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F Simon - One of the best experts on this subject based on the ideXlab platform.
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the canary islands as a model of risk of pulmonary Dirofilariasis in a hyperendemic area
Parasitology Research, 2018Co-Authors: Elena D Cabrera, F Simon, Rodrigo Morchon, Elena Carreton, Y Falconcordon, S Falconcordon, Alberto J MontoyaalonsoAbstract:We assessed the risk of human pulmonary Dirofilariasis in the Canary Islands, hyperendemic for canine heartworm (Dirofilaria immitis), a zoonotic vector-borne infection. For this purpose, 1479 inhabitants were tested for anti-D. immitis antibodies. Four of the 7 islands presented high seroprevalences (from 6.2 to 12.7%), therefore high exposure to the parasite and risk of zoonotic infection. These corresponded to those islands with high canine prevalences of Dirofilariasis and favourable climatic conditions for the development of mosquito vectors. The lowest prevalences (from 0 to 1.6%) were found in the desert islands and those with low canine prevalences of heartworm. Seroprevalences were very variable inside each island as well, being related to the climate and demographic factors. Human pulmonary Dirofilariasis is an emerging zoonosis worldwide which frequently goes undiagnosed. Serological studies could be useful for the correct evaluation of the risk of infection among the human population, and study of the health implications of the continuous contact with the parasite in endemic areas. Sanitary authorities should be aware of the current epidemiological data, and physicians should include human Dirofilariasis in the differential diagnosis of pulmonary nodules.
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the impact of the climate on the epidemiology of dirofilaria immitis in the pet population of the canary islands
Veterinary Parasitology, 2016Co-Authors: Jose Alberto Montoyaalonso, R Morchon, E Carreton, L Silveiraviera, Y Falcon, F SimonAbstract:Cardiopulmonary dirofilariosis (heartworm) is a zoonotic vector borne disease caused by Dirofilaria immitis which affects domestic dogs and cats. Two of the seven Canary Islands are historically hyperendemic areas of dirofilariosis, although no epidemiological study has ever been carried out which includes the other islands. The aim of the study was to complete the epidemiological status of cardiopulmonary dirofilariosis in the canine and feline population throughout all the Canary Islands. 1643 client-owned dogs and 707 client-owned cats were tested for D. immitis antigens (dogs), and anti-D. immitis and anti-Wolbachia antibodies (cats). The prevalence of canine dirofilariosis in the Canary Islands was 15.7%, and the seroprevalence of feline dirofilariosis was 18.1%. A remarkable disparity was found when evaluating the results by island separately, which ranged from from 0% in Lanzarote and El Hierro, low prevalences and seroprevalences in Fuerteventura (1.8% and 2.5% in dogs and cats, respectively), to higher prevalences on the other 4 islands; ranging between 15.7% (dogs) and 14.3% (cats) in La Palma 22.5% (dogs) and 24.1% (cats) in Tenerife. In addition, prevalences and seroprevalences were very variable within each island, these differences being associated to local climate conditions. The distribution and prevalence of dirofilariosis in the Canary Islands is heterogeneous and related to climate, demographic factors and management of pets in the studied areas. Dirofilariosis remains hyperendemic in 4 of the 7 Islands. Since D. immitis is a zoonosis, veterinary and health authorities should be aware of the current prevalence and seroprevalence of animal dirofilariosis. The results show the need for awareness raising campaigns to promote the implementation of prophylactic measures in pets, in order to achieve a decrease in the prevalence of animal dirofilariosis in the Canary Islands.
