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The dog heartworm (Dirofilaria immitis) in man. An epidemic pending or in progress?
Abstract:
Human infection with the dog heartworm (Dirofilaria immitis) may lead to focal pulmonary infarction with granuloma formation. The resulting roentgenographic coin lesion may require a diagnostic thoracotomy in consideration of malignancy. Because of sometimes enigmatic histopathological characteristics, this process may not be receiving the recognition it deserves. Furthermore, the dramatic increase of primary (canine) host infections in the United States presages an increase of secondary (human) host infections. Many thoracotomies will be performed for this innocuous process unless the dirofilarial agent can be controlled or the human pulmonary lesion can be reliably identified without operation.
Insights
Human heartworm infections can mimic lung cancer, leading to unnecessary surgery. Increased canine cases suggest more human infections, highlighting the need for better diagnostic methods to avoid invasive procedures for this benign condition.
Area of Science:
- Veterinary Medicine
- Human Pathology
- Parasitology
Background:
- Canine heartworm (Dirofilaria immitis) infections are increasing in the United States.
- Human dirofilariasis, often asymptomatic, can manifest as pulmonary nodules.
- Pulmonary coin lesions caused by Dirofilaria immitis can be mistaken for malignancy.
Observation:
- Focal pulmonary infarction and granuloma formation are characteristic of human Dirofilaria immitis infection.
- Histopathological features can be enigmatic, complicating diagnosis.
- Roentgenographic coin lesions necessitate differential diagnosis, including malignancy.
Findings:
- Dirofilaria immitis infection in humans can lead to pulmonary lesions resembling lung cancer.
- The condition is often benign but can be misdiagnosed due to its presentation.
- Increased prevalence in dogs suggests a rise in human cases.
Implications:
- Diagnostic challenges may lead to unnecessary surgical interventions like thoracotomy.
- Improved diagnostic strategies are crucial to differentiate dirofilariasis from lung cancer.
- Public health awareness and veterinary control measures are important for preventing human infections.