RESUMEN
A man in his late 50s presented with a gradually enlarging, painless, reddish mass on the white portion of his left eye for 2 weeks. His best-corrected visual acuity was 20/20 in both eyes. Slit-lamp examination showed a congested, nodular, elevated lesion on the temporal bulbar conjunctiva with two pustule-like elevations. Anterior segment optical coherence tomography showed a subconjunctival solid mass rather than an abscess or a cyst. Scleral deroofing was performed and a long thread-like object resembling a dead worm was identified. The worm was removed intact, and its histopathology confirmed the diagnosis of Dirofilaria Peripheral blood smear did not show any microfilariae. No recurrences or new lesions were observed during the follow-up examinations at 1 and 5 months post-surgery. This case highlights the importance of considering a parasitic aetiology in cases of nodular or infectious scleritis.
Asunto(s)
Dirofilariasis , Infecciones Parasitarias del Ojo , Escleritis , Humanos , Masculino , Escleritis/diagnóstico , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Persona de Mediana Edad , Diagnóstico Diferencial , Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/cirugía , Animales , Dirofilaria/aislamiento & purificación , Tomografía de Coherencia Óptica , Enfermedades de la Conjuntiva/diagnóstico , Enfermedades de la Conjuntiva/parasitología , Conjuntiva/parasitología , Conjuntiva/patologíaAsunto(s)
Enfermedades de la Conjuntiva , Dirofilariasis , Infecciones Parasitarias del Ojo , Animales , Humanos , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Enfermedades de la Conjuntiva/diagnóstico , Infecciones Parasitarias del Ojo/diagnóstico , Infecciones Parasitarias del Ojo/cirugía , DirofilariaRESUMEN
Human dirofilariasis is a type of zoonotic infection caused by the Dirofilarial species. It is a type of roundworm which is commonly seen in dogs, cats and is transmitted to humans by mosquito bite. Microfilaria is rarely produced in humans. Although clinically they can have varied presentations, it usually presents as ocular or subcutaneous nodules. Definitive diagnosis requires histopathological findings of this worm. We hereby report three cases of Dirofilariasis from a tertiary care hospital in Wayanad.
Asunto(s)
Dirofilariasis , Humanos , Animales , Perros , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Dirofilariasis/patología , Centros de Atención Terciaria , Dirofilaria , Zoonosis , InvestigaciónRESUMEN
BACKGROUND: Subcutaneous dirofilariasis is a parasitic zoonosis commonly described in Canidae but rarely seen in humans. Most physicians are unfamiliar with this disease, especially in nonendemic areas, which can lead to medication error and diagnostic and treatment delay. To the best of our knowledge, no previous case of subcutaneous dirofilariasis preoperatively diagnosed on ultrasound has been described in Western Europe. CASE PRESENTATION: A 25-year-old Belgian male patient presented with a subcutaneous nodule in the epigastric region. Ultrasound investigation showed a typical cystic lesion with an internal serpiginous structure with echogenic lines, and there was active twirling movement of this serpentine structure during investigation, pathognomonic for subcutaneous dirofilariasis. Surgical extirpation was performed, and the diagnosis was histopathologically confirmed. CONCLUSION: Subcutaneous dirofilariasis has a characteristic appearance on ultrasound but is not well known in nonendemic areas, often leading to diagnostic delay and initial incorrect treatment. More knowledge of this disease and of its characteristic ultrasound appearance will hopefully lead to better patient care.
Asunto(s)
Dirofilariasis , Animales , Humanos , Masculino , Adulto , Dirofilariasis/diagnóstico por imagen , Dirofilariasis/cirugía , Bélgica , Diagnóstico Tardío , Zoonosis , UltrasonografíaRESUMEN
OBJECTIVE: To describe a dog presented with spontaneous pneumothorax secondary to chronic pulmonary changes associated with a history of resolved canine heartworm disease. CASE OR SERIES SUMMARY: A 7-year-old 25.2kg female spayed German Shepherd mix was presented for management of spontaneous pneumothorax. The dog had a history of heartworm disease that underwent therapy prior to adoption, and the dog was heartworm antigen negative (SNAP 4Dx) during hospitalization for the pneumothorax. An exploratory thoracotomy was performed due to an unresolving pneumothorax requiring multiple thoracocenteses. Perioperatively, the lungs did not expand with positive pressure ventilation and diffuse, multifocal to coalescing areas of darkened tissue that were grossly consistent with necrosis and/or hemorrhage were noted. The dog was euthanized intraoperatively due to an assumed poor prognosis. Histopathologic examination findings were consistent with chronic reactive changes related to previous heartworm infection. No neoplastic or infectious etiologies were identified. NEW OR UNIQUE INFORMATION PROVIDED: Spontaneous pneumothorax is a known complication of active heartworm infection. However, this case represents the first report of spontaneous pneumothorax secondary to chronic pulmonary changes caused by resolved heartworm infection.
