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Kuthi L, Zombori T, Tiszlavicz L, Hegedűs F, Almási S, Baráth B, Almakrami M, Ej MJ, Barta N, Ujfaludi Z, Pankotai T, Hajdu A, Furák J, Sejben A. Emerging human pulmonary dirofilariasis in Hungary: a single center experience. Diagn Pathol 2024; 19:85. [PMID: 38907257 PMCID: PMC11191171 DOI: 10.1186/s13000-024-01507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Human pulmonary dirofilariasis (HPD) is rare in Hungary, and it stems from Dirofilaria immitis, mainly transmitted through mosquito bites, with dogs as primary hosts. Despite its prevalence in veterinary settings, human cases are infrequent. Historically, Mediterranean countries report most HPD cases, but sporadic cases occur in temperate European regions. Radiologically, HPD often manifests in a non-specific manner, resembling pulmonary neoplasms, leading to unnecessary surgery and patient distress. METHODS This study presents a notable case series from Hungary, encompassing a 12-year period, documenting 5 instances of HPD with the aim to provide baseline estimate of occurrence for future comparison. RESULTS Among the patients studied, all were of middle age (median: 52 years, range: 37-69) and exhibited tumor-like lesions, primarily localized to the right lung, necessitating lobectomy or wedge resection. Histological examination consistently revealed a necrotizing granulomatous response characterized by remnants of helminths, without the presence of ovules. Furthermore, rigorous diagnostic procedures excluded other potential infectious agents through specialized staining techniques. Polymerase chain reaction analysis definitively confirmed the diagnosis of HPD in each case. CONCLUSIONS This case series highlights HPD as a seldom zoonosis, with a probable escalation in its occurrence within temperate regions. Therefore, clinicians should maintain a heightened awareness of HPD in the differential diagnosis of pulmonary coin lesions. Early recognition and diagnosis are paramount for appropriate management and prevention of potential complications associated with this increasingly recognized infectious entity.
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Affiliation(s)
- Levente Kuthi
- Department of Surgical and Molecular Pathology, Tumor Pathology Center, National Institute of Oncology, Budapest, Hungary
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Tamás Zombori
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - László Tiszlavicz
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Fanni Hegedűs
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Szintia Almási
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Bence Baráth
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Mohammed Almakrami
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Mohammad Jamal Ej
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
| | - Nikolett Barta
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
- Centre of Excellence for Interdisciplinary Research, Development and Innovation, University of Szeged, Szeged, Hungary
| | - Zsuzsanna Ujfaludi
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
- Centre of Excellence for Interdisciplinary Research, Development and Innovation, University of Szeged, Szeged, Hungary
| | - Tibor Pankotai
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary
- Hungarian Centre of Excellence for Molecular Medicine (HCEMM), Genome Integrity, Szeged, Hungary
- Competence Centre of the Life Sciences Cluster of the Centre of Excellence for Interdisciplinary Research, Development and Innovation, University of Szeged, Szeged, Hungary
| | | | - József Furák
- Department of Surgery, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Anita Sejben
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1, Szeged, H-6725, Hungary.
