Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports)

Matějů, Jana; Chanová, Marta; Modrý, David; Mitková, Barbora; Hrazdilová, Kristýna; Žampachová, Víta; Kolářová, Libuše

doi:10.1186/s12879-016-1505-3

Cited by 28 publications

(20 citation statements)

References 19 publications

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“…Our observations of patients with D. repens infection correspond to a row of European scientists from Slovakia [19] , Czech Republic [20] , Greece [21] , Italy [13] , Austria [22] , and others who came to conclusion that the human is a biological deadend for this helminth.…”

Section: Discussionsupporting

confidence: 80%

Clinical and laboratory features of human dirofilariasis in Russia

Ermakova

Nagorny

Pshenichnaya

et al. 2017

IDCases

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The article presents the results of the prospective study of 266 patients with dirofilariasis who received medical and diagnostic assistance in Rostov Scientific Research Institute of Microbiology and Parasitology in Rostov-on-Don, Russia from 2000 to 2016. We have assessed the features of the dynamics of epidemiology of this infection in several territories of the Russian Federation, depending on the social structure of patients. Immature females of dirofilaria were found most commonly in humans (82.9 ± 2.6%), the proportion of maturity females and adult males of worms respectively was 10.5 ± 2.1% and 0.9 ± 0.6%. All mature worms were localized inside a capsule. Peripheral blood eosinophilia was detected only in patients with the migration of helminths (19 of 116 persons – 16.4%). Blood samples of patients examined by the method of concentration in 3% acetic acid for detection of microfilariae, showed negative result in all patients.Our data are consistent with the opinion of KI Skriabin about that human as «dual facultative host» for dirofiliaria. It is rare that parasite in human body is able to develop to the imago stage (according to our observations – 11.4%). The immune response to invasion by dirofiliaria in human is manifested as dense connective tissue which forms a capsule. According to our study the rare cases (22) of detection the sexual mature D. repens (10.4%) were localized inside the capsule. Observations of patients with D. repens infection allowed concluding that human for this helminth is «a biological deadend».

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Section: Discussionsupporting

confidence: 80%

Clinical and laboratory features of human dirofilariasis in Russia

Ermakova

Nagorny

Pshenichnaya

et al. 2017

IDCases

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“…infections has been observed in eastern and central Europe, including an increase of human cases [10, 11]. Moreover, autochthonous cases were detected in countries, which were previously regarded as non-endemic: Austria [12], Poland [13], Germany [14], Czech Republic [15] and Belarus [16]). Moldova is bordered to the East and South by the Odessa region of the Ukraine where incidence rates for human dirofilariasis ranged from 2.43 to 3.71 per 100,000 inhabitants between 1997 and 2012 [10].…”

Section: Introductionmentioning

confidence: 99%

Circulation of Dirofilaria repens and Dirofilaria immitis in Moldova

et al. 2016

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BackgroundOver the last two decades, a significant spread of dirofilariasis has been observed in eastern and central Europe. However, data on the circulation of Dirofilaria spp. in Moldova were absent although direct neighbor states reported high incidence rates of human dirofilariasis.MethodsDaily mean temperature data were used to calculate Dirofilaria spp. development units, which were used to estimate the potential for complete extrinsic development in the mosquitoes (= sum of potential Dirofilaria spp. transmission days). In addition, 4,481 adult female mosquitoes were collected from 25 trapping sites. From 2010 to 2015, sampling was conducted with Centers for Disease Control miniature light traps, indoor resting mosquito collections as well as human landing catches in urban, rural and natural areas. Mosquitoes were analyzed for the presence of D. repens and D. immitis DNA using a duplex real-time PCR assay targeting nucleotide differences within the cytochrome c oxidase subunit 1 (D. repens) and 16S rRNA gene fragment (D. immitis).ResultsThe average of the yearly sum of potential Dirofilaria spp. transmission days between 2010 and 2015 ranged from 90 to 140 days with an increasing gradient from the North to the South of Moldova. Positive mosquito pools for D. repens were found countrywide at 13 of the 25 trapping sites and in 17 of the 22 screened mosquito taxa (26.51% of all 347 tested pools), while D. immitis was detected only at 4 of the trapping sites (Center and South) in 4 different mosquito species (8.65% of all 347 tested pools). Highest infection rates (EIR) per 100 specimens for both Dirofilaria species were found in An. maculipennis (s.l.) (D. repens: EIR = 4.91; D. immitis: EIR = 2.01), whereas the most frequent mosquito taxon Cx. pipiens (s.l.)/torrentium had significantly lower infections rates (D. repens: EIR = 0.88; D. immitis: EIR = 0.47).ConclusionsThe temperature conditions in Moldova are suitable for transmission of Dirofilaria spp. within the entire country, which is supported by a wide distribution of Dirofilaria spp.-positive mosquitoes with high infection rates. The low number of reported human cases most likely does not reflect the current epidemiological situation of dirofilariasis in Moldova.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-016-1916-4) contains supplementary material, which is available to authorized users.

