Concurrent subcutaneous and ocular infections with Dirofilaria repens in a Polish patient: a case report in the light of epidemiological data

Parasitol Int. 2022 Feb:86:102481. doi: 10.1016/j.parint.2021.102481. Epub 2021 Oct 21.

Abstract

Dirofilariasis is an emerging zoonosis caused by nematodes of the genus Dirofilaria, most often D. repens and D. immitis. The main final hosts and reservoirs of pathogens are dogs. The intermediate hosts and vectors of infection are female mosquitoes (Culicidae). Human is an accidental host in which the parasite does not usually mature. Over the past 20 years, the range of Dirofilaria spp. in Europe has expanded. We present an unusual case of multifocal dirofilariasis of mixed subcutaneous-ocular course caused by D. repens in a 52-year-old Polish patient who was probably infected in Spain or Croatia, where she stayed one year before the onset of symptoms. Surgical removal of the nematodes followed by treatment with Ivermectin in a single dose of 1200 μg and Doxycycline 200 mg daily for 7 days resulted in complete recovery. We believe that all cases of human dirofilariasis, especially in countries where the disease is not frequent at present, should be registered for epidemiological purposes. Moreover, due to the widening of the range of D. repens and D. immitis occurrence and the possibility of atypical courses of infection with both nematodes, diagnostics should include the species identification of the parasite.

Keywords: Dirofilaria repens; Dirofilariasis; Multifocal; Ocular; Poland; Subcutaneous.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antiparasitic Agents / administration & dosage
  • Croatia
  • Dirofilaria repens / isolation & purification*
  • Dirofilariasis / diagnosis*
  • Dirofilariasis / drug therapy
  • Dirofilariasis / parasitology
  • Dirofilariasis / surgery
  • Doxycycline / administration & dosage
  • Eye Diseases / diagnosis*
  • Eye Diseases / drug therapy
  • Eye Diseases / parasitology
  • Eye Diseases / surgery
  • Female
  • Humans
  • Ivermectin / administration & dosage
  • Middle Aged
  • Poland
  • Skin Diseases / diagnosis*
  • Skin Diseases / drug therapy
  • Skin Diseases / parasitology
  • Skin Diseases / surgery
  • Spain
  • Travel
  • Treatment Outcome

Substances

  • Antiparasitic Agents
  • Ivermectin
  • Doxycycline