ABSTRACT
Dirofilariasis is a worldwide zoonotic infection that rarely affects humans and is caused by filarial nematodes of the genus Diroflaria transmitted by mosquitoes. Cutaneous dirofilariasis, due to D. repens, presents as inflammatory lesions that develop into subcutaneous nodules. These clinical symptoms may be consistent with Wells' cellulitis. Diagnosis of dirofilariasis involves demonstration of the presence of the nematode during skin biopsy and identification of the worm through macroscopic, histological and PCR analysis. Surgical resection of the nodule remains the gold standard treatment. The number of cases of human cutaneous dirofilariasis has increased in the recent years and the disease must not be misdiagnosed.
Subject(s)
Dirofilariasis , Skin Diseases, Parasitic , Animals , Dirofilariasis/diagnosis , Dirofilariasis/therapy , Humans , Skin Diseases, Parasitic/diagnosis , Skin Diseases, Parasitic/therapy , Skin Diseases, Parasitic/veterinaryABSTRACT
INTRODUCTION: Donovanosis (granuloma inguinale) is a bacterial infection caused by Klebsiella granulomatis that occurs mainly in the genital area and is primarily sexually transmitted; it is seen predominantly in the tropics. Herein, we report a case of the disease contracted in metropolitan France. PATIENTS AND METHODS: A 47-year-old man presented with painless ulceration of the glans, present for one month, with progressive extension; there was no history of any recent trip abroad. Skin biopsy with Whartin-Starry and Giemsa staining revealed Donovan bodies in the cytoplasm of macrophages. Based on these findings, further questioning of the patient revealed unprotected sexual contact two months earlier in France. Treatment was initiated with azithromycin 1g on the first day followed by 500mg per day for three weeks. The clinical outcome was spectacular, with almost complete regression of the ulcer at 7 days. DISCUSSION: This case demonstrates that donovanosis can occur in metropolitan France.