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“…The nodule may be painful and erythematous. The ocular infection includes nodule formation in the orbital zone and eyelids, as well as the presence of intact migrating worm in sub conjunctival and intra vitreous tissues [10] as well as in intra orbital musculature [11].…”

Section: Discussionmentioning

confidence: 99%

Human Dirofilariasis Presenting as Scrotal Mass

Chiaramonte¹

2017

JURNOA

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Surgery Unit complaining a painless nodule on his left hemi scrotum (ASM). He had neither pathological history nor was in contact with dogs or other animals and never visited other countries.The physical examination revealed no pathological findings except for a single painless hard nodule of 1 cm at the apex of the scrotum with any connection to the testis. The skin over the nodule was normal without any signs of inflammation and the inguinal lymph nodes were not palpable Routine laboratory tests of the blood showed no abnormal values for the age. Tumors markers as βHCG and α-fetoprotein were within normal range.Suspecting an extra-testicular neoplasm an ultrasound scan with high-resolution linear probe 10 -12 MHz of the nodule was performed. It showed the presence of an anechoic cystic formation without any vascularization in its contest or vascular pole at the color-doppler integration. Within a cyst mass a tubular coiled structure with parallel echogenic wall in continuous movements was found: to identify the species of worm specialist opinion was requested.The characteristic pattern movements of the nematode (filaria dance sign-FDS) led to diagnosis of human subcutaneous dirofiliasis (HSD). Testicular tissue was normal.(FIGURE 1).The surgery was performed under general anesthesia with minor surgery approach by a transversal scrotal incision of less than 1 cm over the nodule. The mass wasn't in connection with testicular or funicular structures. It was isolated from the dartos without any damage to the capsule and was enucleated intact (FIGURE 2).The hystopathological examination showed a simil-cystic structure with granulomatous inflammatory wall with a high number of eosinophils and a tubular structure of 10 cm of length inside moving when placed in physiological solution (FIGURE 3).The diagnosis of infection from Dirofilariarepens was based on the morphological characteristic of the worm that displayed the tipical features of a female. AbstractA large spectrum of pathology may present in children as an asymptomatic scrotal mass (ASM) ranging from congenital to neoplastic lesions.We observed a 11 months old child referred to us for suspicion of neoplasm presenting with an asymptomatic scrotal mass.High frequency scrotal sonography enabled diagnosis of nematode infection (Dirofilaria repens): viability of the adult worms was assessed by looking for the animated documentation of filarial dance sign (FDS).Differentiation from malignancy allowed an appropriate management consisting in minor surgery.Human Subcutaneous Dirofilariasis (HSD) is an endemic zoonosis spread throughout the world, with dogs and cats being the definitive host for this parasite. Human infections caused by Dirofilaria repens have been reported in Eastern Europe, Mediterranean area, central and Southern Asia, transmitted by various species of mosquitoes and usually presented as subcutaneous nodule.Extra-testicular pathologies are encountered relatively infrequently but awareness of different possible etiology avoids unnecessary extensive s...

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Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports)

Cited by 28 publications

References 19 publications

Clinical and laboratory features of human dirofilariasis in Russia

Clinical and laboratory features of human dirofilariasis in Russia

Circulation of Dirofilaria repens and Dirofilaria immitis in Moldova

Human Dirofilariasis Presenting as Scrotal Mass

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