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delayed diagnosis of Dirofilariasis and complex ocular surgery russia
Emerging Infectious Diseases, 2013Co-Authors: Boris Ilyasov, Javier Gonzalezmiguel, Rodrigo Morchon, Vladimir Kartashev, Nikolay Bastrikov, F SimonAbstract:To the Editor: Dirofilaria repens is a vector-borne, zoonotic, filarial nematode that infects dogs, cats, and humans. In humans, D. repens worms cause subcutaneous Dirofilariasis, characterized by the development of benign subcutaneous nodules that mimic skin carcinomas (1), and ocular Dirofilariasis in orbital, eyelid, conjunctival, retroocular, and intraocular locations (2). Intraocular and retroocular dirofiliariasis causes considerable damage and discomfort in patients from the presence of the worms and from their surgical removal (3). Here, we report a retroocular D. repens nematode infection in a patient in Russia that illustrates the difficulties in clinical management and the inherent risks of surgical procedures to remove the worms. A 20-year-old woman living in Rostov-na-Donu in southwestern Russia who had never traveled outside the city sought ophthalmologic consultation for pain and skin redness and swelling in the inner corner of the upper left eyelid. Swelling migrated successively to the temporal area, the lower eyelid, and the inner corner of the lower eyelid. The patient had no other ocular signs or symptoms, and her general condition was otherwise good. Results of ophthalmologic examination and routine laboratory tests were within normal limits. Four days of treatment with cefotaxime resulted in the remission of signs and symptoms. Approximately 2 months later, swelling in the inner corner of the upper eyelid appeared again, affecting the whole upper eyelid, without itching or tenderness. Allergies were diagnosed; cetirizine was administered for 4 days, and the signs remitted at the third day of treatment. One month later, marked upper left eyelid swelling occurred, resulting in ptosis. Cetirizine was prescribed again; edema subsided after 4 days of treatment but relapsed in the following 3–4 days. At least 4 subsequent relapses occurred; thus, a computed tomographic scan of the paranasal sinuses and orbits was performed, 4 months after signs and symptoms began (Figure, ,panel A).panel A). The scan detected a soft tissue structure, 12 × 13 × 14 mm, behind the left eyeball, adjacent to and medially dislodging the optic nerve. No other abnormalities were found in the visible area of the brain and sinuses. Magnetic resonance imaging (MRI) performed 1 month later (Figure, panel B) corroborated the presence of a cyst-like structure with an irregular, rounded shape and clear, smooth borders closely adhered to the eyeball and optic nerve. T2-weighted images showed that the lesion had a high-density core but the surrounding tissue was low density. Adjacent to the lesion, the retrobulbar tissue was slightly swollen, the optic nerve was displaced medially and downward, and the adjacent upper muscle was displaced medially and upward. The diagnosis was evidence of a retroocular cystic lesion in the left orbit with a well-defined capsule and high-density but heterogeneous core structure. Figure Retroocular nodule of a Dirofilaria repens worm detected in a 20-year-old woman, Rostov-na-Donu, Russia. The cyst (arrows) is shown by computed tomography scan (A) and magnetic resonance imaging (B). Ultrasonography images (C) show a worm-like structure ... High-resolution ultrasound examination (Figure, panel C) revealed a well-defined, 3-mm, cyst-like wall containing fluid and dense, coiled-twisted linear internal structures that appeared to be actively moving (Video 1). Color Doppler examination (Figure, panel D; Video 2) revealed blood vessels in the wall but not inside the cystic structure. These additional examinations led to a diagnosis of a retroocular parasitic cyst in the left orbit, most likely a Dirofilaria spp. parasite. The parasitic cystic nodule was removed during a transpalpebral orbitotomy. A live, adult roundworm, 87 × 0.6 mm, was discharged from the cyst. Conventional PCR identified the roundworm as D. repens (data not shown). Video 1 High-resolution ultrasound examination images showing a Dirofilaria repens worm actively moving inside retroocular nodule in a 20-year-old woman, Rostov-na-Donu, Russia. Video 2 Color Doppler examination images showing the blood flow only outside the retroocular nodule in which the movement of a Dirofilaria repens worm is detected in a 20-year-old woman, Rostov-na-Donu, Russia. Although human subcutaneous Dirofilaria spp. nodules are benign, their detection may raise suspicion for a malignant tumor; thus, differential diagnosis is the key point in the management of human Dirofilariasis (4). The case we described illustrates the difficulties of diagnosis when worms are in deep locations and patients experience unspecific and even unusual signs. These confounders resulted in a lengthy diagnostic procedure, with consequent detrimental physical and psychological effects on the patient. Even though the final diagnosis determined that the nodule was nonmalignant, its anatomic location required aggressive surgical intervention to remove it. D. repens nematodes are spreading in Europe from the south toward the north and east (5–7) as a consequence of global warming, and prediction models have suggested incidence is increasing among animal and human hosts (3). Consequently, human ocular Dirofilariasis will probably be found with increasing frequency in the future. Our experience illustrates that Dirofilariasis should be included in the differential diagnosis of any nodule, independent of its anatomic location and the signs and symptoms shown by the patient. Moreover, ultrasonography represents a noninvasive technique that enables rapid preoperative identification of the parasitic origin of the nodules, thus avoiding unnecessary diagnostic delays. This technique is used for the diagnosis of cardiopulmonary Dirofilariasis in animals (8) but has been used only sporadically for human Dirofilariasis (9,10), which is habitually diagnosed postoperatively, after the surgical removal of the nodules or worms (1).
