Dangerous waters: outbreak of eye lesions caused by fresh water sponge spicules

Abstract

Purpose To describe an extremely uncommon outbreak of eye lesions in a specific area of the Brazilian Amazonia. Methods Prospective noncomparative case series. Fifty-nine patients who developed eye lesions after swimming in the Araguaia river of Tocantins state in Brazil were examined. A team of ophthalmologists equipped with a slit-lamp, gonioscopic lenses, and indirect ophthalmoscopy performed full eye examination. Analysis of the flora and fauna of the river water was undertaken by a group of experts. Results and Conclusions Eighty-three eyes were affected. The most common lesions were corneal opacities seen in 34 eyes and conjunctival nodules diagnosed in 12 eyes. Severe visual acuity loss was detected in seven children with unilateral anterior chamber lesions. Spicules of the sponge species Drulia uruguayensis and Drulia ctenosclera were found inside three blind eyes that have been enucleated for diagnostic purposes. All eye lesions could be attributed to an outbreak of foreign bodies from fresh water sponges. Organic enrichment of the water resulting from the absence of sanitation probably was the key factor, which initiated a cycle of ecological imbalance that provoked human disease.

Treatment of presumed trematode-induced granulomatous anterior uveitis among children in rural areas of Egypt

“…In South India, the aetiology of AC granuloma in children was confirmed to be caused by a trematode named Procerovum varium [7,8]. Two exotic species of molluscs, Mellanoides tuberculatus and Corbicula fluminea are present in enormous numbers in the riverbanks in Brazil and were responsible for an outbreak of ocular lesions in the form of AC granulomas, subconjunctival nodules and corneal opacities [9]. In addition, freshwater sponges Drulia uruguayensis and Drulia ctenosclera can also cause AC granulomas [10].…”

Trends and Gaps in Scientific Production on Freshwater Sponges

“…Finally, 12 publications were counted for the Human Health area, including researches and patents (Figure 1), especially applications for dermatological purposes . On the other hand, a broad bioprospecting, exploring new possibilities for the implementation of natural products in medicine and pharmacy, is necessary, since this group of organisms potentially presents new therapeutic agents (Dos Santos et al 2011;Cruz et al 2013) to be used in the treatment of skin diseases (Marilha, 2007;Marilha, 2009a;Marilha, 2009b), of the urinary tract (Zhang 2015a(Zhang , 2015b, in addition to pancreatic and prostate cancer (Ottinger et al 2012).…”

Exantema Durante Férias na Região Amazónica

“…Possuem espículas compostas de sílica cristalina que se libertam na água quando as esponjas morrem. 1 O principal gênero envolvido em acidentes é o Drulia, com relatos de acidentes que evoluem com eczema local ou mesmo erupção papulo-eritematosa generalizada ,2 como no presente caso. As lesões dermatológicas nesses acidentes ocorrem pelo contato da pele com as espículas das esponjas presentes na água, e iniciam-se de forma imediata, associado a prurido e ardor.…”

“…Há ainda relatos de acometimento ocular e até mesmo cegueira devido à esse tipo de acidente. 1,4 É considerado que, no contato da pele, as espículas de sí-lica das esponjas penetram na epiderme e derme, promovem a ativação de macrófagos e outras células com libertação local de quimiocinas e citocinas pró-inflamatórias como TNF--alfa, IL-1β, proteína quimiotática de monócito-1 (MCP-1) e CXCL-1. Especula-se que, devido à incapacidade de fagocitose da espícula, os macrófagos estimulados entram em apoptose, justificando o quadro clínico autolimitado.…”