The prevalence of Loa loa infections in non-endemic areas such as Korea is very low, even though it is quite common in the endemic regions of West and Central Africa. We describe a patient who presented with temporary localized edema (classical Calabar swellings) after travelling to Cameroon and in whom the diagnosis of loiasis was made by ELISA. This is the second reported case of loiasis in Korea. As international travel is becoming more frequent, Loa loa infection should be considered in the differential diagnosis for patients with eosinophilia and Calabar swellings in Korea.
Adult ; Angioneurotic Edema/parasitology* ; Animal ; Antinematodal Agents/therapeutic use ; Arm/parasitology* ; Case Report ; Enzyme-Linked Immunosorbent Assay ; Human ; Ivermectin/therapeutic use ; Loa/isolation & purification ; Loiasis/pathology* ; Loiasis/parasitology* ; Loiasis/complications ; Male ; Skin Diseases/pathology* ; Skin Diseases/parasitology*

Loa loa is unique among the human filariae in that adult worms are occasionally visible during subconjuntival migration. A 29-yr-old African female student, living in Korea for the past 5 yr without ever visiting her home country, presented with acute eyelid swelling and a sensation of motion on the left eyeball. Her symptoms started one day earlier and became worse over time. Examination revealed a threadlike worm beneath the left upper bulbar conjunctiva with mild eyelid swelling as well as painless swelling of the right forearm. Upon exposure to slit-lamp illumination, a sudden movement of the worm toward the fornix was noted. After surgical extraction, parasitologic analysis confirmed the worm to be a female adult Loa loa with the vulva at the extreme anterior end. On blood smear, the microfilariae had characteristic features of Loa loa, including sheath and body nuclei up to the tip of the tail. The patient also showed eosinophilia (37%) measuring 4,100/microliter. She took ivermectin (200 microgram/kg) as a single dose and suffered from a mild fever and chills for one day. This patient, to the best of our knowledge, is the first case of subconjunctival loiasis with Calabar swelling in Korea.
Adult ; Animals ; Conjunctiva/parasitology ; Conjunctival Diseases/*parasitology ; Eye Infections, Parasitic/*parasitology ; Female ; Humans ; Loa/isolation & purification ; Loiasis/*parasitology