Asunto(s)
Dirofilariasis , Enfermedades de los Perros , Neumotórax , Perros , Animales , Femenino , Neumotórax/terapia , Neumotórax/veterinaria , Neumotórax/complicaciones , Dirofilariasis/complicaciones , Dirofilariasis/cirugía , Dirofilariasis/diagnóstico , Enfermedades de los Perros/diagnósticoRESUMEN
The differential diagnosis of neoplasms of various localizations is the primary task in clinical practice of all physicians. We present a description of the case of invasion with Dirofilaria repens in the lung of a 68-year-old patient. In 2016 the patient was diagnosed with cancer of the left kidney and underwent a left-sided nephrectomy. During the dynamic observation in 2019, a lump was found in the left lung, which was regarded as a metastasis. An atypical SIX resection of the left lung was performed. Microscopy of the removed lump revealed the presence of a nematode of the genus Dirofilaria, presumably D. repens. The species identity of D. repens was confirmed by polymerase chain reaction using species-specific primers. It is known that the morphological identification of parasites up to the species in the surgical material presents certain difficulties and requires high professional training of the researcher. Therefore, the diagnosis of dirofilariasis in atypical localizations of nematodes in the human body is of great importance in the differentiation of malignant and benign formations, and the use of the polymerase chain reaction method can significantly increase the accuracy in establishing the final diagnosis.
Asunto(s)
Dirofilaria repens , Dirofilariasis , Animales , Humanos , Anciano , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Dirofilaria repens/genética , Reacción en Cadena de la Polimerasa , Pulmón/patología , Diagnóstico DiferencialRESUMEN
BACKGROUND: Heartworm infection in dogs is caused by Dirofilaria immitis and common in shelter animals and outdoors dogs. Caval syndrome can develop with severe infection and physical heartworm removal is essential with heartworm burdens. In this study, we used an improved transvenous heartworm extraction brush, which was expected to cause less cardiovascular damage and allow easier manipulation. OBJECTIVES: This study aims to evaluate efficacy of this improved transvenous heartworm extraction brush. METHODS: The brush was designed to improve upon the limitations of the previous brush-type devices. The brush was made of a polyvinyl chloride tube and threads of polyamides or polyglyconates. Metal material was inserted at the front tip for easy visualization under fluoroscopy. The eight dogs diagnosed with caval syndrome with large numbers of heartworms and pulmonary hypertension were used in this study. The removal procedure began with the dissection of the subcutaneous tissue around the right jugular vein. The device was inserted through the jugular vein. After insertion, the tube was rotated to catch the heartworms and extracted with the heartworms hanging on the threads. The procedure was repeated several times. Lastly, jugular vein and skin sutures were made. Adulticidal therapy was administered after heartworm removal. RESULTS: The mean number of removed heartworms was 10.5 ± 4.24 and mean number of remaining heartworms was 0.63 ± 1.06. Total procedure time was 72.63 ± 51.36. Except for three cases, heartworms were not detected on ultrasonography after the procedure. No procedure-related side effects were observed within the 1- to 2-mon. CONCLUSIONS: An improved transvenous heartworm extraction brush is efficient for heartworm removal in dogs with caval syndrome.
Asunto(s)
Dirofilaria immitis , Dirofilariasis , Enfermedades de los Perros , Hipertensión Pulmonar , Perros , Animales , Dirofilariasis/cirugía , Enfermedades de los Perros/cirugía , Enfermedades de los Perros/tratamiento farmacológico , Hipertensión Pulmonar/veterinariaRESUMEN
Abstract: Zoonotic dirofilariasis infestation, caused by Dirofilaria Repens, is described worldwide in different countries. A 31-years-old male patient presented thoracic muscle pain after growth of an ovoidal undefine cyst in left parasternal region. Patient reported several contacts with different species of animals for a familiar activity. In absence of blood inflammatory indices and systemic symptoms, imaging studies showed a suspected muscle cyst infection. Surgical excision was performed and microbiology confirmed parasite nature. Dirofilaria Repens, probably adult female, was identified. Treatment resulted to be definitive and any other clinical and surgical approach was needed. Healing time was uneventful and follow-up showed no further systemic relapses. The case highlights the effectiveness of surgical treatment in this subcutaneous infestation for an increasing number of human cases reported in endemic areas such as Central Italy.
Asunto(s)
Dirofilaria repens , Dirofilariasis , Adulto , Animales , Humanos , Masculino , Femenino , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Dirofilariasis/epidemiología , Músculos Pectorales , Recurrencia Local de Neoplasia , ItaliaRESUMEN
Parasitic diseases are rare in forensic practice. The article presents two observations of dirofilariasis in the facial area. Clinical signs, characteristics, surgical treatment, and description of the parasite extracted from the subcutaneous tissue of the paraorbital region are given.
