Dirofilariasis by Dirofilaria repens: an imported case and a brief review. Issue 5 (October 2015) - Baptista-Fernandes, Teresa
Abstract: Human infections caused by Dirofilaria repens, a cosmopolitan zoonotic parasitosis endemic in Southern and Eastern Europe and Asia still is an underdiagnosed infection due to parasite identification difficulties. Here, we report the first human case of subcutaneous dirofilariasis by D. repens diagnosed in Portugal. This was probably an imported case from India, as judged by epidemiological and clinical data. With this presentation we aim to alert clinicians for the emergence of vector-borne zoonoses associated with global warming and international travel. This case showed that differential diagnosis of D. repens in subcutaneous nodules is needed, in order to avoid further complications. Graphical abstract: Dirofilaria repens removed intact from subcutaneous tissue measuring 13 cm long abd 0.6 mm wide. B — Cuticular surface of D. repens with longitudinal ridges spaced at double the size of height of individual ridge. C — Anterior end of the female worm with visible mouth and esophagus. D — The folded uterus clearly visible in the body. E — Posterior end of the adult worm. Highlights: We report the first human case of subcutaneous dirofilariasis in Portugal. D. repens are now considered an emergent zoonosis in some European countries. Molecular biology techniques overcome the difficulties inherent to its diagnosis. Dirofilariasis should be included in differential diagnosis of subcutaneous nodules.