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| LETTER TO THE EDITOR |
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| Year : 2021 | Volume
: 14
| Issue : 2 | Page : 236 |
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Subcutaneous dirofilariasis
Viroj Wiwanitkit
Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India; Department of Tropical Medicine, Hainan Medical University, Haijou, China
| Date of Submission | 16-Sep-2020 |
| Date of Decision | 16-Oct-2020 |
| Date of Acceptance | 20-Oct-2020 |
| Date of Web Publication | 3-Mar-2021 |
Correspondence Address:
Viroj Wiwanitkit
Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/mjdrdypu.mjdrdypu_442_20
How to cite this article:
Wiwanitkit V. Subcutaneous dirofilariasis. Med J DY Patil Vidyapeeth 2021;14:236 |
The accidental parasitic infestation is an important but little mentioned problem in tropical medicine. Dirofilariasis is an example of accidental parasitic infestation. This kind of infection might exist sporadically, and there are various possible involved organs. The subcutaneous infestation is one of the most common forms of dirofilariasis. The publication in Med J Dr. DY Patil Univ is the best example.[1] Basically, dirofilariais is a nematode infection. This is a kind of blood parasitic infection that the mosquito vector, Culicidae family, is the main vector in transmission cycle of the disease. Mainly, the disease affects animals and human is an accidental host.
Dirofilaria immitis and Dirofilaria repens are the important pathogens causing dirofilariais.[2] Human dirofilariais is sporadically reported. The unexplained subcutaneous nodule is a common clinical presentation. The nodule might be seen at any organs including face, neck, trunk, and extremities.[2] The disease can involve any age groups, but it is usually reported among the middle age groups. Since the disease is a dead-ended parasitic infestation, it usually takes time for disease development and observed by the patient. The history of contact with animal hosts such as cat and dog might be available, but it is not common.[3] The diagnosis of the disease is usually by pathological examination. The identification by clinical microscopic technique might be possible, but it required am expert clinical microscopist. The parasite in blood smear is usually negative. The important point is the awareness of this rare disease.
Imaging might be useful for detecting infections in deeper tissue levels.[4] Polymerase chain reaction analysis of DNA extracted from a worm might help definitive confirmation of species of the parasite.[4] Dirofilariasis should be included in differential diagnosis list for any patients presenting with an asymptomatic subcutaneous nodule, either acute or chronic history of formation.[5] The treatment for subcutaneous dirofilariasis is by surgical excision. Finally, it should note that subcutaneous dirofilariasis might concurrently exist another important form of human dirofilariasis, such as pulmonary dirofilariasis,[6] and ocular dirofilariasis.[7] Therefore, it is necessary to have full investigation for other hidden sites of infection in any patient with subcutaneous dirofilariasis.
| References | |  |
| 1. | Gandham NR, Mirza S, Das NK, Misra RN. A rare case of subcutaneous dirofilariasis from a tertiary care hospital in Western Maharashtra. Med J DY Patil Vidyapeeth 2021;14:80-3.  [Full text] |
| 2. | Wiwanitkit V, Chongboonprasert C. Dirofilariasis repens. Chula Med J 2002;46:463-8. |
| 3. | Jayasinghe RD, Gunawardane SR, Sitheeque MA, Wickramasinghe S. A case report on oral subcutaneous dirofilariasis. Case Rep Infect Dis 2015;2015:648278. |
| 4. | Chandrasena TG, Premaratna R, Mallawaarachchi CH, Gunawardena NK, Gunathilaka PA, Abeyewickrama WY, et al. The diversity of human dirofilariasis in Western Sri Lanka. Biomed Res Int 2019;2019:9209240. |
| 5. | Sukumarakurup S, Payyanadan BM, Mariyath R, Nagesh M, Moorkoth AP, Ellezhuthil D. Subcutaneous human dirofilariasis. Indian J Dermatol Venereol Leprol 2015;81:59-61. [ PUBMED] [Full text] |
| 6. | Benzaquen M, Brajon D, Delord M, Yin N, Bittar F, Toga I, et al. Cutaneous and pulmonary dirofilariasis due to Dirofilaria repens. Br J Dermatol 2015;173:788-91. |
| 7. | Senanayake MP, Infaq ML, Adikaram SG, Udagama PV. Ocular and subcutaneous dirofilariasis in a Sri Lankan infant: An environmental hazard caused by dogs and mosquitoes. Paediatr Int Child Health 2013;33:111-2. |
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