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Dirofilaria repens, a natural parasite of dogs and cats in Europe, Asia, and Africa, sometimes infects man. In man the worms are usually in subcutaneous tissues or in the orbit. A case is herein reported in which a non-gravid, adult Dirofilaria, probably D. repens, was in the subcutaneous tissue of a resident of Wisconsin. The patient, however, acquired the infection 8 years previously in Greece.
On the basis of known DNA sequences of Dirofilaria repens and D. immitis we designed specific primers for the amplification by Polymerase Chain Reaction (PCR) of the DNA from the two species. The PCR-based identification was found to be unambiguous and allowed specific diagnosis of microfilariae in blood samples, of developing larvae in the mosquito vector and of immature adults in bioptic material, overcoming the serious constraints of the morphological separation of these filarial parasites at the pre-adult stages. The technique was found to be very sensitive and applicable to samples stored either dry or in various preservation media, with the exception of formalin. The reliable identification of D. repens and D. immitis from bioptic material is expected to greatly enhance the chances of detecting human infections and to further clarify the role of the two parasites as pathogens of man. The possibility of routine identification of developing larvae in the vector will substantially improve the perspectives for epidemiological investigations, particularly in Southern European regions, such as Italy, where the two nematode species are largely sympatric.
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The differential epidemiology of D. repens and D. immitis is still poorly understood due to the lack of a diagnostic method which would make possible the routine identification of these parasites as developing larvae either in the vector or in unsuitable hosts, including man. The PCR-based method here described allows: i) the unambiguous identification of mature and immature adult worms in bioptic material, of microfilariae in blood samples and of developing larvae in mosquito vectors; ii) the analysis of samples stored either dry or in various preservation media, with the exception of formalin. The high specificity and sensitivity of the diagnosis improve the perspectives for comparative epidemiological investigations on D. repens and D. immitis in areas where the two nematodes are sympatric.
PURPOSE: To report a case of Dirofilaria repens presenting as a subcutaneous tumor of the lower eyelid. METHODS: Interventional case report. RESULTS: A 29-year-old man of Greek origin without systemic symptoms presented with a 3-week history of a small painless mass localized in the medial part of the lower eyelid. There was no history of a preceding trauma, injury, or visual impairment; however, the patient had recently been on a holiday in Italy. The lesion persisted after systemic antibiotic treatment. Routine blood tests were normal and the efferent tear ducts were patent. Upon surgical intervention a yellowish, pea-sized cyst-like structure was found beneath the orbicularis muscle and removed in toto. Histologic examination revealed the presence of a wormlike structure with the characteristic features of a single adult Dirofilaria repens nematode. CONCLUSIONS: Infection with the nematode Dirofilaria repens has to be considered in the differential diagnosis of malignant and benign tumors of subcutaneous periocular tissues in patients who traveled to endemic areas.
Human dirofilariasis caused by Dirofilaria repens D. repens is a common zoonosis in the Mediterranean countries and parts of South Asia. During the last decade, it has been reported from countries previously considered non-endemic. This is likely due to the increased awareness regarding Dirofilaria infection. In some such cases however, dirofilariasis correlated with the travel of the patient to the endemic areas. We present the case of a Saudi male who had D. repens infection in the subcutaneous tissues of the forearm. The patient had traveled to Iraq, Syria, United Arab Emirates and Kuwait in the last 2 years. However, the known Dirofilaria endemic countries were not visited. Any prior occurrence of the human dirofilariasis in the Kingdom of Saudi Arabia is not documented. Lack of epidemiological studies or incidence reports in the Arabian region precludes any factual evaluation of Dirofilaria prevalence, which requires increased awareness amongst health workers regarding its potential occurrence in the native population.
Dirofilariasis involving Dirofilaria repens is an exceedingly rare event in France. Most cases have involved subcutaneous lesions but ocular and peri-ocular involvement have been observed. The present report describes a case of dirofilariasis involving the conjunctiva in a 61 year-old-man in France. Onset was characterized by the sudden appearance of painful conjunctival cyst. Clinical examination and laboratory tests did not allow diagnosis. Opening the cyst and extracting the parasite allowed diagnosis and treatment. Microscopic examination identified the parasite as a female Dirofilaria repens. This new case of ocular dirofilariasis emphasizes that this parasitic disease is present and probably underestimated in mainland France. Opening of the conjunctival cyst allowed identification of the parasite and successful treatment without sequels.
Zoonotic filariasis caused by Dirofilaria repens, a parasite of carnivores occurs mainly in countries surrounding Mediterranean region. The infection occurs in and around eye among animal handlers through vector transmission. We are reporting a case of human Dirofilariasis affecting subtenons region in a 63 year-old woman from Coimbatore, South India. The purpose of this article is to review the clinical course and management of ocular Dirofilariasis.
1 - Dogs infected with Dirofilaria repens from Italy were found to show seasonal variations in the number of microfilariae in the peripheral blood. 2 - The rise in the number of microfilariae occured in August and September and is coincidental with the higher probability of trasmission. 3 - Rise and fall of microfilaraemia was induced experimentally by exposure of the host to high and low temperatures respectively. 4 - The importance of such variations in microfilaraemia is stressed in relation to the evaluation of the infection from a clinical, pharmacological and epizoological point of view.
