• Am. J. Med. Sci. · Jan 2022

    Review

    Human Pulmonary Dirofilariasis: A Review for the Clinicians.

    • Biplab K Saha, Alyssa Bonnier, Woon Hean Chong, Hau Chieng, Adam Austin, Kurt Hu, and Boris Shkolnik.
    • Division of Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, Missouri, USA. Electronic address: spanophiliac@yahoo.com.
    • Am. J. Med. Sci. 2022 Jan 1; 363 (1): 11-17.

    AbstractHuman pulmonary dirofilariasis (HPD) is a rare zoonotic disease caused by Dirofilaria immitis, the nematode responsible for canine cardiopulmonary dirofilariasis (dog heartworm). The incidence of HPD is on the rise throughout the world due to increased awareness and factors affecting the vector (mosquito). Humans are accidental hosts for D. immitis. Most patients are asymptomatic and present with an incidental pulmonary nodule that mimics primary or metastatic pulmonary malignancy. Some patients suffer from pulmonary and systemic symptoms in the acute phase of pneumonitis caused by pulmonary arterial occlusion by the preadult worms resulting in pulmonary infarction and intense inflammation. These patients may have ill-defined pulmonary infiltrate on chest radiology. Pulmonary nodules represent the end result of initial pneumonitis. There are no specific clinical, laboratory, or radiologic findings that differentiate HPD from other causes of a pulmonary nodule. Although serologic tests exist, they are usually not commercially available. The majority of patients are diagnosed by histopathologic identification of the decomposing worm following surgical resection of the lesion.Copyright © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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