A rare case of human pulmonary dirofilariasis with nodules mimicking malignancy: approach to diagnosis and treatment
- PDF / 2,557,789 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 63 Downloads / 195 Views
CASE REPORT
Open Access
A rare case of human pulmonary dirofilariasis with nodules mimicking malignancy: approach to diagnosis and treatment Paolo Albino Ferrari1,5* , Antonella Grisolia2, Stefano Reale3, Rosa Liotta4, Alessandra Mularoni2 and Alessandro Bertani1
Abstract Background: Human pulmonary dirofilariasis is a rare zoonosis caused by the dog worm Dirofilaria spp., a parasite transmitted by mosquitos and resulting in peripheral lung nodules. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle and dies causing a small pulmonary infarction that may embolize through the pulmonary vessels and may appear as a solitary nodule. These nodules are usually incidentally identified in asymptomatic patients undergoing chest imaging studies, and are generally interpreted to be malignant. Case presentation: We present the case report of a human dirofilariasis in a patient with multiple pulmonary nodules resected using video-assisted thoracic surgery (VATS). According to our literature review, this is the first case with double synchronous lung nodules reported in Italy. Conclusions: Minimally invasive resection with histologic examination may be the best approach for the diagnosis and treatment of pulmonary dirofilariasis. Polymerase Chain Reaction testing may provide a more accurate etiological diagnosis in case of an inconclusive pathology result. Keywords: Pulmonary dirofilariasis, Video-assisted thoracic surgery, PCR, Lung nodules
Background Human dirofilariasis is a zoonotic infection mostly caused by the filarial nematodes Dirofilaria repens and Dirofilaria immitis. It is poorly recognized even in endemic areas such as the Mediterranean and the south of Italy. Dirofilariae are Onchocercidae nematodes that usually target dogs and wild carnivores living in tropical and temperate regions. Humans can be accidentally infected with Dirofilaria larvae through mosquito bites [1, 2]. Nodules presenting in parenchymal organs are often
* Correspondence: [email protected]; [email protected] 1 Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT, Via Tricomi 5, Palermo, Italy 5 Division of Thoracic Surgery, “A. Businco” Oncology Hospital – Azienda Ospedaliera Brotzu, Via Jenner 1, 09100 Cagliari, Italy Full list of author information is available at the end of the article
misidentified as malignant tumors, requiring biopsy or surgery before being correctly diagnosed [3, 4]. According to our review of the literature, we report the first case of an Italian patient with two pulmonary nodules, mimicking malignant lesions, which were surgically resected and underwent subsequent morphological and molecular identification of Dirofilaria repens [5–12].
Case presentation A 63-year-old woman from the south of Italy was admitted to the thoracic surgical service for the evaluation of two coin lesions of the right lung. The lesions were found incidentally on a chest X-ray (Fig. 1) that the patient received for a clinical suspic
Data Loading...