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human and animal Dirofilariasis the emergence of a zoonotic mosaic
Clinical Microbiology Reviews, 2012Co-Authors: F Simon, Javier Gonzalezmiguel, Mar Sileslucas, Rodrigo Morchon, Isabel Mellado, Elena Carreton, Jose Alberto MontoyaalonsoAbstract:SUMMARY Dirofilariasis represents a zoonotic mosaic, which includes two main filarial species (Dirofilaria immitis and D. repens) that have adapted to canine, feline, and human hosts with distinct biological and clinical implications. At the same time, both D. immitis and D. repens are themselves hosts to symbiotic bacteria of the genus Wolbachia, the study of which has resulted in a profound shift in the understanding of filarial biology, the mechanisms of the pathologies that they produce in their hosts, and issues related to Dirofilariasis treatment. Moreover, because Dirofilariasis is a vector-borne transmitted disease, their distribution and infection rates have undergone significant modifications influenced by global climate change. Despite advances in our knowledge of D. immitis and D. repens and the pathologies that they inflict on different hosts, there are still many unknown aspects of Dirofilariasis. This review is focused on human and animal Dirofilariasis, including the basic morphology, biology, protein composition, and metabolism of Dirofilaria species; the climate and human behavioral factors that influence distribution dynamics; the disease pathology; the host-parasite relationship; the mechanisms involved in parasite survival; the immune response and pathogenesis; and the clinical management of human and animal infections.
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what is happening outside north america regarding human Dirofilariasis
Veterinary Parasitology, 2005Co-Authors: F Simon, Rodrigo Morchon, J Lopezbelmonte, C Marcosatxutegi, J R MartinpachoAbstract:Abstract The etiologic agents of human Dirofilariasis in the Old World are Dirofilaria immitis, which cause pulmonary and subcutaneous nodules, and Dirofilaria repens, which cause ocular lesions. Although reports of new cases of Dirofilariasis are sporadic in other parts of the world, a considerable amount of information is generated in Europe regarding human Dirofilariasis. Most cases have been detected in the Mediterranean countries, Ukraine, and Russia; however, isolated or short series of cases have been reported in the Balkan Republics and central and northern European countries. Seroepidemiologic studies have provided evidence that humans living in endemic areas present rates of infection similar to those of the autochthonous canine populations. Antibodies against endosymbiont Wolbachia bacteria have been demonstrated recently in human Dirofilaria infections. During D. immitis infections, preadult worms and third- and fourth-stage larvae are often destroyed by the host reaction, releasing a considerable amount of Wolbachia, and a Th1-type response against Wolbachia and/or filarial antigens is mounted. On the contrary, infections with D. repens, in which worms frequently remain intact, no Th1-type response has been observed. As humans are resistant hosts, the Th1-response could have a role in the resistance against parasites. The causes for the rise in the incidence of human Dirofilariasis as well as the possible application of Wolbachia antigens in the serodiagnosis of human infections are discussed.
Javier Gonzalezmiguel - One of the best experts on this subject based on the ideXlab platform.
