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Pulmonary dirofilariasis: a diagnostic challenge.

R B Adkins, A H Dao

    Southern Medical Journal
    |March 1, 1984
    PubMed
    Summary

    Canine heartworm (Dirofilaria immitis) can cause lung granulomas in humans. A rare Mississippi Valley case highlights diagnostic challenges differentiating these parasitic lesions from cancerous neoplasms.

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    Area of Science:

    • Veterinary Pathology
    • Human Pathology
    • Parasitology

    Background:

    • Dirofilaria immitis, the canine heartworm, is a known cause of pulmonary granulomas in humans.
    • Reported cases in the United States are rare, primarily concentrated along coastal regions.
    • No cases have been previously documented in the Mississippi Valley states.

    Observation:

    • A patient with a history of smoking presented with an enlarging pulmonary nodule.
    • Diagnostic imaging revealed a suspicious lesion requiring surgical resection.
    • The resected nodule was found to contain a filarial worm.

    Findings:

    • Histopathological examination confirmed the presence of Dirofilaria immitis within the pulmonary nodule.
    • The case represents a rare instance of human dirofilariasis in the Mississippi Valley.
    • The parasitic granuloma mimicked a neoplastic lesion on initial evaluation.

    Implications:

    • This case underscores the importance of considering parasitic infections in the differential diagnosis of pulmonary nodules.
    • It highlights the diagnostic challenges in distinguishing parasitic lung lesions from lung neoplasms, especially in atypical geographic locations.
    • Further awareness and diagnostic vigilance are necessary for identifying human dirofilariasis, even outside endemic areas.

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