CASE REPORT   

Journal of Radiological Review 2022 March;9(1):29-31

DOI: 10.23736/S2723-9284.21.00160-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

The worm “repens” in the city: a case of subcutaneous dirofilariasis in a 12-year-old female

Dolores FERRARA ¹, Angela BARBIERI ², Divina D’AURIA ³ ✉, Luisa CASTELLI ¹, Parvin GHOLAMI SHANAGOLABAD ¹, Massimo ZECCOLINI ¹, Francesco ESPOSITO ⁴

¹ Department of Radiology, AORN Santobono Pausilipon Children’s Hospital, Naples, Italy; ² Unit of Radiology, Presidio Ospedaliero San Leonardo Castellammare di Stabia, Naples, Italy; ³ Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; ⁴ Unit of Emergency Radiology, AORN Santobono-Pausilipon Children’s Hospital, Naples, Italy

Human dirofilariasis represents an emerging zoonotic infection in Italy, mostly reported in rural areas of Piedmont, Emilia-Romagna, Sicily, Sardinia, Tuscany, Apulia and Lombardy. The infection is caused by different species of filarial nematodes of genus Dirofilaria, which habitually infects animals (firstly dogs). Humans are known to be rare accidental dead-end hosts of infection, but in the past few years data of Dirofilaria repens endemic foci are being increasingly reported, especially in Italy. Human dirofilariasis typically manifests as either subcutaneous nodules or as lung parenchyma disease. The affected age ranges from 4 months to 100 years, most of the cases being in their 40s, with no prevalence in incidence between male and female. The most important risk factors are warm climate, the excessive number of mosquitoes and the microfilaremic dogs. Clinical diagnosis can be a real challenge and it is often wrong, so final diagnosis is based on histopathological findings. Ultrasound examination provides a suitable instrumental approach to quickly identify these lesions leading to the surgical removal of the worm with a biopsy and helping in both diagnosis and treatment. We describe a case of a cutaneous dirofilariasis by D. repens in an Italian girl, recently observed at our hospital, who came from a city in southern Italy. Although living in Naples, the family used to spend the summer holidays in the Tuscan countryside.

KEY WORDS: Dirofilariasis; Zoonoses; Child; Ultrasonography; Infectious skin diseases