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delayed diagnosis of Dirofilariasis and complex ocular surgery russia
Emerging Infectious Diseases, 2013Co-Authors: Boris Ilyasov, Javier Gonzalezmiguel, Rodrigo Morchon, Vladimir Kartashev, Nikolay Bastrikov, F SimonAbstract:To the Editor: Dirofilaria repens is a vector-borne, zoonotic, filarial nematode that infects dogs, cats, and humans. In humans, D. repens worms cause subcutaneous Dirofilariasis, characterized by the development of benign subcutaneous nodules that mimic skin carcinomas (1), and ocular Dirofilariasis in orbital, eyelid, conjunctival, retroocular, and intraocular locations (2). Intraocular and retroocular dirofiliariasis causes considerable damage and discomfort in patients from the presence of the worms and from their surgical removal (3). Here, we report a retroocular D. repens nematode infection in a patient in Russia that illustrates the difficulties in clinical management and the inherent risks of surgical procedures to remove the worms. A 20-year-old woman living in Rostov-na-Donu in southwestern Russia who had never traveled outside the city sought ophthalmologic consultation for pain and skin redness and swelling in the inner corner of the upper left eyelid. Swelling migrated successively to the temporal area, the lower eyelid, and the inner corner of the lower eyelid. The patient had no other ocular signs or symptoms, and her general condition was otherwise good. Results of ophthalmologic examination and routine laboratory tests were within normal limits. Four days of treatment with cefotaxime resulted in the remission of signs and symptoms. Approximately 2 months later, swelling in the inner corner of the upper eyelid appeared again, affecting the whole upper eyelid, without itching or tenderness. Allergies were diagnosed; cetirizine was administered for 4 days, and the signs remitted at the third day of treatment. One month later, marked upper left eyelid swelling occurred, resulting in ptosis. Cetirizine was prescribed again; edema subsided after 4 days of treatment but relapsed in the following 3–4 days. At least 4 subsequent relapses occurred; thus, a computed tomographic scan of the paranasal sinuses and orbits was performed, 4 months after signs and symptoms began (Figure, ,panel A).panel A). The scan detected a soft tissue structure, 12 × 13 × 14 mm, behind the left eyeball, adjacent to and medially dislodging the optic nerve. No other abnormalities were found in the visible area of the brain and sinuses. Magnetic resonance imaging (MRI) performed 1 month later (Figure, panel B) corroborated the presence of a cyst-like structure with an irregular, rounded shape and clear, smooth borders closely adhered to the eyeball and optic nerve. T2-weighted images showed that the lesion had a high-density core but the surrounding tissue was low density. Adjacent to the lesion, the retrobulbar tissue was slightly swollen, the optic nerve was displaced medially and downward, and the adjacent upper muscle was displaced medially and upward. The diagnosis was evidence of a retroocular cystic lesion in the left orbit with a well-defined capsule and high-density but heterogeneous core structure. Figure Retroocular nodule of a Dirofilaria repens worm detected in a 20-year-old woman, Rostov-na-Donu, Russia. The cyst (arrows) is shown by computed tomography scan (A) and magnetic resonance imaging (B). Ultrasonography images (C) show a worm-like structure ... High-resolution ultrasound examination (Figure, panel C) revealed a well-defined, 3-mm, cyst-like wall containing fluid and dense, coiled-twisted linear internal structures that appeared to be actively moving (Video 1). Color Doppler examination (Figure, panel D; Video 2) revealed blood vessels in the wall but not inside the cystic structure. These additional examinations led to a diagnosis of a retroocular parasitic cyst in the left orbit, most likely a Dirofilaria spp. parasite. The parasitic cystic nodule was removed during a transpalpebral orbitotomy. A live, adult roundworm, 87 × 0.6 mm, was discharged from the cyst. Conventional PCR identified the roundworm as D. repens (data not shown). Video 1 High-resolution ultrasound examination images showing a Dirofilaria repens worm actively moving inside retroocular nodule in a 20-year-old woman, Rostov-na-Donu, Russia. Video 2 Color Doppler examination images showing the blood flow only outside the retroocular nodule in which the movement of a Dirofilaria repens worm is detected in a 20-year-old woman, Rostov-na-Donu, Russia. Although human subcutaneous Dirofilaria spp. nodules are benign, their detection may raise suspicion for a malignant tumor; thus, differential diagnosis is the key point in the management of human Dirofilariasis (4). The case we described illustrates the difficulties of diagnosis when worms are in deep locations and patients experience unspecific