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Pulmonary dirofilariasis--clinicopathological study
Hiroshi Hirano1, Tomohiko Kizaki, Terumasa Sashikata
1Department of Pathology, Toneyama National Hospital, Osaka, Japan.
The Kobe Journal of Medical Sciences
|December 28, 2002
Summary
Pulmonary dirofilariasis, a rare lung infection caused by the dog heartworm Dirofilaria immitis, can present as asymptomatic nodules. Diagnosis requires careful pathological examination due to the lack of distinct clinical signs.
Area of Science:
- Veterinary parasitology
- Human infectious diseases
- Pulmonary pathology
Background:
- Pulmonary dirofilariasis (PD) is an uncommon parasitic infection in humans, typically caused by Dirofilaria immitis, the canine heartworm.
- Human cases are often asymptomatic and diagnosed incidentally through imaging studies.
- Understanding the presentation and diagnosis of PD is crucial for public health.
Observation:
- Four human cases of pulmonary dirofilariasis were recently identified.
- Patients presented with single, spherical nodules in the right lung on chest X-rays.
- No clinical symptoms or direct contact with dogs were reported; mild eosinophilia was noted in one case.
Findings:
- Pathological examination revealed well-circumscribed, round nodules in the lungs.
- Histology showed coagulation necrosis, fibrosis, and inflammation at the nodule edges.
- Silver staining and immunohistochemistry confirmed the presence of Dirofilaria immitis structures within the nodules.
Implications:
- Pulmonary dirofilariasis should be considered in the differential diagnosis of pulmonary nodules, even in the absence of typical risk factors.
- Accurate diagnosis relies on integrating imaging, pathological, and specific serological or immunohistochemical findings.
- Further research into human dirofilariasis is warranted to better understand its epidemiology and clinical spectrum.