Szénási Zsuzsanna, Kovács András Hári, Pampiglione Silvio, Fioravanti Maria Letizia, Kucsera István, Tánczos Balázs, Tiszlavicz László
Department of Parasitology, National Center for Epidemiology, Budapest, Hungary.
Wien Klin Wochenschr. 2008;120(3-4):96-102. doi: 10.1007/s00508-008-0928-2.
In the temperate regions of Europe, mainly Italy, France, Greece, and in recent years Hungary, a specific filarioid worm, Dirofilaria (Nochtiella) repens, a parasite of dogs, cats and some other carnivores, transmitted by mosquitoes, has occasionally been contracted, causing dirofilariosis in humans. We report a case of dirofilariosis and review all previously observed cases in Hungary.
MATERIALS, METHODS AND RESULTS: The authors present a case of human subconjunctival dirofilariosis in a 56-year-old man with mild itching and a burning sensation in his right eye. A slow-moving, whitish, thread-like worm was detected by slit-lamp examination. The worm was surgically removed and parasitological examination identified it as an immature male Dirofilaria repens. A review of Hungarian cases from 1880 to 2000 is presented, with updates of earlier reports. In addition, 16 new cases (8 men; 8 women) diagnosed between 2001 and 2006 are reviewed. The mean age of these 16 patients was 60 years; eight cases had ocular localization, seven were subcutaneous and one was diagnosed in a histopathological section of removed axillary lymph node in a patient with lymphoid leukemia. Twelve of the 16 identified Dirofilariae were females, four were males. According to their recorded histories the patients had not traveled internationally.
Most of the above cases of dirofilariosis are certainly autochthonous infections. The increasing number of diagnosed cases suggests that this zoonosis is becoming more important in central Europe and that the incidence may increase with the improvement of clinical diagnosis.
在欧洲温带地区，主要是意大利、法国、希腊，近年来还有匈牙利，一种特定的类丝虫——匐行恶丝虫（Dirofilaria (Nochtiella) repens），它是狗、猫和其他一些食肉动物的寄生虫，通过蚊子传播，偶尔会感染人类，导致人类患恶丝虫病。我们报告一例恶丝虫病病例，并回顾匈牙利之前观察到的所有病例。
材料、方法与结果：作者报告一例56岁男性患人结膜下恶丝虫病的病例，其右眼有轻度瘙痒和烧灼感。通过裂隙灯检查发现一条蠕动缓慢、白色、线状的蠕虫。手术取出该蠕虫，寄生虫学检查确定其为未成熟的雄性匐行恶丝虫。本文呈现了对1880年至2000年匈牙利病例的回顾，并更新了早期报告。此外，还回顾了2001年至2006年间诊断出的16例新病例（8名男性；8名女性）。这16例患者的平均年龄为60岁；8例为眼部感染，7例为皮下感染，1例是在一名淋巴白血病患者切除的腋窝淋巴结组织病理学切片中诊断出来的。16条已确认的恶丝虫中有12条为雌性，4条为雄性。根据他们记录的病史，这些患者没有国际旅行史。
上述大多数恶丝虫病病例肯定是本土感染。确诊病例数量的增加表明，这种人畜共患病在中欧正变得越来越重要，而且随着临床诊断的改善，发病率可能会上升。
