Three new cases of human infection withDirofilaria repens, one pulmonary and two subcutaneous, in the Egyptian governorate of Assiut

Abstract

Human dirofilariasis caused by Dirofilaria repens is a parasitic infection, currently considered to be an emerging zoonosis, that has been observed in many areas of the Old World. Dogs are the main 'reservoir' host. In humans, D. repens can cause inflammatory nodules, most commonly in the subcutaneous tissues or in the subconjunctival space. Lung involvement, which is the most common of the non-cutaneous and non-ocular manifestations, is frequently mis-diagnosed as a primary or metastatic lung tumour. Two new subcutaneous cases and one new pulmonary case, all observed in the Egyptian governorate of Assiut, are described here. This represents the first report of human pulmonary dirofilariasis caused by D. repens on the African continent. All the worms collected from the cases, including a living worm from the left lung of the pulmonary case, were identified morphologically, and the identity of the lung parasite was confirmed by PCR.

A First Human Case of Ocular Dirofilariosis due toDirofilaria repensin Northeastern France

“…Increased international travel in recent decades has favored the emergence of unusual zoonotic parasites such as dirofilaria [5, 6, 8]. Our patient seems to have contracted the infection in Senegal, as he presented with the orbital nodule four months later, in keeping with the reported incubation period of four to eight months [2].…”

“…Dirofilaria repens is the most frequent human pathogenic nematode species and is encountered almost exclusively in the old world [1–3, 6]. Most cases have been reported in Italy, followed by France and Greece [1–3, 8].…”

“…Most cases have been reported in Italy, followed by France and Greece [1–3, 8]. In France, most cases occur in the southeast, near the Mediterranean coast, where the infection is endemic [1–3, 6, 8, 10]. …”

“…Likewise, a patient diagnosed in the United States presented with a periorbital mass due to D. repens ten months after returning from a two-year stay in Senegal [11]. Human dirofilariasis is present in Africa, and Senegal is an important reservoir for D. repens in dogs and a variety of other animals [6, 11, 12]. The number of human cases of dirofilariasis in Senegal may be underestimated [6].…”

Review of Parasitic Zoonoses in Egypt

“…Dogs are the main host of D. repens . Three new cases of human infection with D. repens , one pulmonary and two subcutaneous, were reported in the Assiut Governorate, representing the first report of human pulmonary dirofilariosis caused by D. repens in Africa [86]. Antibodies to D. immitis antigens were observed in the sera of 6 (3.4%) of 174 feral cats ( Felis catus ) collected from Cairo [41].…”