Dirofilariasis

Dirofilariasis is a disease caused by the parasitic nematode Dirofilaria immitis, which resides mainly in the large blood vessels of the host, mostly in the pulmonary arteries, as well as in the heart in advanced cases. The transmission is carried out through the bite of culicid mosquitoes. Although this disease is more common in animals, chiefly dogs, it can be transmitted to humans on rare occasions. The symptoms develop gradually. Chronic cough, dyspnea and syncope after exercise or excitement initially appear. Once the disease is more advanced, congestive heart failure, heart murmurs, arrhythmias, thromboembolism, and pulmonary hypertension appear, and can lead to death due to respiratory failure if the disease is not stopped in time. The treatment applied in these cases are antiparasitics, along with corticosteroids and antihistamines. In more advanced cases, it could require surgical intervention. As prevention, it is recommended to administer macrocyclic lactones, monthly in case of oral or topical route, and annually in case of intravenous route. The diagnosis of dirofilariasis is made by direct observation of microfilariae, antigen detection, antibody detection, or diagnostic imaging in more advanced cases.

Dirofilariasis is a zoonotic disease present throughout the world, with a higher prevalence in tropical and subtropical areas. In Europe, this zoonosis is already endemic in all the countries of the Mediterranean basin, and there is an expansion towards the countries of the center and north of the continent.