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Review
. 2025 Oct 7.
doi: 10.1007/s10096-025-05299-y. Online ahead of print.

Autochthonous human subconjunctival dirofilariasis in europe: a case report from Italy and literature review

Luca Santilli  1 , Benedetta Canovari  2 , Maria Balducci  2 , Giulia Cesaretti  2 , Francesco Ginevri  2 , Monia Maracci  2 , Antonio Polenta  2 , Norma Anzalone  2   3 , Lucia Franca  2   3 , Beatrice Mariotti  2   3 , Lucia Sterza  2   3 , Luca Lanzafame  4 , Giacomo Bongiovanni  4 , Giacomo Pellegrini  4 , Ilaria Pascucci  5 , Cristina Canonico  5 , Francesco Barchiesi  2   3
Affiliations
Review

Autochthonous human subconjunctival dirofilariasis in europe: a case report from Italy and literature review

Luca Santilli et al. Eur J Clin Microbiol Infect Dis. .

Abstract

Autochthonous human dirofilariasis cases have increased in Europe for the last few decades probably due to climate change, including increased temperature and a greater distribution of the biological vector. Dirofilariasis can present in different ways depending on the species, leading clinicians to incorrect diagnoses. Here we present a case of a 75-year-old man from Italy with no travel history presenting with a of subconjunctival nodule caused by Dirofilaria repens. We review European cases of the last ten years including 17 cases of subconjunctival dirofilariasis. In severe cases, the definitive diagnosis was reached late after initial erroneous hypotheses such as conjunctivitis or scleritis. In almost all cases the responsible agent was D. repens and only in one case D. immitis. We underline the importance of considering dirofilariasis as a possible diagnosis even in temperate regions. The One Health approach is increasingly necessary to manage the spread of dirofilariasis as well as other zoonoses.

Keywords: Dirofilaria repens; Filariasis; Subconjunctival dirofilariasis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical review and approval were waived for this study according to Ministry Law 425–2024. Consent to publish: The patient has consented to the publication of the clinical case and the images related to it, always in compliance with the current regulations on privacy. Competing interests: The authors declare no competing interests.

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