and even unusual signs. These confounders resulted in a lengthy diagnostic procedure, with consequent detrimental physical and psychological effects on the patient. Even though the final diagnosis determined that the nodule was nonmalignant, its anatomic location required aggressive surgical intervention to remove it. D. repens nematodes are spreading in Europe from the south toward the north and east (5–7) as a consequence of global warming, and prediction models have suggested incidence is increasing among animal and human hosts (3). Consequently, human ocular Dirofilariasis will probably be found with increasing frequency in the future. Our experience illustrates that Dirofilariasis should be included in the differential diagnosis of any nodule, independent of its anatomic location and the signs and symptoms shown by the patient. Moreover, ultrasonography represents a noninvasive technique that enables rapid preoperative identification of the parasitic origin of the nodules, thus avoiding unnecessary diagnostic delays. This technique is used for the diagnosis of cardiopulmonary Dirofilariasis in animals (8) but has been used only sporadically for human Dirofilariasis (9,10), which is habitually diagnosed postoperatively, after the surgical removal of the nodules or worms (1).
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human and animal Dirofilariasis the emergence of a zoonotic mosaic
Clinical Microbiology Reviews, 2012Co-Authors: F Simon, Javier Gonzalezmiguel, Mar Sileslucas, Rodrigo Morchon, Isabel Mellado, Elena Carreton, Jose Alberto MontoyaalonsoAbstract:SUMMARY Dirofilariasis represents a zoonotic mosaic, which includes two main filarial species (Dirofilaria immitis and D. repens) that have adapted to canine, feline, and human hosts with distinct biological and clinical implications. At the same time, both D. immitis and D. repens are themselves hosts to symbiotic bacteria of the genus Wolbachia, the study of which has resulted in a profound shift in the understanding of filarial biology, the mechanisms of the pathologies that they produce in their hosts, and issues related to Dirofilariasis treatment. Moreover, because Dirofilariasis is a vector-borne transmitted disease, their distribution and infection rates have undergone significant modifications influenced by global climate change. Despite advances in our knowledge of D. immitis and D. repens and the pathologies that they inflict on different hosts, there are still many unknown aspects of Dirofilariasis. This review is focused on human and animal Dirofilariasis, including the basic morphology, biology, protein composition, and metabolism of Dirofilaria species; the climate and human behavioral factors that influence distribution dynamics; the disease pathology; the host-parasite relationship; the mechanisms involved in parasite survival; the immune response and pathogenesis; and the clinical management of human and animal infections.
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heartworm disease dirofilaria immitis and their vectors in europe new distribution trends
Frontiers in Physiology, 2012Co-Authors: R Morchon, E Carreton, Javier Gonzalezmiguel, I MelladohernandezAbstract:Cardiopulmonary Dirofilariasis is a cosmopolitan disease caused by Dirofilaria immitis, which affects mainly canids and felids. Moreover, it causes zoonotic infections, producing pulmonary Dirofilariasis in humans. Heartworm disease is a vector-borne transmitted disease, thus transmission depends on the presence of competent mosquito species, which is directly related to favorable climate conditions for its development and survival. Cardiopulmonary Dirofilariasis is mainly located in countries with temperate and tropical climates. Europe is one of the continents where animal Dirofilariasis has been studied more extensively. In this article we review the current prevalence of canine and feline cardiopulmonary Dirofilariasis in the European continent, the transmission vectors, the current changes in the distribution and the possible causes, though the analysis of the epidemiological studies carried out until 2001 and between 2002-2011. The highest prevalences have been observed in the southern European countries, which are considered historically endemic/hyperendemic countries. Studies carried out in the last 10 years suggest an expansion of cardiopulmonary Dirofilariasis in dogs towards central and northern Europe. Several factors can exert an influence on the spreading of the disease, such as movement of infected animals, the introduction of new species of mosquitoes able to act as vectors, the climate change caused by the global warming, and development of human activity in new areas. Veterinary controls to prevent the spreading of this disease, programs of control of vectors, and adequate protocols of prevention of Dirofilariasis in the susceptible species should be carried out.
