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Extrapulmonary Dirofilaria immitis-like infections in the Western Hemisphere
Y Gutierrez1, M J Catellier, D L Wicker
1Department of Pathology, University Hospitals of Cleveland, OH 44106, USA.
Abstract:
One worm recovered from the orbit of a patient in Indiana, and two from the peritoneal cavity of another patient in California are described and classified as Dirofilaria. Both patients were elderly men who have lived all their lives in the United States. The main morphologic feature of these three immature worms is the presence of a smooth cuticle devoid of longitudinal ridges, similar to the cuticle of D. immitis. However, because other dirofilariid with similar cuticular characteristics have been found in animals in the Western Hemisphere, and they cannot be conclusively ruled out as the cause of the infection in our patients, a diagnosis of D. immitis-like organism is proposed for these nematodes. The relationship of these worms to other dirofilariid of animals and humans on the American continent is important because of the diagnostic problems these infections posed to practicing pathologists.
Insights
Three Dirofilaria worms found in two US patients were classified as D. immitis-like organisms due to unique cuticular features. Further research is needed to distinguish them from similar animal-borne nematodes.
Area of Science:
- Veterinary Parasitology
- Human Pathology
Background:
- Dirofilaria infections in humans are increasingly recognized, posing diagnostic challenges.
- Morphological identification is crucial for understanding parasite-host relationships and transmission dynamics.
Observation:
- Three immature Dirofilaria worms were recovered from two elderly male patients in the United States (Indiana and California).
- The worms exhibited a smooth cuticle without longitudinal ridges, a characteristic shared with Dirofilaria immitis.
Findings:
- The observed morphological features, particularly the smooth cuticle, are similar to Dirofilaria immitis.
- However, the possibility of infection by other dirofilariids with similar cuticular characteristics found in animals in the Western Hemisphere could not be excluded.
Implications:
- A diagnosis of "D. immitis-like organism" is proposed for these nematodes.
- Accurate identification of Dirofilaria species is critical for practicing pathologists to manage human infections.
- Understanding the relationship between animal and human Dirofilaria in the Americas is essential for public health and veterinary medicine.