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Norman FF, Gonzalez-Sanz M. Pulmonary infections in the returning traveler. Curr Opin Pulm Med 2024; 30:243-251. [PMID: 38323419 DOI: 10.1097/mcp.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW The recent COVID-19 pandemic has shaped the epidemiology of other infectious diseases globally. International tourist arrivals are increasing and recovering to prepandemic levels. This review focuses on respiratory infections in travelers, highlighting the characteristics of the main imported viral, bacterial, fungal, and parasitic infections with pulmonary involvement. RECENT FINDINGS A recent systematic review estimated a prevalence of respiratory symptoms in travelers of around 35%, increasing to nearly 65% in the context of mass gatherings. Common viral and bacterial pathogens account for the majority of respiratory infections with an identified cause; however, recent data focus on the need for surveillance of emerging infections such as MERS-CoV, henipaviruses and multidrug resistant bacteria, which may be spread through travel. Fungal and parasitic respiratory infections are less common, and acquisition is usually associated with specific risk factors or exposure in endemic areas. Special risk groups, such as immunocompromised travelers, may be particularly vulnerable, presenting with severe disease or reactivation of latent infections. SUMMARY The next significant international epidemic could involve another new infectious agent causing respiratory disease and spreading via mobile populations. Official protocols should be adhered to, and public health interventions implemented for effective control. Continued and globally coordinated investments in research for new vaccines, therapeutic agents, disease modeling, and digital tracking strategies are essential.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS
- Universidad de Alcalá
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Gonzalez-Sanz
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS
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Esteves-Guimarães J, Matos JI, Leal-Sousa B, Oliveira P, Lobo L, Silvestre-Ferreira AC, Soares CS, Rodríguez-Escolar I, Carretón E, Morchón R, Fontes-Sousa AP, Montoya-Alonso JA. Current State of Canine Heartworm in Portugal. Animals (Basel) 2024; 14:1300. [PMID: 38731304 PMCID: PMC11083104 DOI: 10.3390/ani14091300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
The favourable geo-climatic conditions in Portugal have made it highly conducive to the development of Dirofilaria immitis in dogs, leading to its identification as an endemic region. This nematode is rapidly spreading across Europe, particularly in northeastern countries. The objective of this study was to provide an updated assessment of the prevalence of this disease in Portuguese dogs, analysing the results in relation to epidemiological and geo-environmental factors, and to identify potential risk factors. A total of 1367 dogs from all continental and insular districts were included in the study and tested for D. immitis antigens. The overall prevalence was found to be 5.9%. It was observed that the disease is spreading northward, with previously unaffected districts now reporting cases, and that the prevalence in coastal districts exceeded that of inland ones. Notably, the Aveiro district exhibited a significant increase in D. immitis prevalence, while in certain districts such as Setúbal, Santarém, Madeira, or Faro, a stabilisation or decrease in prevalence was noted. Furthermore, outdoor and older dogs were found to be at a higher risk of infection. No positive cases were detected in the Azores. Most of the infected dogs were located in areas of high and medium risk of infection. This study underscores the importance of implementing pharmacological prophylaxis, vector control strategies, and public awareness programs to control the spread of this zoonotic disease.
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Affiliation(s)
| | - Jorge Isidoro Matos
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain; (J.I.M.); (E.C.); (R.M.); (J.A.M.-A.)
| | | | - Pedro Oliveira
- EPIUnit, ICBAS—Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal;
| | - Luís Lobo
- Veterinary Hospital of Porto, 4250-475 Porto, Portugal;
- Faculty of Veterinary Medicine, Lusófona University, 1749-024 Lisboa, Portugal
- Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente (ICETA) da Universidade do Porto, Praça Gomes Teixeira, Apartado 55142, 4051-401 Porto, Portugal
| | - Ana Cristina Silvestre-Ferreira
- Center for Animal and Veterinary Science (CECAV), Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.C.S.-F.); (C.S.S.)
| | - Carla S. Soares
- Center for Animal and Veterinary Science (CECAV), Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.C.S.-F.); (C.S.S.)
- VetLamaçães, Veterinary Clinic, 4715-303 Braga, Portugal
- CIVG—Vasco da Gama Research Center, EUVG—Vasco da Gama University School, 3020-210 Coimbra, Portugal
| | - Iván Rodríguez-Escolar
- Zoonotic Diseases and One Health GIR, Biomedical Research Institute of Salamanca (IBSAL), Faculty of Pharmacy, University of Salamanca, Campus Miguel Unamuno, 37007 Salamanca, Spain;
| | - Elena Carretón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain; (J.I.M.); (E.C.); (R.M.); (J.A.M.-A.)
| | - Rodrigo Morchón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain; (J.I.M.); (E.C.); (R.M.); (J.A.M.-A.)
- Zoonotic Diseases and One Health GIR, Biomedical Research Institute of Salamanca (IBSAL), Faculty of Pharmacy, University of Salamanca, Campus Miguel Unamuno, 37007 Salamanca, Spain;
| | - Ana Patrícia Fontes-Sousa
- Department of Immuno-Physiology and Pharmacology, Center for Pharmacological Research and Drug Innovation (MedInUP), Veterinary Hospital of the University of Porto (UPVET), ICBAS—Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
| | - José Alberto Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35413 Las Palmas de Gran Canaria, Spain; (J.I.M.); (E.C.); (R.M.); (J.A.M.-A.)
