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Human disease caused by dog heartworm.
J Watson1, W J Wetzel, J Burkhalter
1Department of Pathology, Mississippi Baptist Medical Center, Jackson.
Journal of the Mississippi State Medical Association
|November 1, 1991
Summary
Pulmonary dirofilariasis caused by Dirofilaria immitis is a rare lung disease in humans. Definitive diagnosis relies on identifying the worm through histologic examination of lung lesions.
Area of Science:
- Veterinary Pathology
- Human Pathology
- Parasitology
Background:
- Pulmonary dirofilariasis, caused by Dirofilaria immitis, is an uncommon cause of human lung disease.
- While historically underreported, cases are increasing, particularly in North America.
Observation:
- Clinical diagnosis is challenging, with no cases reported in children.
- The typical age range for affected individuals is 40-60 years, and it is diagnosed more frequently in males.
- Histologic examination revealing the nematode within lung lesions is the definitive diagnostic method.
Findings:
- The parasite is often found in a minority of tissue sections, necessitating multiple examinations.
- Distinguishing D. immitis from other lung-dwelling nematodes like Enterobius vermicularis, Wuchereria bancrofti, Brugia malayi, and Onchocerca volvulus is crucial.
- Morphological differences, including size and the presence of reproductive organs, differentiate D. immitis from ascarids, strongyloids, and hookworm larvae.
Implications:
- Pulmonary infarction with a granulomatous response warrants thorough histologic evaluation for D. immitis.
- Identifying nematode fragments in pulmonary infarcts in North America is highly suggestive of pulmonary dirofilariasis.
- Accurate diagnosis is essential for understanding the epidemiology and clinical impact of this zoonotic disease.