Rodrigo Morchon - One of the best experts on this subject based on the ideXlab platform.
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the canary islands as a model of risk of pulmonary Dirofilariasis in a hyperendemic area
Parasitology Research, 2018Co-Authors: Elena D Cabrera, F Simon, Rodrigo Morchon, Elena Carreton, Y Falconcordon, S Falconcordon, Alberto J MontoyaalonsoAbstract:We assessed the risk of human pulmonary Dirofilariasis in the Canary Islands, hyperendemic for canine heartworm (Dirofilaria immitis), a zoonotic vector-borne infection. For this purpose, 1479 inhabitants were tested for anti-D. immitis antibodies. Four of the 7 islands presented high seroprevalences (from 6.2 to 12.7%), therefore high exposure to the parasite and risk of zoonotic infection. These corresponded to those islands with high canine prevalences of Dirofilariasis and favourable climatic conditions for the development of mosquito vectors. The lowest prevalences (from 0 to 1.6%) were found in the desert islands and those with low canine prevalences of heartworm. Seroprevalences were very variable inside each island as well, being related to the climate and demographic factors. Human pulmonary Dirofilariasis is an emerging zoonosis worldwide which frequently goes undiagnosed. Serological studies could be useful for the correct evaluation of the risk of infection among the human population, and study of the health implications of the continuous contact with the parasite in endemic areas. Sanitary authorities should be aware of the current epidemiological data, and physicians should include human Dirofilariasis in the differential diagnosis of pulmonary nodules.
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delayed diagnosis of Dirofilariasis and complex ocular surgery russia
Emerging Infectious Diseases, 2013Co-Authors: Boris Ilyasov, Javier Gonzalezmiguel, Rodrigo Morchon, Vladimir Kartashev, Nikolay Bastrikov, F SimonAbstract:To the Editor: Dirofilaria repens is a vector-borne, zoonotic, filarial nematode that infects dogs, cats, and humans. In humans, D. repens worms cause subcutaneous Dirofilariasis, characterized by the development of benign subcutaneous nodules that mimic skin carcinomas (1), and ocular Dirofilariasis in orbital, eyelid, conjunctival, retroocular, and intraocular locations (2). Intraocular and retroocular dirofiliariasis causes considerable damage and discomfort in patients from the presence of the worms and from their surgical removal (3). Here, we report a retroocular D. repens nematode infection in a patient in Russia that illustrates the difficulties in clinical management and the inherent risks of surgical procedures to remove the worms. A 20-year-old woman living in Rostov-na-Donu in southwestern Russia who had never traveled outside the city sought ophthalmologic consultation for pain and skin redness and swelling in the inner corner of the upper left eyelid. Swelling migrated successively to the temporal area, the lower eyelid, and the inner corner of the lower eyelid. The patient had no other ocular signs or symptoms, and her general condition was otherwise good. Results of ophthalmologic examination and routine laboratory tests were within normal limits. Four days of treatment with cefotaxime resulted in the remission of signs and symptoms. Approximately 2 months later, swelling in the inner corner of the upper eyelid appeared again, affecting the whole upper eyelid, without itching or tenderness. Allergies were diagnosed; cetirizine was administered for 4 days, and the signs remitted at the third day of treatment. One month later, marked upper left eyelid swelling occurred, resulting in ptosis. Cetirizine was prescribed again; edema subsided after 4 days of treatment but relapsed in the following 3–4 days. At least 4 subsequent relapses occurred; thus, a computed tomographic scan of the paranasal sinuses and orbits was performed, 4 months after signs