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Perles L, Dantas-Torres F, Krücken J, Morchón R, Walochnik J, Otranto D. Zoonotic dirofilariases: one, no one, or more than one parasite. Trends Parasitol 2024; 40:257-270. [PMID: 38228446 DOI: 10.1016/j.pt.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/17/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024]
Abstract
Dirofilaria spp. are vector-borne filarial nematodes that affect a variety of animal species, including humans. Dirofilaria immitis and Dirofilaria repens are the two main zoonotic species, but also other wildlife-associated Dirofilaria species are occasionally reported as causative agents of human dirofilariasis, including Dirofilaria striata, Dirofilaria tenuis, Dirofilaria ursi, Dirofilaria spectans, and Dirofilaria magnilarvata. Since the etiological identity of most of the species mentioned here is arguable, we summarized and critically discussed data concerning infections in humans, focusing on the reliability of Dirofilaria species identification. We advocate the importance of combined morphological and genomic approaches to provide unequivocal evidence for their zoonotic potential and pathogenicity.
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Affiliation(s)
- Livia Perles
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | | | - Jürgen Krücken
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Rodrigo Morchón
- Zoonotic Diseases and One Health, Biomedical Research Institute of Salamanca (IBSAL), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Julia Walochnik
- Center for Pathophysiology, Infectiology, and Immunology, Medical University of Vienna, Vienna, Austria
| | - Domenico Otranto
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy; Department of Veterinary Clinical Sciences, City University of Hong Kong, Kowloon, Hong Kong.
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Silva WID, Gomes ARD, Francisco MCD, Silva JMD, Oliveira Filho HSD, Feitosa TF, Vilela VLR. Subcutaneous dirofilariasis due to Dirofilaria immitis in a dog in Brazil: first report. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA = BRAZILIAN JOURNAL OF VETERINARY PARASITOLOGY : ORGAO OFICIAL DO COLEGIO BRASILEIRO DE PARASITOLOGIA VETERINARIA 2023; 32:e001423. [PMID: 37283421 DOI: 10.1590/s1984-29612023032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
The aim of this study was to report on the presence of microfilariae of Dirofilaria immitis causing nodular pyogranulomatous dermatitis in a dog in the state of Rio Grande do Norte, northeastern Brazil. A 4-year-old male dachshund dog with lesions in the nostrils and left dorsolateral regions was treated. Tests were requested to aid in making the diagnosis, such as skin cytology, Knott's test, thick smear and histopathology of the lesions. From these, presence of a diffuse pyogranulomatous process was observed and, amidst the cellular material, microfilariae of Dirofilaria spp. A conventional polymerase chain reaction test on tissue samples from the lesions revealed the presence of the species D. immitis. Treatment based on ivermectin (3mg) was administered at a single oral dose of 0.6 mg/kg. In the first seven days there was regression of the lesions, but after 30 days there was recurrence. A new treatment was administered, consisting of 10% imidacloprid + 2.5% moxidectin (4-10 mg/kg), with one application per month for 6 months, and doxycycline (100 mg), 10 mg/kg, 1 tablet, 2 times a day, for 30 days. In conclusion, D. immitis microfilariae caused pyogranulomatous lesions in the subcutaneous tissue of a dog. This had not previously been described in Brazil.
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Affiliation(s)
- Welitânia Inácia da Silva
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande - UFCG, Patos, PB, Brasil
| | | | | | | | | | - Thais Ferreira Feitosa
- Departamento de Medicina Veterinária, Instituto Federal da Paraíba - IFPB, Sousa, PB, Brasil
| | - Vinícius Longo Ribeiro Vilela
- Programa de Pós-graduação em Ciência e Saúde Animal, Universidade Federal de Campina Grande - UFCG, Patos, PB, Brasil
- Departamento de Medicina Veterinária, Instituto Federal da Paraíba - IFPB, Sousa, PB, Brasil
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