Ocular dirofilariasis masquerading as orbital cellulitis: A case report and review of the literature

Ocular dirofilariasis is no longer a rare disease as more cases are being reported across the world and in India as awareness about this disease among health care professionals has increased. It is a helminthic infection which is caused by filarial parasite of the genus dirofilaria. It has a varied clinical presentation and the definitive diagnosis is based on microbiological and histopathological examination of the parasite. Herein, we report a unique case of ocular dirofilariasis in which a patient initially presented with features mimicking orbital cellulitis. Subsequently, the patient developed a subconjunctival lesion when orbital cellulitis subsided after three days of broad-spectrum antibiotics. The live worm was found when the lesion was incised, which was removed in toto and sent for microbiological examination. The nematode in our case was identified as dirofilaria repens. There was complete resolution of symptoms following surgical extraction of worm and no sign of recurrence was seen at 6 months follow-up.