Some aspects of the epidemiology, clinical manifestations, and diagnosis of human dirofilariasis caused by Dirofilaria repens

Abstract

In recent years, zoonotic filariae Dirofilaria immitis and Dirofilaria (Nochtiella) repens are gaining popularity as incidental human parasitic pathogens. The usual hosts for these nematodes are domestic and wild carnivorous animals. The medical significance of human dirofilariasis is due to frequent misdiagnosis as malignancy and in many cases diagnosis is made after invasive surgical procedures. The aim of this study was to ascertain the geographical distribution and clinical manifestations of a relatively rare among people zoonotic disease such as dirofilariasis, whose epidemiological features depends on prevalence of the parasite among usual hosts, presence of suitable vector, and human activities favoring exposure. Data for a 39-year period were analyzed, during which, in Bulgaria, were recorded 47 cases of human dirofilariasis with various organ localizations. Morphological methods were also used for species identification of Dirofilaria (N.) repens and serological diagnostic tests for filariasis. Some epidemiological parameters such as annual incidence, prevalence for different geographic areas in Bulgaria, distribution by gender (28 females and 19 males) and age (from 19 to 77 years of age) of the diseased were identified, and aspects of the clinical manifestations, diagnosis, and treatment of the disease were discussed. Comparison was made between the number of cases in Bulgaria and those in other European countries. Although the climatic and faunal conditions in Bulgaria are favorable for disease transmission between animal reservoir hosts and humans, the diagnosis of dirofilariasis is often omitted.

Case of human Dirofilaria repens infection manifested by cutaneous larva migrans syndrome

“…It has firm, elastic consistency and is often associated with erythema and pruritus (Simón et al 2012). Between 20 and 40 % of infections is connected with localisation of lesion around the eyes (orbital zone, eyelids, subconjuctival and intravitreous tissues), some of them with serious consequences and complications (Simón et al 2012;Salamatin et al 2013;Harizanov et al 2014). Orbital localisation of parasite is usually associated with symptoms as ocular discomfort, blepharedema, palpebral ptosis and hyperemia of bulbar conjunctiva (Stringfellow et al 2002;Ondriska et al 2014).…”

Epididymal Dirofilariasis in a Child: First Case Report from Bulgaria

“…Only a few sporadic cases of human infection caused by D. repens have been reported. A recent retrospective study of human dirofilariasis in Bulgaria for the period 1973–2011 described 47 recorded cases [4]. The youngest patient in the study was a 19-year-old male.…”

“…The youngest patient in the study was a 19-year-old male. Subcutaneous and ocular localizations were observed and only two cases with involvement of the male reproductive system were described [4, 5]. …”

Screening of mosquitoes for filarioid helminths in urban areas in south western Poland—common patterns in European Setaria tundra xenomonitoring studies

“…Both S. tundra and Dirofilaria repens were detected in the same xenomonitoring studies (Czajka et al 2012; Kronefeld et al 2014; Zittra et al 2015; Kemenesi et al 2015), and in most cases, the detection of S. tundra was a result of xenomonitoring mosquitoes for Dirofilaria spp. Animal and human dirofilariosis, caused by D. repens , has become a filarial disease established in many European countries (Simón et al 2012; Sałamatin et al 2013; Harizanov et al 2014; Antolová et al 2015; Fuehrer et al 2016), and the veterinary and medical importance of the parasite was well studied. The infections caused by S. tundra have not been investigated in such detail as the Dirofilaria spp.…”