Kurup Seema, Veeraraghavan Ravi, Jose Renju, Puthalath Ushass
Department of Oral Medicine and Radiology, Amrita School of Dentistry, Kochi, Kerala, India.
Contemp Clin Dent. 2013 Apr;4(2):254-7. doi: 10.4103/0976-237X.114883.
Filariasis is an endemic disease in tropical and subtropical countries. Filarial nematodes can infect humans through vectors, commonly mosquitoes. Human infection can manifest as lymphatic filariasis, subcutaneous or pulmonary nodules and with eye involvement. Intra-oral presentation is very rare and often poses a diagnostic dilemma to the dentist. We report a case of intra-oral Dirofilaria repens infection in a 54-year-old female patient, involving the buccal mucosa. History was unremarkable and on clinical examination, a diffuse swelling with no significant signs and symptoms was seen. Laboratory investigations and radiographs were non-contributory to diagnosis. Ultrasound findings revealed a hypo-echoic lesion in the muscular layer of the left cheek. Differential diagnoses considered were minor salivary gland tumor, parotid sialolith, and cysticercosis among others. The presence of a Dirofilaria worm in the excised nodule confirmed the diagnosis. Medical awareness of the risk of intra-oral nematode infection is essential. A detailed travel history, awareness of endemic status of certain diseases, proper diagnosis and management helps in better prognosis for the patient.
丝虫病是热带和亚热带国家的一种地方病。丝虫线虫可通过媒介（通常是蚊子）感染人类。人类感染可表现为淋巴丝虫病、皮下或肺部结节以及眼部受累。口腔内表现非常罕见，常常给牙医带来诊断难题。我们报告一例54岁女性患者口腔内感染匐行恶丝虫的病例，累及颊黏膜。病史无异常，临床检查可见弥漫性肿胀，无明显体征和症状。实验室检查和X光片对诊断无帮助。超声检查结果显示左颊肌层有一个低回声病变。鉴别诊断考虑包括小唾液腺肿瘤、腮腺涎石、囊尾蚴病等。切除的结节中存在恶丝虫确诊了诊断。提高对口腔内线虫感染风险的医学认识至关重要。详细的旅行史、对某些疾病地方病状况的认识、正确的诊断和管理有助于患者获得更好的预后。