INTRODUCTION: Dirofilariasis due to Dirofilaria repens is a parasitic disease affecting domestic animals and transmitted to man by mosquito bites. Human infestation is rare and involves benign subcutaneous and ocular manifestations. The diagnosis is made by excisional biopsy, which is also the sole recommended treatment. There are few reports of human infection in Tunisia. CASE REPORT: We report herein the second case of conjunctival dirofilariasis in a 21-year-old woman residing in Tunis (Tunisia). The clinical presentation evoked orbital cellulites. Clinical and radiological investigations did not provide a diagnosis. Surgical excision and histological examination established the diagnosis by the presence of an adult female worm identified as Dirofilaria repens. Parasite extraction allowed successful treatment. CONCLUSION: Dirofilariasis is rare in Tunisia, with only seven cases reported. The true incidence of dirofilariasis is probably greater than recognized. This can be explained by the apparent benign nature of the lesions that may not warrant excision.
The paper reports a case of Dirofilaria repens subcutaneous parasitism with the larva migrans phenomenon in the North Causasus area where epidemiological prerequisites are available for spread of dirofilariasis. The clinical picture, surgical intervention, and the diagnosis of the infection are presented. The parasite is defined by the authors as Dirofilaria repens.
The fourth case of zoonotic Dirofilaria repens infection in Israel is reported, and the diagnostic morphologic characteristics of this filariid are reviewed. The importance of the exact anatomic diagnosis of this filaria is stressed in view of the fact that Israel has pockets of settlers from East Africa, a region endemic for lymphatic filariasis (Wuchereria bancrofti). Since the possibility of introduction of such an infection into the country exists, differentiating this zoonotic Dirofilaria from other filarial worms is essential. The clinicopathological features of a Dirofilaria repens infection are distinct. The patient initially has a painful subcutaneous or conjunctival swelling; the excisional biopsy shows the presence of a dead or alive, usually female worm that measures 220-660 microns across; the central intestine and the genital organs (two uteri) are located in the pseudocoelom; the thick, multilayered cuticle is provided with 95-105 sharp, longitudinal ridges, the latter being separated from each other by a distance of 12 microns; the circumferential muscle cell layer, covering the inner side of the cuticle, is bilaterally interrupted by the large chord cells, two to five nuclei of which are discernible in each cross section.
INTRODUCTION: Cutaneous dirofilariasis caused by Dirofilaria repens is a parasitic disease in dogs and cats. It is exceedingly rare in man who is an occasional host. The parasite fails to reach maturity. The true incidence of dirofilariasis is probably greater than recognized. This can be explained by the apparent benign nature of the lesions that may not warrant excision. CASE REPORT: A 12-year-old girl presented a cutaneous nodular lesion involving the forehead. Surgical excision allowed diagnosis: cutaneous dirofilariasis caused by Dirofilaria repens. The child had always stayed in mainland France. Histopathological examination showed the worm trial with inflammatory granulomatous reaction of the deep dermis. The parasite extraction allowed successful treatment. DISCUSSION: This new case of cutaneous dirofilariasis emphasizes that this parasitic disease is present in mainland France. The infection is more common in Southern France. The present report describes a pediatric case in Gironde, where it is exceedingly rare. Microscopic examination identified, and it was unusual, a male worm.
BACKGROUND: Human dirofilariosis is endemic in southern France. The causal agent is Dirofilaria repens transmitted to man by mosquitos. The human organism is an accidental host while the dog is the reservoir. Approximately 60 cases have been reported in France, mainly in southern continental areas and Corsica. Most cases involve subcutaneous and occular manifestations. CASE REPORT: A 47-year old woman living in the Var department in southern france consulted for a subcutaneous nodule with the aspect of an epidermoid cyst. At incision, the nodule was found to contain a helminth found at parasite examination to be Dirofilaria repens. DISCUSSION: The prevalence of endemic subcutaneous dirofilariosis is probably underestimated as the clinical expression is non-specific and spontaneous cure is common. The diagnosis of epidermoid cyst is frequently suggested. History taking does not reveal travel to intertropical areas. The helminth is discovered when the nodule is opened, also providing successful cure.
A female patient resident in Germany is described, who had developed dirofilariasis presenting as a hard subcutaneous nodule at the glabella. Dirofilaria repens was isolated after surgical removal of the skin lesion. She was treated with diethylcarbamazine (Hetrazan) for 4 weeks. Exposures related to infection with Dirofilaria repens are discussed.
Cases of zoonotic dirofilariasis infection, caused by Dirofilaria repens, occur widely throughout European, African, Middle Eastern, and Asian countries. The reports of this infection in humans in India are limited, and we herein report the case of a 23-year-old man who presented with subconjunctival swelling in the right eye with no local symptoms. A large nematode was visualized on examination and the intact worm was surgically removed. The parasite was identified as a male D. repens.
The authors describe a case of Dirofilaria repens subcutaneous dirofilariasis, in a resident of Corsica (France). Epidemiological and morphological features are related for various species of Dirofilariasis. These data, mainly based on clinical history, are usually sufficient to exclude other forms of subcutaneous filariosis, especially tropical.
A case of dirofilariasis in a Norwegian man is reported. The causal agent was identified as Dirofilaria repens Railliet et Henry, 1911. To the best of our knowledge, this is the first report from a Scandinavian country on dirofilariasis caused by Dirofilaria repens. The infection was probably acquired in Majorca four years before it was diagnosed in Molde, Norway.