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Cited by 123Parasitic Diseases Research and TreatmentParasitic infections in humans and animalsHelminth infection and control

Public health aspects of dirofilariasis in the United States

Theis, J.H.·2005·Veterinary Parasitology
DOI 10.1016/j.vetpar.2005.04.007
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Abstract

Coin lesions in the human lung present significant differential diagnostic problems to the physician. There are at least 20 known causes of such lesions, including neoplastic lesions, infectious diseases, and granulomas. The human medical literature contains many misconceptions about the life cycle of Dirofilaria immitis, including the method of entry of the infective-stage larvae and the development of the young adult worm. These misconceptions have obscured the recognition of the clinical presentation of pulmonary dirofilariasis and the potential for D. immitis to lodge in many other areas of the human body besides the lung. Exposure to infective larvae of D. immitis is more common in humans than is currently recognized. Reported cases in humans reflect the prevalence in the canine population in areas of the United States. The veterinary literature provides compelling evidence that D. immitis is a vascular parasite, not an intracardiac one. Its presence in the right ventricle is a post-mortem artifact, because it has never been shown to be there by echocardiography or angiography in a living dog, even though these techniques have demonstrated adult D. immitis in the pulmonary, femoral, and hepatic arteries; posterior vena cava; and right atrium of live dogs. Physicians have taken the name "heartworm" literally, believing that the worm lives in the heart and only after it dies does it embolize to the pulmonary artery. However, the coin lesion is spherical in shape, not pyramidal, as embolic infarcts to the lung in humans are known to be. The coin lesion is an end-stage result of the parasite's death in the vascular bed of the lungs and the stimulation of a pneumonitis followed by granuloma formation. This pneumonitis phase of human pulmonary dirofilariasis is often not recognized by the radiologist because of the way pneumonitis is diagnosed and treated and because the developing nodule is obscured by the lung inflammation. Serologic methods for use in humans are needed for clinical evaluations of patients with pneumonitis living in highly enzootic D. immitis regions. As well, epidemiological surveys are needed to determine the real extent of this zoonotic infection.

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  • It is not infrequent to find worms of both D. immitis and D. repens in anatomical locations distinct from those commonly associated with each species.

    “It is not infrequent to find worms of both species in anatomical locations distinct from those commonly associated with each species.”

    From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [423]

  • D. immitis worms have been found in cranial, hepatic, intraocular, and mesenteric adipose tissues; testicular arteries; and conjunctival tissues.

    “D. immitis worms have been found in cranial, hepatic, intraocular, and mesenteric adipose tissues; testicular arteries; and conjunctival tissues (22,423)”

    From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [423]

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Authors
Theis, J. H.
Affiliations
University of California, Davis (US)
Corresponding author
Theis, J.H.
Venue
Veterinary Parasitology
Publisher
Elsevier BV
Published
2005-10
Volume
133
Issue
2-3
Pages
157-180
ISSN
0304-4017 (ISSN-L)
DOI
10.1016/j.vetpar.2005.04.007
OpenAlex
W2075239457
Cited by
123
References
140
Citations by year
2026: 2 · 2025: 4 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 14 · 2020: 6 · 2019: 6 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 9 · 2014: 7 · 2013: 7 · 2012: 4
FWCI
3.41
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Veterinary Parasitology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Parasitic infections in humans and animals
  • Health Sciences › Veterinary › Small Animals › Helminth infection and control
Keywords
pulmonary dirofilariasis, Dirofilaria immitis, solitary pulmonary nodule, zoonoses, canine heartworm disease, granuloma, serological diagnosis, United States
MeSH terms
Animals, Solitary Pulmonary Nodule, Diagnosis, Differential, Dirofilaria immitis, Dirofilariasis, Host-Parasite Interactions, Humans, Lung, Public Health, United States, Zoonoses

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