experiencing headaches, saw internistwho referred to Ophthalmologist Ophthalmologist referred patient to us. 10. Past Medical History Itching and swelling of wrists and hands Initially thought to be caused by lifting plates inher job as waitress However, symptoms persisted after leaving job. 11. Social History Social History: Drinks socially Denies smoking Family History: diabetes both grandparents No systemic meds No known allergies Arrived in the US at age 14, has never been back to her country since 12. Exam: Orientation, Mood and Affect: Alert, oriented, aprehensive Vision uncorrected OD: 20/20 OS: 20/20 Slit-Lamp Exam: +2 injection. Relatively large worm actively moving inthe subconjunctival space. Reassured and Transferredto microscope for removal. 13. Prescription:Plan: Zylet 0.3-0.5% tid. Referred for further care to Thomas Nutman, M.D.NIH/NIAID Patient returned for follow up on 10/5/2011. Patientstated to have FBS. Besides that no other eyesymptoms. Currently her writ and hand swelling and itchinghave disappeared.