Asunto(s)
Dirofilariasis , Animales , Humanos , Dirofilariasis/diagnóstico , Dirofilariasis/parasitología , Dirofilariasis/cirugía , Medicina LegalAsunto(s)
Dirofilariasis , Enfermedades Pulmonares Parasitarias , Nódulo Pulmonar Solitario , Animales , Dirofilariasis/diagnóstico , Dirofilariasis/cirugía , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico por imagen , Nódulo Pulmonar Solitario/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.
Asunto(s)
Dirofilaria repens , Dirofilariasis , Mucocele , Adulto , Animales , Croacia , Dirofilariasis/diagnóstico , Dirofilariasis/parasitología , Dirofilariasis/cirugía , Humanos , Labio/cirugía , Masculino , Mucocele/diagnóstico , Mucocele/cirugíaRESUMEN
Dirofilariasis is an emerging zoonosis caused by nematodes of the genus Dirofilaria, most often D. repens and D. immitis. The main final hosts and reservoirs of pathogens are dogs. The intermediate hosts and vectors of infection are female mosquitoes (Culicidae). Human is an accidental host in which the parasite does not usually mature. Over the past 20 years, the range of Dirofilaria spp. in Europe has expanded. We present an unusual case of multifocal dirofilariasis of mixed subcutaneous-ocular course caused by D. repens in a 52-year-old Polish patient who was probably infected in Spain or Croatia, where she stayed one year before the onset of symptoms. Surgical removal of the nematodes followed by treatment with Ivermectin in a single dose of 1200 µg and Doxycycline 200 mg daily for 7 days resulted in complete recovery. We believe that all cases of human dirofilariasis, especially in countries where the disease is not frequent at present, should be registered for epidemiological purposes. Moreover, due to the widening of the range of D. repens and D. immitis occurrence and the possibility of atypical courses of infection with both nematodes, diagnostics should include the species identification of the parasite.
Asunto(s)
Dirofilaria repens/aislamiento & purificación , Dirofilariasis/diagnóstico , Oftalmopatías/diagnóstico , Enfermedades de la Piel/diagnóstico , Animales , Antiparasitarios/administración & dosificación , Croacia , Dirofilariasis/tratamiento farmacológico , Dirofilariasis/parasitología , Dirofilariasis/cirugía , Doxiciclina/administración & dosificación , Oftalmopatías/tratamiento farmacológico , Oftalmopatías/parasitología , Oftalmopatías/cirugía , Femenino , Humanos , Ivermectina/administración & dosificación , Persona de Mediana Edad , Polonia , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/parasitología , Enfermedades de la Piel/cirugía , España , Viaje , Resultado del TratamientoRESUMEN
Human pulmonary dirofilariasis (HPD) is a rare zoonotic disease caused by Dirofilaria immitis, the nematode responsible for canine cardiopulmonary dirofilariasis (dog heartworm). The incidence of HPD is on the rise throughout the world due to increased awareness and factors affecting the vector (mosquito). Humans are accidental hosts for D. immitis. Most patients are asymptomatic and present with an incidental pulmonary nodule that mimics primary or metastatic pulmonary malignancy. Some patients suffer from pulmonary and systemic symptoms in the acute phase of pneumonitis caused by pulmonary arterial occlusion by the preadult worms resulting in pulmonary infarction and intense inflammation. These patients may have ill-defined pulmonary infiltrate on chest radiology. Pulmonary nodules represent the end result of initial pneumonitis. There are no specific clinical, laboratory, or radiologic findings that differentiate HPD from other causes of a pulmonary nodule. Although serologic tests exist, they are usually not commercially available. The majority of patients are diagnosed by histopathologic identification of the decomposing worm following surgical resection of the lesion.
Asunto(s)
Dirofilaria immitis , Dirofilariasis , Cardiopatías , Enfermedades Pulmonares Parasitarias , Nódulos Pulmonares Múltiples , Animales , Dirofilariasis/diagnóstico , Dirofilariasis/epidemiología , Dirofilariasis/cirugía , Perros , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico por imagen , Enfermedades Pulmonares Parasitarias/epidemiología , Mosquitos VectoresAsunto(s)
Anafilaxia , Dirofilariasis , Anafilaxia/etiología , Animales , Dirofilaria , Dirofilariasis/cirugía , Humanos , Tejido SubcutáneoRESUMEN
Purpose: To report a case of ocular dirofilariasis causing extensive chorio-retinal damage.Method: Surgical removal of the worm and identification of the same by microscopic examinationand polymerase chain reaction.Results: The worm was identified as Dirofilaria repens.Conclusion: Ocular dirofilariasis is an arthropod borne parasitic infestation affecting the subconjunctival tissue and anterior chamber. Vitreous involvement in Dirofilaria is very rare. Dirofilaria repens can cause extensive chorio-retinal damage resembling diffuse unilateralsubacute neuroretinitis.
