Human pulmonary dirofilariasis masquerading as a mass

Jacob, Sheeba; Parameswaran, Ashok; Santosham, Rajan

doi:10.1177/0218492316658569

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…According to foreign researchers, pleuropulmonary and intraorganic damage in humans were reported only in cases of the infection with D. immitis [16] , [17] . During our observation only 1 case with the parasite inside the vitreous humor was registered, but due to the threat of serious complications the surgery was not performed, so the species of the helminth was not estimated.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“…According to some scientists, human dirofilariasis is not a serious disease and has value mainly in the aspect of the differential diagnosis of tumors [16] , [17] .…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory features of human dirofilariasis in Russia

Ermakova

Nagorny

Pshenichnaya

et al. 2017

IDCases

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“…7,21 Surgical excision of the nodule is the preferred treatment when symptoms arise. 7,21,25,26 Medical treatment is advised when total excision of the nodule or surgical intervention is impractical, or the patient is immunocompromised. 21 Due to the rarity of diro lariasis, established medical treatment recommendations are lacking.…”

Section: Discussionmentioning

confidence: 99%

Dirofilariasis Presenting as Pleural Effusion: a Rare Case Report With Unusual Manifestations and Treatment Modalities

Valčiukaitė-Žilinskienė,

Zablockienė,

Zablockis

2024

Preprint

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Background: We present an extremely rare manifestation of dirofilariasis in the pleural cavity. This is the first human pulmonary dirofilariasis reported in Lithuania; according to our knowledge, only two other patients were documented with this pathology in the world. Case presentation: A 72-year-old woman was admitted to the hospital complaining of dyspnea, left-side chest pain, and a dry cough. She was a retiree living alone in the countryside without domestic pets (sometimes stray dogs appear) or a travel history. A complete blood count was within normal limits, with a CRP level of 16.8 mg/l and D-dimer concentration of 900 µg/l, which raised suspicion of pulmonary embolism. In chest computed tomography angiography, pulmonary embolism was excluded, and only left pleural effusion without abnormal lesions was confirmed. Right thoracocentesis was performed, and the pleural fluid was evaluated as an exudate with a predominance of eosinophils (59%), along with the presence of parasites. These parasites exhibited the morphology of Dirofilaria repens. Oral doxycycline (100 mg, twice daily) and albendazole (400 mg, twice daily) were prescribed for a 14-day course. A month later, there were no pathological findings on the chest X-ray, and the patient no longer had respiratory symptoms. However, the patient presented with a newly emerged, painful palpable right axillary region mass. Ultrasound imaging revealed a 1.5 x 2 cm nodule, which was surgically removed. Parasites consistent with Dirofilaria repens were suspected but not definitively identified. Pharmacological treatment for dirofilariasis was not further prescribed. Conclusions: This case encourages doctors to be more vigilant because the patient, who neither traveled nor kept any pets, contracted dirofilariasis. Diagnostic and treatment guidelines are lacking, necessitating further research. Treatment with doxycycline and albendazole yielded positive outcomes, suggesting potential efficacy.

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“…Pulmonary dirofilariasis is a self-limiting disease and in the absence of symptoms, specific treatment is unnecessary [ 7 , 21 ]. Surgical excision of the nodule is the preferred treatment when symptoms arise [ 7 , 21 , 25 , 26 ]. Medical treatment is advised when total excision of the nodule or surgical intervention is impractical, or the patient is immunocompromised [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Dirofilariasis presenting as pleural effusion: a rare case report with unusual manifestations and treatment modalities

Valčiukaitė-Žilinskienė,

Zablockienė,

Zablockis

2024

BMC Pulm Med

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Background We present an extremely rare manifestation of dirofilariasis in the pleural cavity. This is the first human pulmonary dirofilariasis reported in Lithuania; according to our knowledge, only two other patients were documented with this pathology in the world. Case presentation A 72-year-old woman was admitted to the hospital complaining of dyspnea, left-side chest pain, and a dry cough. She was a retiree living alone in the countryside without domestic pets (sometimes stray dogs appear) or a travel history. A complete blood count was within normal limits, with a CRP level of 16.8 mg/l and D-dimer concentration of 900 µg/l, which raised suspicion of pulmonary embolism. In chest computed tomography angiography, pulmonary embolism was excluded, and only left pleural effusion without abnormal lesions was confirmed. Left thoracocentesis was performed, and the pleural fluid was evaluated as an exudate with a predominance of eosinophils (59%), along with the presence of parasites. These parasites exhibited the morphology of Dirofilaria repens. Oral doxycycline (100 mg, twice daily) and albendazole (400 mg, twice daily) were prescribed for a 14-day course. A month later, there were no pathological findings on the chest X-ray, and the patient no longer had respiratory symptoms. However, the patient presented with an emerged, painful palpable right breastmass, where the rash was previously observed. Ultrasound imaging revealed a 1.5 × 2 cm nodule, which was surgically removed. Parasites consistent with Dirofilaria repens were suspected but not definitively identified. Pharmacological treatment for dirofilariasis was not further prescribed. Conclusions This case encourages doctors to be more vigilant because the patient, who neither travelled nor kept any pets, contracted dirofilariasis. Diagnostic and treatment guidelines are lacking, necessitating further research. Treatment with doxycycline and albendazole yielded positive outcomes, suggesting potential efficacy for dirofilarial pleuritis.

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Human pulmonary dirofilariasis masquerading as a mass

Cited by 8 publications

References 5 publications

Clinical and laboratory features of human dirofilariasis in Russia

Clinical and laboratory features of human dirofilariasis in Russia

Dirofilariasis Presenting as Pleural Effusion: a Rare Case Report With Unusual Manifestations and Treatment Modalities

Dirofilariasis presenting as pleural effusion: a rare case report with unusual manifestations and treatment modalities

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