[CLINICAL CASE OF DIROFILARIASIS.]

Area of Science:

• Parasitology
• Human Pathology
• Medical Entomology

Background:

• Dirofilariasis is a zoonotic parasitic disease caused by filarial nematodes of the genus Dirofilaria.
• Human infections are typically asymptomatic or present as subcutaneous nodules, often in the lungs, skin, or eyes.
• Genital dirofilariasis in males is exceptionally rare, with few documented cases globally.

Observation:

• A patient presented with a migratory subcutaneous mass on the chest, followed by a dense penile mass.
• Surgical excision of the penile mass revealed a gravid female Dirofilaria spp. nematode.
• Histological examination confirmed the presence of Dirofilaria sections and numerous microfilariae within the female worm's body cavity.

Findings:

• The removed penile tumor contained a pregnant Dirofilaria female, a highly unusual localization.
• Microfilariae were abundant within the nematode but undetectable in the patient's blood via routine methods and PCR.
• This suggests a potential localized lifecycle or sequestration of microfilariae within the parasite.

Implications:

• This case highlights the potential for unusual clinical presentations and rare localizations of Dirofilaria infections in humans.
• It underscores the importance of considering parasitic etiologies in unexplained subcutaneous masses, even in atypical locations.
• Further research may be needed to understand the pathogenesis and diagnostic challenges of genital dirofilariasis and microfilariae sequestration.