Human subcutaneous dirofilariasis of forearm an unusual presentation

Abstract

Human subcutaneous dirofilariasis (HSD) is a rare zoonotic filarial infection caused by filarial worms of the genus Dirofilaria. In view, recent rise in human Dirofilaria repens infections in several regions of the world, is considered as emerging zoonotic infection transmitted to man by zooanthrophilic blood sucking insects. Most of the documented cases of human dirofilariasis recorded in India are ocular infections and very few cases of subcutaneous dirofilariasis have been reported. We hereby present a case of subcutaneous human dirofilariasis of forearm and also emphasize on increased awareness of this entity for clinicians and pathologists in the differential diagnosis of patients with subcutaneous nodules.

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“…Dirofilariasis is usually seen in wild animals. Various species of Dirofilaria, including D. immitis, D. repens, D. striata, D. tenuis, D. Ursi, and D. spectans, have been reported to cause incidental infections in humans [ 1 ]. The Aedes, Armigeres, Culex, Anopheles, and Mansonia species of mosquitoes are involved in the transmission of this parasite [ 1 ].…”

“…Various species of Dirofilaria, including D. immitis, D. repens, D. striata, D. tenuis, D. Ursi, and D. spectans, have been reported to cause incidental infections in humans [ 1 ]. The Aedes, Armigeres, Culex, Anopheles, and Mansonia species of mosquitoes are involved in the transmission of this parasite [ 1 ]. Although this zoonosis is endemic in Mediterranean countries, there are reports from Africa, Asia, America, and Australia as well [ 2 ].…”

“…D. repens belongs to the subgenus Nochitella. There are multiple reports of it affecting the subcutaneous spaces of the forearm, axilla, and breast [ 1 , 4 ]. Ocular infection is rare; however, subconjunctival, eyelid, orbital, and even intraocular cases have been reported [ 3 ].…”

“…Surgical removal is the treatment of choice, and diagnosis is confirmed by histopathological examination [ 1 , 2 ]. In rare cases, blood eosinophilia or an elevated serum immunoglobulin E (IgE) level may be noted, which limits the use of eosinophilic counts and serum IgE level in screening for dirofilariasis in suspected individuals.…”

“…In rare cases, blood eosinophilia or an elevated serum immunoglobulin E (IgE) level may be noted, which limits the use of eosinophilic counts and serum IgE level in screening for dirofilariasis in suspected individuals. A deoxyribonucleic acid (DNA) extraction along with a pan-filarial polymerase chain reaction (PCR) can be used to confirm the diagnosis of D. repens [ 1 , 2 ].…”