Purpose

Dirofilariasis caused by the filarial nematode Dirofilaria repens is mainly a disease of dogs and other carnivores. Also, humans can be accidentally infected with this parasite. The infective third-stage filariform larvae are transmitted by various species of mosquitoes. Until this day, a total of 17 human cases caused by D. repens have been diagnosed in Slovakia, 11 subcutaneous, 4 ocular, 1 pulmonary and 1 in the epididymis. The aim of this report was to describe an unusual clinical case of dirofilariasis of the scrotum.

Methods

Extirpated worm was subjected to the molecular and histological identification. PCR for the amplification of cytochrome oxidase subunit 1 (CO1) was performed using specific D. repens primer pair.

Results

Here we document the 13th case of human dirofilariasis in a 46-year-old man from southwestern Slovakia. Very rare in humans, genital involvement manifests itself as pseudotumor nodule affecting the epididymis. The patient consulted a general practitioner due to a palpable subcutaneous lump in the scrotum. Routine laboratory analysis revealed blood eosinophilia (16.6%). The ultrasound examination was indicated, and subsequently, surgical excision of the right epididymal nodule was performed. On the basis of histological microscopic examination and PCR-based detection, the helminth was identified as Dirofilaria repens. This represents the ninth case of autochthonous dirofilariasis in Slovakia.

Conclusions

The majority of D. repens infections were recorded in southwestern regions of Slovak Republic, which are considered to be endemic areas for canine dirofilariasis. Our described patient also comes from southwestern part of Slovakia (Topoľníky, Dunajská Streda region).

中文翻译：

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附睾假瘤，罕见的人类双丝虫病临床表现：斯洛伐克西南部丝虫病本地病例报道。

目的

由丝状线虫引起的双丝虫病主要是狗和其他食肉动物的疾病。同样，人类可能会意外地被这种寄生虫感染。感染性的第三阶段丝状幼虫通过各种蚊子传播。到今天为止，斯洛伐克共诊断出17例由白毛病引起的人类病例，皮下有11例皮下，4眼，1例肺和1例。该报告的目的是描述阴囊丝虫病的罕见临床病例。

方法

对灭绝的蠕虫进行分子和组织学鉴定。使用特异的D. repens引物对进行PCR，扩增细胞色素氧化酶亚基1（CO1）。

结果

在这里，我们记录了斯洛伐克西南部一名46岁男子中的第13例人铁丝虫病。生殖器官受累在人类中非常罕见，表现为影响附睾的假瘤结节。由于阴囊中有明显的皮下肿块，患者咨询了全科医生。常规实验室分析显示血液嗜酸性粒细胞增多（16.6％）。需进行超声检查，随后进行右附睾结节的手术切除。在组织学显微镜检查和基于PCR的检测的基础上，蠕虫被鉴定为Dirofilaria repens。这代表了斯洛伐克的第九例本地丝虫病。

结论

大部分D. repens感染都记录在斯洛伐克共和国的西南地区，该地区被认为是犬丝虫病的流行地区。我们描述的患者也来自斯洛伐克的西南部（Topoľníky，DunajskáStreda地区）。