Subcutaneous Human Dirofilariosis By D. Repens In South Italy: A Case Report

Human dirofilariosis is a zoonosis caused by different Dirofilaria species: D. repens, D. immitis, D. tenuis and D. ursi, thin nematodes belonging to the Onchocercidae family, whose larval stages are generally found in the natural (felines and canids) or accidental (human) definitive host. In Europe, human infection is rare, even in areas considered endemic such as Spain or Italy. In this paper we describe the case of an 82-year-old woman living in Modugno (Bari municipality), who came to our observation for a subcutaneous nodule on her right thigh that had appeared in the previous two weeks and gradually became necrotic. The woman lived in an apartment with a dog. An adult worm, white, thin, about 140 mm long, came out of the necrotic area spontaneously. After microscopic examination, the worm was identified as D. repens. In Apulia, a South-Italy region, human dirofilariosis is a rare disease and since 1885 only 11 cases have been reported. In recent years we have witnessed an increase in the number of diseases transmitted by vectors at all latitudes, and in our region an increase in the Aedes albopticus population has been reported, so it is reasonable to expect an increase in dirofilariosis cases in humans.