Two cases of ectopic dirofilariasis by Dirofilaria immitis in subconjunctival and subcutaneous tissues in dogs

We report two cases of ectopic dirofilariasis caused by Dirofilaria immitis in the subconjunctival and subcutaneous tissues of dogs. In Case 1, a 10-year-old female poodle suffered from a subconjunctival mass in the left eye that was refractory to antibiotic and steroid treatments. The mass was removed surgically, and a whitish nematode was identified within the mass. In Case 2, a stray 3-year-old male greyhound was rescued and transferred to a local veterinary hospital. During care, two nematodes were observed on the left hind paw and leg. The observed worms were not typical of D. immitis; therefore, the species was confirmed using molecular methods. Phylogenetic analysis revealed high genetic identity with other previously reported D. immitis strain. Subcutaneous and subconjunctival dirofilariasis have been mainly caused by D. repens. To the best of our knowledge, this is the first report of subconjunctival ectopic dirofilariasis by D. immitis in a dog, and the first report of subcutaneous localization in Korea. Therefore, in endemic regions, ectopic dirofilariasis caused by D. immitis should be considered as a differential diagnosis in subconjunctival and subcutaneous masses.