1/53. Pulmonary dirofilariasis.BACKGROUND: Pulmonary dirofilariasis is a rare entity caused by dirofilaria immitis, the dog heartworm that is transmitted to humans by mosquitos. This filarial nematode enters the subcutaneous tissue, travels to the right ventricle where it dies, and then embolizes the pulmonary vasculature, causing a small pulmonary infarction, which subsequently appears as a solitary nodule. Although these nodules are usually identified incidentally by chest radiography in asymptomatic patients, the lesion is generally presumed to be neoplastic. diagnosis is made by surgical excision. methods: We reviewed the pathology reports at Memorial Medical Center, Savannah, GA since 1990. RESULTS: There have been approximately 150 cases reported in the literature worldwide. We found 4 patients with pulmonary dirofilariasis diagnosed at our hospital since 1992. A review of the pathogenesis of the disease and clinical manifestations, diagnosis, and treatment of this entity are presented. CONCLUSIONS: Pulmonary dirofilariasis is a benign condition, transmitted by mosquitos to humans that results in peripheral pulmonary nodules. awareness of this entity is important in the differential diagnosis of pulmonary coin lesions.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
2/53. Pulmonary presentation of dirofilaria immitis (canine heartworm) in man.Canine heartworm or dirofilaria immitis can occasionally infect man. We present the case of a 36-year-old Balkan woman referred to us for a thoracoscopic biopsy of a well defined pulmonary mass. The latter was thoracoscopically resected and proved to be due to dirofilaria immitis on histopathological examination. To our knowledge this is the second reported case in western australia, the first being that reported by Brine et al. The prevalence of the disease in Australia was recognized in 1969 in one study in the state of queensland, where 12% of 761 dogs at one veterinary clinic and 20% of 296 dogs at another were shown to be infected. dirofilaria immitis resides in the right ventricle and pulmonary arteries of dogs. The microfilariae are released into the blood stream and are transmitted to secondary hosts by mosquitoes.- - - - - - - - - - ranking = 7keywords = immitis (Clic here for more details about this article) |
3/53. Nine more cases of human infections by dirofilaria repens diagnosed in italy by morphology and recombinant dna technology.Dirofilariosis is a mosquito-borne disease of carnivors due, in italy, to dirofilaria repens and D. immitis species which are sympatric in many areas. Nine more cases of human infection are here reported, detected in Italian patients living in northern regions (where D. immitis and D. repens are largely present), in Tuscany (where D. repens is more frequent than D. immitis), and in sicily (where D. immitis is present only sporadically). The nematodes surgically removed (7 female and 2 male specimens) have been identified by a PCR-based method and by morphology as D. repens. Morphological, clinical, and epidemiological data of these human infections are discussed.- - - - - - - - - - ranking = 4keywords = immitis (Clic here for more details about this article) |
4/53. The first Korean case of human pulmonary dirofilariasis.Human pulmonary dirofilariasis has been documented from many parts of the world, but not in korea so far. We experienced a patient of pulmonary dirofilariasis who had visited a local clinic because of chest pain for 1 month. On chest radiograph, a coin lesion of 2 cm diameter and enlargement of the mediastinal lymph node were shown. An exploratory lung resection was done. Pathologically the lesion was a pulmonary dirofilariasis complicated with necrotic pneumonia, fibrosis, and infarction. At the center of the lesion, degenerated nematode sections with multilayered cuticle, thick musculature, and bilateral internal ridges on each side were found, which was identified to be dirofilaria immitis. This is the first report of human pulmonary dirofilariasis in korea.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
5/53. Human pulmonary dirofilariasis presenting as a small nodule with a cavity.A 73-year-old woman had a 4-year history of lung fibrosis from collagen vascular disease. She presented with a complaint of dry cough. A chest radiograph showed a 2-cm solitary pulmonary nodule with a small cavity in the right lower lobe. Preoperatively, we performed computed tomography of the chest and measured tumor markers. Video-assisted thoracotomy was performed because we could not rule out lung cancer. Pathologic analysis confirmed the presence of a granuloma with dirofilaria immitis. In japan, the incidence of human dirofilariasis has steadily increased and must be considered in the workup of cavitary pulmonary nodules.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
