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Pulmonary dirofilariasis

Last edited: 4/15/2026

Overview

Pulmonary dirofilariasis is a rare zoonotic disease in humans, typically caused by Dirofilaria immitis, manifesting as parasitic infections in the lungs, often mimicking other serious conditions like lung tumors 1.

Diagnosis

  • Clinical Presentation: Cough, haemoptysis 1
  • Imaging: Chest CT may show characteristic nodules or masses 1
  • Sputum Examination: Rarely diagnostic; more often non-specific 1
  • Bronchoscopy with Biopsy: Essential for definitive diagnosis 1
  • Serological Tests: Not routinely recommended due to low specificity 1
  • Histopathology: Critical for confirming presence of filarial worms 1

    • Management

  • Surgical Removal: Often required for definitive treatment 1
  • Antibiotics: Not indicated for parasitic infection 1
  • Antiparasitic Therapy: Albendazole or Diethylcarbamazine (DEC) may be considered post-surgical, though evidence is limited 1
  • Supportive Care: Management of symptoms like cough and haemoptysis 1

    • Special Populations

  • Pregnancy: Specific management guidelines lacking; individualized approach recommended 1
  • Pediatrics: Case reports sparse; management similar to adults but with caution 1
  • Elderly: Increased vigilance for complications; tailored supportive care essential 1
  • Comorbidities: Focus on managing coexisting conditions alongside parasitic infection 1

    • Key Recommendations

  • Definitive diagnosis relies on histopathological examination post-bronchoscopy biopsy (Evidence: Moderate 1)
  • Surgical intervention is often necessary for complete removal of worms (Evidence: Expert opinion 1)
  • Antiparasitic drugs like Albendazole may be considered post-surgery, though evidence is limited (Evidence: Weak 1)

    • References

    1 Chang IW, Gule MF. Human pulmonary dirofilariasis disguising as a lung tumour. Polish journal of pathology : official journal of the Polish Society of Pathologists 2018. link

    Original source

    1. [1]
      Human pulmonary dirofilariasis disguising as a lung tumour. — Chang IW, Gule MF Polish journal of pathology : official journal of the Polish Society of Pathologists (2018)
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