Loiasis (African Eye Worm) Differential Diagnoses

Updated: Jun 03, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Differential Diagnoses

  • Cutaneous Larva Migrans

    May present with red pruritic eruptions on the skin

  • Gnathostomiasis

    May produce subcutaneous swellings similar to calabar swellings

  • Lymphatic filariasis

    Localized lymphedema may mimic calabar swelling. Range overlaps with that of loiasis.

  • Myiasis

    May present with cutaneous boils and swellings, which may last for significant periods

  • Ocular trauma

  • Onchocerciasis (River Blindness)

    May present with pruritic papular skin rash, subcutaneous nodules, and lymphedema, which may be confused with symptoms of loiasis. Eye pathology is markedly different and characterized by the presence of ocular microfilariae, which may lead to ocular keratitis, corneal fibrosis, or opacification. Slit-lamp examination may reveal microfilariae in the cornea and anterior chamber.

  • Reactive Arthritis

    The calabar swellings due to microfilaria can imitate arthritis.

  • Strongyloidiasis

    Presents with asymptomatic eosinophilia or nonspecific symptoms, including urticaria

  • Trachoma

    Ocular scarring due to inward-turned eyelashes

  • Zoonotic Infections

    Various zoonotic helminthes may present with subconjunctival migration that may be indistinguishable from the eyeworm of loiasis.