Live Intraoral Dirofilaria repens of Lower Lip Mimicking Mucocele—First Reported Case from Croatia

Abstract

Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.

A Rare Case of Dirofilariasis in the Genian Region

“…The infection with the parasite D. repens can be manifested by the appearance of subcutaneous swelling with slow evolution, located predominantly in the eye area [ 20 ]. Due to its localization and its slowly evolving and painless character, it can be confused with a benign tumor such as an adenoma, mucocele or lipoma [ 41 ]. The clinical signs and evolution of the parasitic cyst in our case limited the differential diagnosis to benign tumors arising from the soft tissues of the face.…”

“…Treatment against dirofilariasis is exclusively surgical, consisting of the removal of the cystic outgrowth along with the parasite. Previous articles report a failure rate of surgical treatment of 5% [ 41 , 46 ]. Preventing the transmission of dirofilariasis involves controlling mosquito vectors and administering prophylactic treatments.…”

Estimated specific antibody-based true sero-prevalences of canine filariosis in dogs in Central Europe and the UK

“…Previous autochthonous cases of D. repens in humans have been described in Poland (Cielecka et al 2012 ), Italy (Pampiglione et al 2001 ), nine countries of the Balkan Peninsula (Tasić-Otašević et al 2015 ), Hungary (Dóczi et al 2015 ) and Slovakia (Babal et al 2008 ; Boldiš et al 2020 ). More recently, between 2017 and 2022, single cases of human D. repens infections were reported again from the Balkan area, in Serbia (Krstic et al 2017 ), Croatia (Skrinjar et al 2022 ), Bulgaria (Velev et al 2019 ) and Romania (Ciuca et al 2018 ), and further cases from Greece (Bozidis et al 2021 ) and Italy (Ahmed et al 2022 ), Interestingly, also in Austria, overall 39 human cases of dirofilariosis were identified between 1978 and 2020, with a general increasing course since 1998 (Riebenbauer et al 2021 ). In addition, single human cases were reported from south-eastern France (Hennocq et al 2020 ) and Germany (Uslu et al 2017 ), confirming a north- and westwards trend in Europe.…”