A case of pulmonary dirofilariasis in Ferrara, Italy

The pulmonary filariasis is a rare entity and it is caused by a dog worm (Dirofilaria) that is transmitted to humans by mosquitoes. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle, dies and then embolizes the pulmonary vessels causing a small pulmonary infarction. Usually it is casually identified by chest radiography, done for other reasons, in asymptomatic patients; the coin-lesion shape is generally presumed to be neoplastic. We reported a case of human pulmonary filariasis in a man who shown multiple lung coin-lesions shaped presumed to be neoplastic. The patient underwent surgery with double-wedge resection of the right lung and he was discharged on the fifth post-operative day. The Dirofilariasis incidence is increasing in the canine population, making human pulmonary dirofilariasis likely to occur. The differential diagnosis of a solitary pulmonary nodule includes primary lung cancer, metastatic cancer, infectious disease, septic embolism, Wegner's granulomatosis, pulmonary echinococcosis and reumatoid nodules. No single preoperative laboratory test has been a diagnostic value. Human pulmonary dirofilariasis should be considered in the differential diagnosis of solitary or multiple subpleural, non calcified pulmonary nodules in the clinical and appropriated epidemiological setting, since more cases of this infectious disease are likely to be found with greater awareness of this condition.