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Revista do Instituto de Medicina Tropical de São Paulo

Print version ISSN 0036-4665

Rev. Inst. Med. trop. S. Paulo vol.37 no.6 São Paulo Nov./Dec. 1995

http://dx.doi.org/10.1590/S0036-46651995000600009 

REVIEW

 

Human pulmonary dirofilariasis: a review

 

Dirofilaríase humana pulmonar: revisão

 

 

Rosângela Rodrigues-SilvaI; Hércules MouraII; Cerusa DreyerIII; Luiz ReyIV

IDepartamento de Helmintologia, IOC/FIOCRUZ
IIDepartamento de Patologia e Laboratórios, UERJ & Hospital Evandro Chagas, FIOCRUZ
IIIDepartamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, FIOCRUZ
IVDepartamento de Medicina Tropical, IOC/FIOCRUZ

Correspondence to

 

 


SUMMARY

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 unneccessary surgery. These techniques may reveal the true prevalence of this parasitic infection in our environment.

Keywords: Human pulmonary dirofilariasis; Epidemiology; Dirofilaria immitis; Dirofilaria repens; Brazil.


RESUMO

Os autores realizaram minuciosa revisão sobre a distribuição geográfica, a clínica, a patologia e o diagnóstico da dirofilaríase pulmonar humana. Esta zoonose, que tem como principal agente etiológico a Dirofilaria immitis, é um problema médico porque produz um quadro clínico, embora benigno, que se confunde com neoplasia e, assim interpretado, pode conduzir o paciente à cirurgia do tórax. Dos 229 casos citados na literatura, apenas 17 foram descritos no Brasil, apesar da existência de condições muito favoráveis à transmissão da infecção para o homem, admitindo-se portanto, que é uma parasitose subdiagnosticada. Finalmente, a importância do diagnóstico diferencial entre dirofilaríase e neoplasias pulmonares nos casos de presença de nódulo solitário subpleural ("coin lesion") é destacada, além do que o desenvolvimento e aprimoramento de técnicas modernas de diagnóstico imunológico são essenciais para distinguir esta doença benigna de outras patologias mais sérias e evitar cirurgias desnecessárias. Estas técnicas poderão fornecer a prevalência real da parasitose em nosso meio.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

ACKNOWLEDGMENTS

We wish to thank Prof. José Roberto Machado e Silva, Departamento de Patologia e Laboratórios, Universidade do Estado do Rio de Janeiro for critical suggestions, and Prof. Roberto Magalhães Pinto, Departamento de Helmintologia, IOC-FIOCRUZ for a critical review and translation of the text.

 

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Correspondence to:
Rosângela Rodrigues e Silva
Laboratório de Helmintos Parasitos de Vertebrados, Departamento de Helmintologia, Instituto Oswaldo Cruz, FIOCRUZ
CP 926
21045-900 Rio de Janeiro, RJ, Brasil

Recebido para publicação em 11/05/1995.
Aceito para publicação em 07/11/1995.