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. 2016 Apr 19:16:171.
doi: 10.1186/s12879-016-1505-3.

Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports)

Jana Matějů  1   2 , Marta Chanová  1 , David Modrý  3   4   5 , Barbora Mitková  3   4 , Kristýna Hrazdilová  4   6 , Víta Žampachová  7 , Libuše Kolářová  8   9
Affiliations

Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports)

Jana Matějů et al. BMC Infect Dis. .

Abstract

Background: Human dirofilariasis is a zoonotic infection that continues to spread to previously unaffected areas of Europe. In the South Moravian Region of the Czech Republic (CR), imported as well as autochthonous canine infections were recorded in the last decade, and parasite DNA was detected in mosquitoes of Aedes vexans. In the present paper, human Dirofilaria infections are reported from the country for the first time.

Case presentation: The samples from five patients with suspected tissue helminthiases were investigated. In particular cases, nematodes were isolated from various tissues including skin of lower leg, soft tissues of finger, subcutaneous tissue of hypogastrium, lymph node and peritoneum. The diagnosis was based on light microscopic morphology and/or DNA analysis of the worms. In addition, ELISA examination of patients' sera for anti-filaria IgG antibodies was performed.

Conclusions: In the CR, five cases of human dirofilariasis caused by Dirofilaria repens were recorded during 2010-2014 (species determination for three of them was confirmed besides morphological also by DNA analysis). At least, three of the cases were of autochthonous origin (the patients are Czech citizens residing in South Moravian Region who have never travelled abroad). The findings confirm the natural setting of D. repens in South Moravian Region of the CR. Dirofilariasis should be therefore considered as endemic in this area where it may represent a significant risk factor for public health.

Keywords: Autochthonous diseases in Czech Republic; Dirofilaria repens; Emerging disease; Human dirofilariasis.

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Figures

Fig. 1
Fig. 1
Histological section of subcutaneous formation extracted from hypogastrium (PAS staining; Case 1). a Section of the nodule containing the coiled worm (arrowheads) with visible genital tube (g), intestine (i), coelomyar musculature (m) and striated cuticle (c); 100 x. b Detailed view on longitudinal and transversal striation of the cuticle (arrowhead); 400 x
Fig. 2
Fig. 2
Subadult female of Dirofilaria repens found in the peritoneum of the patient during hernia surgery (Case 2). a General view of intact worm. b Detail on the cuticle with transversal and longitudinal striation, with visible uterus containing germinative cells; 200 x. c Anterior end of the worm with sensoric papillae (arrowheads); 200 x
Fig. 3
Fig. 3
The worm extracted from the nodule on the left middle-finger of the patient (Case 4). a. Detail on cuticular structure with Dirofilaria-specific longitudinal ridges (-----) and transversal striation (∙∙∙∙∙); Photo P. Kotíková
Fig. 4
Fig. 4
Histological sections of infected lymph node (PAS staining; Case 5). a Cross section of the nodule with parasite surrounded by inflammatory infiltration; uterus branches with developing microfilariae visible (arrowhead); 100 x. b Detail on longitudinal cuticle ridges; well-developed musculature (m); intestine (i).and uterus branches (arrowheads); 400 x
Fig. 5
Fig. 5
Geographical distribution of Dirofilaria repens records in the Czech Republic, South Moravian Region including findings from mosquitoes, dogs and humans
See this image and copyright information in PMC

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