Asunto(s)
Enfermedades de la Coroides/parasitología , Dirofilaria repens/aislamiento & purificación , Dirofilariasis/parasitología , Infecciones Parasitarias del Ojo/parasitología , Enfermedades de la Retina/parasitología , Cuerpo Vítreo/parasitología , Adulto , Animales , Enfermedades de la Coroides/fisiopatología , Enfermedades de la Coroides/cirugía , ADN Protozoario/genética , Dirofilaria repens/genética , Dirofilariasis/fisiopatología , Dirofilariasis/cirugía , Electrorretinografía , Infecciones Parasitarias del Ojo/fisiopatología , Infecciones Parasitarias del Ojo/cirugía , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Retina/fisiopatología , Enfermedades de la Retina/fisiopatología , Enfermedades de la Retina/cirugía , Agudeza Visual/fisiología , Campos Visuales/fisiología , VitrectomíaRESUMEN
INTRODUCTION: Caval syndrome due to infection with Dirofilaria (D.) immitis is a life-threatening situation, needing immediate therapeutic intervention. Severe pulmonary hypertension due to dirofilariosis was diagnosed echocardiographically in a 3.6 kg dog with heart failure and moderate hemolytic anemia. A ball of adult worms was visualized in the tricuspid valve area. Using a modified pigtail catheter, these worms were removed under fluoroscopic guidance by a transvenous approach. Already intraoperatively the hemodynamic condition improved. Subsequently, additional routine adulticide treatment was performed without complications. Over the following weeks the severe pulmonary hypertension normalized slowly but steadily. Manual extraction of adult D. immitis can be achieved with relatively simple tools and allows rapid stabilization of a critically sick patient.
INTRODUCTION: Le syndrome cave supérieur dû à une infestation à Dirofilaria (D.) immitis est une situation potentiellement mortelle nécessitant un traitement immédiat. Une hypertension pulmonaire sévère due à la dirofilariose a été diagnostiquée par échocardiographie chez un chien de 3,6 kg présentant une insuffisance cardiaque et une anémie hémolytique modérée. Une boule de vers adultes a été visualisée dans la région de la valvule tricuspide. En utilisant un cathéter queue de cochon modifié, ces vers ont été retirés sous guidage fluoroscopique par une approche transveineuse. Déjà durant l'opération, l'état hémodynamique s'est amélioré. Par la suite, un traitement adulticide de routine supplémentaire a été réalisé sans complications. Au cours des semaines suivantes, l'hypertension artérielle pulmonaire sévère s'est normalisée lentement mais régulièrement. L'extraction manuelle de D. immitis adultes peut être réalisée avec des outils relativement simples et permet la stabilisation rapide d'un patient gravement atteint.
Asunto(s)
Dirofilariasis/complicaciones , Dirofilariasis/cirugía , Enfermedades de los Perros/cirugía , Hipertensión Pulmonar/veterinaria , Animales , Dirofilaria immitis , Dirofilariasis/tratamiento farmacológico , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/tratamiento farmacológico , Perros , Ecocardiografía/veterinaria , Filaricidas/uso terapéutico , Hipertensión Pulmonar/etiología , Resultado del TratamientoRESUMEN
Ocular filariasis commonly presents as subconjunctival or eyelid nodules. We report a rare case of a live, motile worm causing floaters. The worm was isolated from the vitreous cavity and revealed to be Dirofilaria repens. Correct recognition of the worm is necessary as human dirofilariasis does not present as microfilaremia and does not require systemic therapy; in contrast to other causes of ocular filariasis, which require systemic therapy. As ophthalmologist may be the first physician to encounter such patients, a high index of suspicion is required for timely and adequate management.
Asunto(s)
Dirofilaria repens/aislamiento & purificación , Dirofilariasis/diagnóstico , Infecciones Parasitarias del Ojo/diagnóstico , Cuerpo Vítreo/parasitología , Animales , Dirofilariasis/parasitología , Dirofilariasis/cirugía , Infecciones Parasitarias del Ojo/parasitología , Infecciones Parasitarias del Ojo/cirugía , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Raras , Esclerostomía/métodos , Vitrectomía , Cuerpo Vítreo/diagnóstico por imagenRESUMEN
Human ocular Dirofilariasis is a relatively rare, zoonotic disease, caused by a filarial nematode, Dirofilaria repens. This parasitic infestation usually presents as a subconjunctival nodule with hyperemia. The authors present a case of subconjunctival dirofilariasis in a 91-year-old gentleman, who presented with manifestations of orbital cellulitis. The live worm was surgically removed and identified to be D. repens.