Ciuca Lavinia, Gabrielli Simona, Forgione Patrizia, Di Napoli Evaristo, Paciello Orlando, Panariello Maria Vittoria, Ascierto Marianna, Petrullo Luciana, Montella Maria Ortensia, Maurelli Maria Paola, Rinaldi Laura
Department of Veterinary Medicine and Animal Production, Center for Monitoring of Parasitosis (CREMOPAR), University of Naples Federico, Naples, Italy.
Department of Public Health and Infectious Diseases, University of Rome 'Sapienza', Rome, Italy.
Parasitology. 2025 Apr;152(4):399-408. doi: 10.1017/S0031182025000290.
is the primary etiological agent of human dirofilariosis in the Old World, with Italy reporting the highest number of cases in Europe. This study describes two new cases of infection in humans, in southern Italy, where canine dirofilariosis is endemic. The first case involved a 33-year-old man from Caserta (Campania, Southern Italy) who presented with a subcutaneous mass on the upper eyelid. Surgical excision revealed an immature female worm measuring 14 cm, lacking microfilariae in both the uterus and peripheral blood. The second case was a 67-year-old man from Pozzuoli (Metropolitan City of Naples, Southern Italy) with an oval-shaped nodule in the left frontal scalp region. A live gravid female worm measuring 15–16 cm was extracted, also without microfilariae in the peripheral blood and no male worm detected. PCR sequencing confirmed a 100% match with . Both patients tested positive for antibodies by IgG ELISA. These cases underscore the continuous spread of human dirofilariosis in southern Italy and highlight diagnostic challenges due to variable clinical presentations. The discovery of a gravid female without microfilaremia suggests complexities in the parasite’s life cycle in humans, challenging the notion of humans as strict dead-end hosts. Given the rising prevalence in both humans and dogs, a comprehensive epidemiological study is recommended. Inclusion of dirofilariosis in the national surveillance system for notifiable diseases would improve case identification and tracking, aiding in better monitoring and control of this zoonotic infection.
是旧大陆人类丝虫病的主要病原体，在欧洲，意大利报告的病例数最多。本研究描述了意大利南部两例人类感染的新病例，该地区犬类丝虫病呈地方性流行。第一例病例是一名来自卡塞塔（意大利南部坎帕尼亚大区）的33岁男子，其右上眼睑出现皮下肿块。手术切除显示一条未成熟的雌虫，长14厘米，子宫和外周血中均无微丝蚴。第二例病例是一名来自波佐利（意大利南部那不勒斯大都会市）的67岁男子，其左额头皮区域有一个椭圆形结节。取出一条活的孕雌虫，长15 - 16厘米，外周血中也无微丝蚴，未检测到雄虫。PCR测序证实与[具体名称]100%匹配。两名患者通过IgG ELISA检测[具体病原体]抗体均呈阳性。这些病例强调了人类丝虫病在意大利南部的持续传播，并突出了由于临床表现多样而带来的诊断挑战。发现一条无微丝蚴血症的孕雌虫表明该寄生虫在人类体内的生命周期存在复杂性，对人类作为严格终末宿主的观念提出了挑战。鉴于人类和犬类中该病的患病率不断上升，建议开展全面的流行病学研究。将丝虫病纳入国家法定疾病监测系统将改善病例识别和追踪，有助于更好地监测和控制这种人畜共患感染。
