Rodrigues-Silva R, Moura H, Dreyer G, Rey L
Departamento de Helmintologia, IOC/FIOCRUZ, Rio de Janeiro, Brasil.
Rev Inst Med Trop Sao Paulo. 1995 Nov-Dec;37(6):523-30. doi: 10.1590/s0036-46651995000600009.
The authors presented a detailed summary of the geographical distribution, clinical and pathological aspects of human pulmonary dirofilariasis. Although benign, this zoonosis, of which Dirofilaria immitis is the major etiological agent, represents a medical problem since it produces symptoms which may be confused with neoplasia and thus may subject patients to unnecessary thoracic surgery. Of 229 cases cited in the literature, only 17 were reported in Brazil, despite the existence of highly favorable conditions for the transmission of this infection in man. Thus it may well be that this parasitic infection remains underdiagnosed. Finally, the importance of a differential diagnosis between dirofilariasis and pulmonary neoplasia is emphasized in cases where there is a solitary subpleural nodule ("coin lesion") present. In addition, the development and improvement of modern immunological diagnostic techniques are essential to distinguish this benign disease from other pathological conditions and thus avoid unnecessary surgery. These techniques may reveal the true prevalence of this parasitic infection in our environment.
作者们详细总结了人类肺丝虫病的地理分布、临床和病理方面。尽管这种人畜共患病是良性的，其主要病原体为犬恶丝虫，但它仍是一个医学问题，因为它所产生的症状可能与肿瘤相混淆，从而可能使患者接受不必要的胸外科手术。在文献中引用的229例病例中，巴西仅报告了17例，尽管巴西存在有利于这种感染在人类中传播的极为有利的条件。因此，很可能这种寄生虫感染仍未得到充分诊断。最后，在出现孤立性胸膜下结节（“钱币状病变”）的病例中，强调了丝虫病与肺肿瘤之间鉴别诊断的重要性。此外，现代免疫诊断技术的发展和改进对于将这种良性疾病与其他病理状况区分开来并因此避免不必要的手术至关重要。这些技术可能揭示这种寄生虫感染在我们环境中的真实流行情况。