and symptoms began (Figure, ,panel A).panel A). The scan detected a soft tissue structure, 12 × 13 × 14 mm, behind the left eyeball, adjacent to and medially dislodging the optic nerve. No other abnormalities were found in the visible area of the brain and sinuses. Magnetic resonance imaging (MRI) performed 1 month later (Figure, panel B) corroborated the presence of a cyst-like structure with an irregular, rounded shape and clear, smooth borders closely adhered to the eyeball and optic nerve. T2-weighted images showed that the lesion had a high-density core but the surrounding tissue was low density. Adjacent to the lesion, the retrobulbar tissue was slightly swollen, the optic nerve was displaced medially and downward, and the adjacent upper muscle was displaced medially and upward. The diagnosis was evidence of a retroocular cystic lesion in the left orbit with a well-defined capsule and high-density but heterogeneous core structure. Figure Retroocular nodule of a Dirofilaria repens worm detected in a 20-year-old woman, Rostov-na-Donu, Russia. The cyst (arrows) is shown by computed tomography scan (A) and magnetic resonance imaging (B). Ultrasonography images (C) show a worm-like structure ... High-resolution ultrasound examination (Figure, panel C) revealed a well-defined, 3-mm, cyst-like wall containing fluid and dense, coiled-twisted linear internal structures that appeared to be actively moving (Video 1). Color Doppler examination (Figure, panel D; Video 2) revealed blood vessels in the wall but not inside the cystic structure. These additional examinations led to a diagnosis of a retroocular parasitic cyst in the left orbit, most likely a Dirofilaria spp. parasite. The parasitic cystic nodule was removed during a transpalpebral orbitotomy. A live, adult roundworm, 87 × 0.6 mm, was discharged from the cyst. Conventional PCR identified the roundworm as D. repens (data not shown). Video 1 High-resolution ultrasound examination images showing a Dirofilaria repens worm actively moving inside retroocular nodule in a 20-year-old woman, Rostov-na-Donu, Russia. Video 2 Color Doppler examination images showing the blood flow only outside the retroocular nodule in which the movement of a Dirofilaria repens worm is detected in a 20-year-old woman, Rostov-na-Donu, Russia. Although human subcutaneous Dirofilaria spp. nodules are benign, their detection may raise suspicion for a malignant tumor; thus, differential diagnosis is the key point in the management of human Dirofilariasis (4). The case we described illustrates the difficulties of diagnosis when worms are in deep locations and patients experience unspecific and even unusual signs. These confounders resulted in a lengthy diagnostic procedure, with consequent detrimental physical and psychological effects on the patient. Even though the final diagnosis determined that the nodule was nonmalignant, its anatomic location required aggressive surgical intervention to remove it. D. repens nematodes are spreading in Europe from the south toward the north and east (5–7) as a consequence of global warming, and prediction models have suggested incidence is increasing among animal and human hosts (3). Consequently, human ocular Dirofilariasis will probably be found with increasing frequency in the future. Our experience illustrates that Dirofilariasis should be included in the differential diagnosis of any nodule, independent of its anatomic location and the signs and symptoms shown by the patient. Moreover, ultrasonography represents a noninvasive technique that enables rapid preoperative identification of the parasitic origin of the nodules, thus avoiding unnecessary diagnostic delays. This technique is used for the diagnosis of cardiopulmonary Dirofilariasis in animals (8) but has been used only sporadically for human Dirofilariasis (9,10), which is habitually diagnosed postoperatively, after the surgical removal of the nodules or worms (1).
