1
|
Perles L, Dantas-Torres F, Krücken J, Morchón R, Walochnik J, Otranto D. Zoonotic dirofilariases: one, no one, or more than one parasite. Trends Parasitol 2024; 40:257-270. [PMID: 38228446 DOI: 10.1016/j.pt.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/17/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024]
Abstract
Dirofilaria spp. are vector-borne filarial nematodes that affect a variety of animal species, including humans. Dirofilaria immitis and Dirofilaria repens are the two main zoonotic species, but also other wildlife-associated Dirofilaria species are occasionally reported as causative agents of human dirofilariasis, including Dirofilaria striata, Dirofilaria tenuis, Dirofilaria ursi, Dirofilaria spectans, and Dirofilaria magnilarvata. Since the etiological identity of most of the species mentioned here is arguable, we summarized and critically discussed data concerning infections in humans, focusing on the reliability of Dirofilaria species identification. We advocate the importance of combined morphological and genomic approaches to provide unequivocal evidence for their zoonotic potential and pathogenicity.
Collapse
Affiliation(s)
- Livia Perles
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | | | - Jürgen Krücken
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Rodrigo Morchón
- Zoonotic Diseases and One Health, Biomedical Research Institute of Salamanca (IBSAL), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Julia Walochnik
- Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Vienna, Austria
| | - Domenico Otranto
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy; Department of Veterinary Clinical Sciences, City University of Hong Kong, Kowloon, Hong Kong.
| |
Collapse
|
2
|
Subcutaneous Dirofilariasis in the United States. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
3
|
Momčilović S, Gabrielli S, Golubović M, Smilić T, Krstić M, Đenić S, Ranđelović M, Tasić-Otašević S. Human dirofilariosis of buccal mucosa - First molecularly confirmed case and literature review. Parasitol Int 2019; 73:101960. [PMID: 31442663 DOI: 10.1016/j.parint.2019.101960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/03/2019] [Accepted: 07/14/2019] [Indexed: 11/25/2022]
Abstract
When presented in unusual manner, human dirofilariosis is hard to recognize and often leads to misdiagnosis and unjustified use of various medications. Herein, we report a rare case of Dirofilaria infection localized in buccal mucosa. A 45-year-old male, residing in the Central Serbia, developed striking edema of buccal mucosa followed by leucocytosis, with both neutrophylia and eosinophylia. Thirty days after first symptoms occurred, nodule was formed along the lateral edge of right maxilla. Therefore, patient underwent surgical extirpation and subsequent histopathological analysis of the specimen revealed the presence of a nematode. Based on morphological characteristics of detected parasite, the diagnosis of submucosal Dirofilaria repens-like infection was made. The diagnosis was confirmed, being the first case in the world analyzed by molecular methods. So far, only 13 such cases have been reported worldwide and our paper brings attention to rare form of this zoonosis and updates the data about human dirofilariosis in buccal mucosa.
Collapse
Affiliation(s)
- Stefan Momčilović
- Plastic and Reconstructive Surgery Clinic, Clinical Center Niš, Blvd Zorana Djindjica 48, Niš 18000, Serbia; Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia.
| | - Simona Gabrielli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazza le Aldo Moro 5, Rome 00185, Italy
| | - Milan Golubović
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia
| | - Tanja Smilić
- Center for Radiology, Clinical Center Niš, Blvd Zorana Djindjica 48, Niš 18000, Serbia
| | - Miljan Krstić
- Department of Pathology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia
| | - Saša Đenić
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia
| | - Marina Ranđelović
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia
| | - Suzana Tasić-Otašević
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Blvd Zorana Djindjica 81, Niš 18000, Serbia
| |
Collapse
|
4
|
Chaudhry K, Khatana S, Dutt N, Mittal Y, Shailja Sharma, Elhence P. Systematic Review of Lesser Known Parasitoses: Maxillofacial Dirofilariasis. J Maxillofac Oral Surg 2019; 18:180-189. [PMID: 30996536 PMCID: PMC6441424 DOI: 10.1007/s12663-018-1139-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/25/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Dirofilariasis is an endemic disease in tropical and subtropical countries caused by about 40 different species of dirofilari. Dirofilariasis of the oral cavity is extremely rare and is usually seen as mucosal or submucosal nodules. We also present a case of dirofilariasis of the mandibular third molar region submucosally in a 26 year old male patient. PURPOSE To identify, enlist and analyze the cases of dirofilariasis in maxillofacial region reported worldwide so as to understand the clinical presentation and encourage the consideration of helminthic infections as a possible differential diagnosis in maxillofacial swellings. METHODS Two authors KC and SK independently searched the electronic database of PUBMED, OVID, Google Scholar and manual search from other sources. A general search strategy was planned and anatomic areas of interest identified. The search was made within a bracket of 1 month by the independent authors KC and SK who assessed titles, abstracts and full texts of articles based on the decided keywords. The final selection of articles was screened for the cases that were reported in the maxillofacial region including the age, gender, site of occurrence and region of the world reported in. A geographic distribution of the reported cases was tabulated. RESULTS A total number of 265, 97, 1327, 3 articles were identified by PubMed, Ovid, GoogleScholar and manual search respectively. The final articles were manually searched for duplicates and filtered according to the inclusion/exclusion criteria which led to a final list of 58 unique articles that were included in the study. In total 99 cases were identified. CONCLUSION Although intraoral dirofilarial infections are extremely uncommon, it should be considered in the differential diagnosis of an intraoral or facial swelling that does not completely respond to routine therapy especially in patients from endemic areas.