6/53. Human extrapulmonary dirofilariasis in texas.Human pulmonary infection due to the dog heartworm, dirofilaria immitis, has been reported in the medical literature for many decades. Extrapulmonary infection due to this pathogen is less widely reported, including only nine cases in north america. We report a case of extrapulmonary dirofilariasis manifested as asymptomatic nodular lesions in the anterior abdominal wall of a patient having exploratory laparotomy for carcinoma. We review previously reported cases and discuss the pathophysiology of both pulmonary and extrapulmonary dirofilariasis.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
7/53. Case report: Unusual location of dirofilaria immitis in a 28-year-old man necessitates orchiectomy.The fourth case of zoonotic dirofilaria immitis infection in a california resident is reported. This case was unique in that it involved the spermatic cord, produced significant symptoms, and upon physical examination was suspected of being an incarcerated inguinal hernia. At surgery frozen sections were inconclusive regarding neoplasia and cord involvement precluded removal of the mass without orchiectomy, which was done. Histopathology revealed a well-preserved immature male D. immitis, the canine heartworm, in a branch of the spermatic artery. The morphological identification of the worm was confirmed by polymerase chain reaction (PCR) studies. This case illustrates that D. immitis infections can complicate differential diagnosis of extrapulmonary lesions and suggests that the public health significance of this vector-borne filarial worm needs to be evaluated through appropriate epidemiological studies in enzootic areas.- - - - - - - - - - ranking = 7keywords = immitis (Clic here for more details about this article) |
8/53. Human pulmonary dirofilariasis. A case report and review of the literature.A case of pulmonary dirofilariasis in a 48-year-old woman is presented. This rare pulmonary disorder is caused by dirofilaria immitis, the canine heartworm. A review of the literature revealed 40 documented cases, most of which have occurred in the united states within the past 10 years. The incidence of pulmonary dirofilariasis appears to be increasing; thus, this entity represents an important zoonosis and indicates a need for familiarity with the pathologic features of the lesions and the morphologic characteristics of the worm.- - - - - - - - - - ranking = 1keywords = immitis (Clic here for more details about this article) |
9/53. The first human case of hepatic dirofilariasis.Most of human dirofilariasis are pulmonary or subcutaneous infections, but there have been a few reports of human dirofilariasis in unusual sites, such as large vessels, mesentery, peritoneal cavity, and spermatic cord. We present the first case of human hepatic dirofilariasis, which was surgically diagnosed. A 39-year-old man without any evidence of systemic symptom was found incidentally to have a hepatic nodule during routine physical check-up. The histologic findings of the resected lesion showed a granulomatous lesion with central necrosis containing up to 35 transverse sections of a nematode, ranging 30-80 micro m in diameter. Thin (1.5-5 micro m) cuticle with transverse striations surrounded polymyarian and muscle bundles occupied a sixth of both sides of outer body cavity. Central portion of the body cavity was occupied with an intestine-like tubular structure and a larger reproductive tube. These microscopic findings were consistent with degenerated dirofilaria immitis. Antibody test by enzyme-linked immunosorbent assay for patient serum reacted positively against adult D. immitis antigen.- - - - - - - - - - ranking = 2keywords = immitis (Clic here for more details about this article) |
10/53. Pulmonary dirofilariasis--clinicopathological study.Pulmonary dirofilariasis (PD), caused by dirofilaria immitis (D. immitis), the dog heartworm, is not common in humans, though we recently encountered 4 cases. Chest X-ray images from annual health examinations showed a single spherical nodule in the inferior or middle portion of the right lung in each patient. None of the patients showed any clinical symptoms and had no contact with dogs. Hematological results in 3 of the cases were within normal limits, while mild eosinophilia was found in one. Serological tests for the Anti-Dirofilaria antibodies were not performed. There were no characteristic clinical manifestation of PD in any of the patients, however, we consider it important to keep a diagnosis of PD in mind, when we experienced these cases, they present no characteristic clinical manifestations. Pathologically, macroscopic findings showed well-circumscribed nodules that were round peripheral lesions in lungs. Histological results revealed coagulation necrosis with fibrosis and granulation in the nodule edge, which contained inflammatory cells. By means of silver staining, the worm structures in the nodules could be identified well, and the quadrant cells in the sections were numbered about 30. Immunohistochemically, the somatic muscle tissues were stained with anti-Dirofilaria antibody. These findings indicated that the pulmonary lesions in all 4 cases were due to D. immitis.- - - - - - - - - - ranking = 3keywords = immitis (Clic here for more details about this article) |
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