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human and animal Dirofilariasis the emergence of a zoonotic mosaic
Clinical Microbiology Reviews, 2012Co-Authors: F Simon, Javier Gonzalezmiguel, Mar Sileslucas, Rodrigo Morchon, Isabel Mellado, Elena Carreton, Jose Alberto MontoyaalonsoAbstract:SUMMARY Dirofilariasis represents a zoonotic mosaic, which includes two main filarial species (Dirofilaria immitis and D. repens) that have adapted to canine, feline, and human hosts with distinct biological and clinical implications. At the same time, both D. immitis and D. repens are themselves hosts to symbiotic bacteria of the genus Wolbachia, the study of which has resulted in a profound shift in the understanding of filarial biology, the mechanisms of the pathologies that they produce in their hosts, and issues related to Dirofilariasis treatment. Moreover, because Dirofilariasis is a vector-borne transmitted disease, their distribution and infection rates have undergone significant modifications influenced by global climate change. Despite advances in our knowledge of D. immitis and D. repens and the pathologies that they inflict on different hosts, there are still many unknown aspects of Dirofilariasis. This review is focused on human and animal Dirofilariasis, including the basic morphology, biology, protein composition, and metabolism of Dirofilaria species; the climate and human behavioral factors that influence distribution dynamics; the disease pathology; the host-parasite relationship; the mechanisms involved in parasite survival; the immune response and pathogenesis; and the clinical management of human and animal infections.
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what is happening outside north america regarding human Dirofilariasis
Veterinary Parasitology, 2005Co-Authors: F Simon, Rodrigo Morchon, J Lopezbelmonte, C Marcosatxutegi, J R MartinpachoAbstract:Abstract The etiologic agents of human Dirofilariasis in the Old World are Dirofilaria immitis, which cause pulmonary and subcutaneous nodules, and Dirofilaria repens, which cause ocular lesions. Although reports of new cases of Dirofilariasis are sporadic in other parts of the world, a considerable amount of information is generated in Europe regarding human Dirofilariasis. Most cases have been detected in the Mediterranean countries, Ukraine, and Russia; however, isolated or short series of cases have been reported in the Balkan Republics and central and northern European countries. Seroepidemiologic studies have provided evidence that humans living in endemic areas present rates of infection similar to those of the autochthonous canine populations. Antibodies against endosymbiont Wolbachia bacteria have been demonstrated recently in human Dirofilaria infections. During D. immitis infections, preadult worms and third- and fourth-stage larvae are often destroyed by the host reaction, releasing a considerable amount of Wolbachia, and a Th1-type response against Wolbachia and/or filarial antigens is mounted. On the contrary, infections with D. repens, in which worms frequently remain intact, no Th1-type response has been observed. As humans are resistant hosts, the Th1-response could have a role in the resistance against parasites. The causes for the rise in the incidence of human Dirofilariasis as well as the possible application of Wolbachia antigens in the serodiagnosis of human infections are discussed.
Jyotirmay Biswas - One of the best experts on this subject based on the ideXlab platform.
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A case of subconjunctival Dirofilariasis in South India
Journal of Ophthalmic Inflammation and Infection, 2012Co-Authors: Savita Bhat, Ovi Sofia, M. Raman, Jyotirmay BiswasAbstract:We describe a case of subconjunctival Dirofilariasis from South India. The worm was identified by detailed morphologic study.
Naoki Yoshimi - One of the best experts on this subject based on the ideXlab platform.
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Thirteen cases of pulmonary Dirofilariasis in a single institution in Okinawa Island
Virchows Archiv, 2019Co-Authors: Eriko Atsumi, Hirofumi Matsumoto, Naohiro Taira, Tomofumi Yohena, Hidenori Kawasaki, Tsutomu Kawabata, Naoki YoshimiAbstract:Pulmonary Dirofilariasis is an infection caused by Dirofilaria immitis , which is an endemic parasite in Japan. We experienced 13 surgical cases of pulmonary Dirofilariasis in our hospital. Of the 13 patients, 61.5% were men. The responsible lesions were located in the right lung in all cases, and 76.9% of them were in the lower lobe. Histologically, 12 cases showed necrotic nodules with peripheral granuloma with worms inside the pulmonary artery. One case did not show a necrotic nodule but showed only thickening and hyalinization of the pulmonary artery wall with a degenerated worm inside. Eosinophils were found histologically in all cases. Thirteen cases of Dirofilariasis in one institution seem to be the largest number in Japan, based on previous reports. One reason for this increased prevalence may be the hot and humid climate of our prefecture considering the ecology of the mosquito as a vector. Elastic staining and eosinophils in peripheral granulomatous areas can contribute to the diagnosis when the worms are degenerated.