Collapse
Affiliation(s)
| | - Shruti Khatana
- Maxillofacial Surgery (Trauma & Emergency), AIIMS Jodhpur, Jodhpur, India
| | - Naveen Dutt
- Department of Pulmonary Medicine, AIIMS Jodhpur, Jodhpur, India
| | - Yogesh Mittal
- Department of Maxillofacial Surgery, Jodhpur Dental College, Jodhpur, India
| | - Shailja Sharma
- Department of Biochemistry, AIIMS Jodhpur, Jodhpur, India
| | | |
Collapse
|
5
|
Vélez-Pérez A, Liang L, Syklawer E, Chavez V, Zhang S, Wanger A. Dirofilariasis Presenting as an Infiltrative Mass in the Right Buccal Space. Int J Surg Pathol 2016; 24:660-2. [DOI: 10.1177/1066896916653212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dirofilariasis is caused by filarial nematodes (roundworms) of the genus Dirofilaria. Dirofilariasis of the oral mucosa is very rare. Herein, we report a case of a 79-year-old man who had a slowly growing infiltrative mass in the right buccal space. Histopathologic examination showed an inflammatory infiltrate with eosinophilia, histiocytes, and small organisms (0.2-0.3 mm). Digital images were sent to the Centers for Disease Control and Prevention, which identified the parasite as a nematode in the genus Dirofilaria. It appeared to be dead and degenerating, but external, fine longitudinal cuticular ridges and the presence of tall muscle cells were diagnostic. Thus, Dirofilaria, despite its rarity, should be considered in the differential diagnosis of tumor-like lesions in the buccal mucosa.
Collapse
Affiliation(s)
| | - Li Liang
- The University of Texas Health Science Center at Houston, TX, USA
| | - Erica Syklawer
- The University of Texas Health Science Center at Houston, TX, USA
| | - Violeta Chavez
- The University of Texas Health Science Center at Houston, TX, USA
| | - Songlin Zhang
- The University of Texas Health Science Center at Houston, TX, USA
| | - Audrey Wanger
- The University of Texas Health Science Center at Houston, TX, USA
| |
Collapse
|
6
|
|
7
|
Hassona Y, Scully C, Delgado-Azanero W, de Almeida OP. Oral helminthic infestations. ACTA ACUST UNITED AC 2014; 6:99-107. [PMID: 24574305 DOI: 10.1111/jicd.12077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 08/04/2013] [Indexed: 11/28/2022]
Abstract
Oral infections caused by helminths (worms) are rarely encountered in clinical practice, and consequently, there is a paucity of information in the medical and dental literature about these conditions. In the present article, we review the English literature related to oral helminthic infestations. The main oral infections caused by helminths include four roundworm (trichinosis, trichuriasis, filariasis, and larva migrans) and three tapeworm infections (cysticercosis, sparganosis, and echinococcosis). Cases are mainly encountered in endemic areas and mainly present a benign clinical picture. The diagnosis of oral helminthic infections is mostly established after histopathological examination, which shows parasitic larvae lined by fibrous tissue and inflammatory cells. Surgical excision is the preferred treatment of isolated oral lesions caused by helminths; however, patients should undergo thorough medical evaluation to exclude the possible involvement of other body systems.
