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Subcutaneous dirofilariasis: single inoculum, multiple worms

T C Orihel1, D Helentjaris, J Alger

  • 1Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana 70112, USA.

The American Journal of Tropical Medicine and Hygiene
|April 1, 1997
PubMed
Summary

This case report details a rare subcutaneous dirofilariasis infection caused by Dirofilaria repens. A patient presented with a living worm in the periorbital tissues, indicating a prolonged, asymptomatic infection.

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Area of Science:

  • Veterinary Parasitology
  • Human Infectious Diseases
  • Medical Entomology

Background:

  • Subcutaneous dirofilariasis is a parasitic infection caused by Dirofilaria species, often transmitted by mosquitoes.
  • Dirofilaria repens is a nematode parasite commonly found in canids, but can infect humans, typically causing subcutaneous nodules.

Observation:

  • A 42-year-old male presented with a palpable, mobile worm in the periorbital area on two separate occasions, 10 months apart.
  • Both extracted worms were identified as mature, nongravid female Dirofilaria repens.
  • Analysis of reproductive maturity and egg distribution suggested both worms originated from a single infection event.

Findings:

  • The first worm was estimated to be at least two years old, and the second worm was ten months older.

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  • These findings suggest that Dirofilaria repens can develop and persist in human tissues for extended periods (2-3 years) without significant host inflammatory response.
  • The worms were found to be mature but nongravid, indicating a lack of reproduction within the host.
  • Implications:

    • This case highlights the potential for prolonged, asymptomatic subcutaneous dirofilariasis in humans.
    • It underscores the importance of considering Dirofilaria repens in the differential diagnosis of migratory subcutaneous or periorbital lesions, especially in endemic areas.
    • Further research is needed to understand the host-parasite interactions that allow for such prolonged, undetected infections.