Recurrent Swelling and Microfilaremia Caused by <i>Dirofilaria repens</i> Infection after Travel to India

Huebl, Lena; Tappe, Dennis; Giese, Manfred; Mempel, Sandra; Tannich, Egbert; Kreuels, Benno; Ramharter, Michael; Veletzky, Luzia; Jochum, Johannes

doi:10.3201/eid2706.210592

Cited by 3 publications

(5 citation statements)

References 15 publications

(21 reference statements)

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“…Consequently, the maturation of Dirofilaria worms in humans should not be considered a rare condition. Attention should be paid to the appearance of new similar cases to establish the biological relevance of these facts regarding the adaptive process of the different species of Dirofilaria to the human host and its consequences (Huebl et al., 2021). The species analysis pointed out differences in this regard, since the vast majority of mature worms recovered were identified as D. repens , while D. immitis infections were significantly associated with immature worms.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature

Simón

Diosdado

Siles-Lucas

et al. 2021

Transbounding Emerging Dis

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Human dirofilariosis is a clinical entity caused by infection with nematode species of the genus Dirofilaria. The traditional picture depicts the disease as a sporadic event associated with the presence of a single immature worm causing a nodular lesion. With the aim to reassess this paradigm, establishing a more accurate picture of the disease and homogenize criteria, a scoping review was conducted by searching, screening and analysing published clinical cases of human dirofilariosis worldwide during the 21st century. After extracting data from 305 publications containing 576 case reports, results showed that human dirofilariosis is currently caused by five Dirofilaria species (mainly D. repens). Maturation was not uncommon, since 42.95% of the parasites recovered were described as mature worms, most of them females, 26.42% of which contained micofilariae in the uterus. Moreover, six microfilaremic cases have been described. The predominant clinical manifestation was the presence of a worm encapsulated within a nodule, but there is a considerable variety of accompanying symptoms depending on anatomical location and type of dirofilariosis. Parasites/nodules were found in 71 different anatomical locations, being the traditional nomenclature of human dirofilariosis unable to properly cover this complex situation. Delay in seeking medical assistance (patient perception) and the frequency of wrong clinical suspicions (doctor knowledge), strongly influenced clinical management. The initial suspicion in cases of subcutaneous and pulmonary dirofilariosis is predominantly a tumour, while in the ocular dirofilariosis a parasite (but not directly Dirofilaria) is mostly suspected.Surgery is usually applied, regardless of the use of non-invasive techniques during preoperative management and although its use is still limited, molecular approach is the most accurate technique to establish a species-level diagnosis. Accurate epidemiological, parasitological and clinical information while handling and reporting human clinicalThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature

Simón

Diosdado

Siles-Lucas

et al. 2021

Transbounding Emerging Dis

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“…study by German authors (Huebl et al, 2021). Considering the 10 cases of local microfilariasis reported by Pupić-Bakrač et al, and 14 cases of female worms containing intrauterine microfilariae reported in this study, it is our opinion that humans should not be considered as a deadend host for D. repens anymore.…”

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confidence: 47%

Regarding ‘Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature’

Pupić‐Bakrač

Pupić-Bakrač

Beck

et al. 2022

Transbounding Emerging Dis

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“…Second, unlike in most cases, it seems that our patient was infested with > 2 macrofilariae, 1 located in the pleura and 1 located in the subcutaneous tissue of the upper body. Clinical manifestation with multiple parasites is rarely encountered in humans and might lead to microfilaremia in some exceptional cases ( 3 – 6 ). Because the filarial qPCR result of a whole blood sample with a detection limit of 1.5 × 10 −4 microfilariae/mL of blood ( 11 ) was negative, microfilaremia was less probable for our patient.…”

Section: Discussionmentioning

confidence: 99%

“…Microfilariae are ingested by female mosquitoes, where they develop to infective larvae and are introduced to another definitive host during the blood meal of the vector ( 2 ). Humans can also acquire the infection, but are considered a dead-end host because microfilaremia in humans has only rarely been demonstrated ( 3 , 4 ).…”

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confidence: 99%

Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia

Biasizzo¹,

Šoba²,

Ilovski³

et al. 2022

Emerg. Infect. Dis.

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Recurrent Swelling and Microfilaremia Caused by Dirofilaria repens Infection after Travel to India

Cited by 3 publications

References 15 publications

Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature

Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature

Regarding ‘Human dirofilariosis in the 21st century: A scoping review of clinical cases reported in the literature’

Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia

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