Collapse
Affiliation(s)
- Yazan Hassona
- Department of Oral Surgery, Oral Medicine, Pathology and Periodontics, The University of Jordan, Amman, Jordan; WHO Collaborating Centre for Oral Health-General Health, Oral Medicine, Bristol Dental Hospital and School, Bristol, UK
| | | | | | | |
Collapse
|
8
|
|
9
|
Akst LM, Dipasquale B, Berho M, Greene D, Roberts J. Dirofilarial infection presenting as a facial mass: case report of an emerging zoonosis. Am J Otolaryngol 2004; 25:134-7. [PMID: 14976662 DOI: 10.1016/j.amjoto.2003.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dirofilariasis is a parasitic infection caused by nematodes. Human infection remains rare but is increasing in scope, particularly in endemic areas. Dirofilariasis typically presents as a subcutaneous mass or with pulmonary nodules. Here, we present the case of a 73-year-old woman whose asymptomatic facial mass was caused by dirofilarial infection. The pathophysiology, diagnosis, and treatment of dirofilariasis of the head and neck will be discussed. In endemic areas, dirofilariasis must be considered in the differential diagnosis of facial masses.
Collapse
Affiliation(s)
- Lee M Akst
- Department of Otolaryngology and Comunicative Disorders, The Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | | | | | | |
Collapse
|
10
|
Abstract
Cutaneous dirofilariasis usually affects animals such as cats and dogs which are known to be the natural host of Dirofilaria. Dirofilariasis displays a worldwide distribution. Certain geographic regions account for the majority of reported cases. South-eastern United States, Australia and Europe have been identified as endemic regions (1, 2). However, new endemic areas are arising with increased awareness in African and Asian regions. Out of about 40 different species of Dirofilaria only a few species are commonly known to infect man, namely Dirofilaria immitus, D. tenices and D. repens. Human infection occurs when a human becomes a blood meal of an infected arthropod vector and on accidental entering of the worm. Rarely this zoonotic infection affects the oral mucosa (3). Man is the dead end of this parasite. Since the human body is an abnormal environment for the parasite, the development of the larvae is inhibited by means of retardation of sexual maturity. Lesions are presented as single non-tender subcutaneous nodules, and most patients are asymptomatic. Diagnosis is established by H&E sections prepared from excised nodules. In a majority of the cases, only a single worm either a male or a female could be identified. The worm is usually dead and degenerated with a massive inflammatory cell infiltration. Seven new cases presented as intra-oral nodules with their clinicopathological correlation are discussed.
Collapse
Affiliation(s)
- W M Tilakaratne
- Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya. Sri Lanka.
| | | |
Collapse
|
11
|
To EWH, Tsang WM, Chan KF. Human dirofilariasis of the buccal mucosa: a case report. Int J Oral Maxillofac Surg 2003; 32:104-6. [PMID: 12653245 DOI: 10.1054/ijom.2001.0217] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human dirofilariasis is a helminthic zoonosis that is common in some parts of the world. A sporadic case of dirofilariasis affecting the buccal mucosa has been reported in a non-endemic area of southern China. Clinical findings, diagnosis, pathogenesis and management are discussed. This is the fourth case of human dirofilariasis involving the oral mucosa reported in world literature.
Collapse
Affiliation(s)
- E W H To
- Oral and Maxillofacial Surgery Center, St Teresa's Hospital, 327 Prince Edward Road, Kowloon, Hong Kong.
| | | | | |
Collapse
|
12
|
Latifoğlu O, Ozmen S, Sezer C, Yavuzer R, Altintaş K, Uluoğlu O. Dirofilaria repens presenting as a premasseteric nodule. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:217-20. [PMID: 12221389 DOI: 10.1067/moe.2002.125275] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dirofilariasis is a rare zoonosis that is mainly seen with subcutaneous or pulmonary involvement. Natural hosts are dogs, cats, jackals, and raccoons; however, humans can rarely become an accidental host for the parasite. In the reported case, infection manifested as a subcutaneous nodule, representing a significant diagnostic challenge for both the surgeon and the pathologist. A case of a 62-year-old man with a premasseteric soft tissue mass caused by Dirofilaria repens is presented with histopathologic confirmation.
Collapse
Affiliation(s)
- Osman Latifoğlu
- Department of Plastic and Reconstructive Surgery, Gazi University, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|