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      Case Report: Successful Treatment of a Patient with Microfilaremic Dirofilariasis Using Doxycycline

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          Abstract.

          We report the case of a 56-year-old woman with microfilaremic dirofilariasis due to Dirofilaria repens, which is a very rare condition in humans. Of note, just one of six large-volume blood samples of this patient was positive for microfilariae. Polymerase chain reaction (PCR) and sequencing of the parasite gene determined the geographic origin of the causative helminth. The patient was treated successfully with doxycycline. This drug was chosen because of the patient’s reluctance to the use of ivermectin and to provide an anthelmintic effect by targeting the bacterial endosymbiont Wolbachia present in most filarial species.

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          Human and animal dirofilariasis: the emergence of a zoonotic mosaic.

          Fernando Simón, Mar Siles-Lucas, Rodrigo Morchón … (2012)
          Dirofilariasis represents a zoonotic mosaic, which includes two main filarial species (Dirofilaria immitis and D. repens) that have adapted to canine, feline, and human hosts with distinct biological and clinical implications. At the same time, both D. immitis and D. repens are themselves hosts to symbiotic bacteria of the genus Wolbachia, the study of which has resulted in a profound shift in the understanding of filarial biology, the mechanisms of the pathologies that they produce in their hosts, and issues related to dirofilariasis treatment. Moreover, because dirofilariasis is a vector-borne transmitted disease, their distribution and infection rates have undergone significant modifications influenced by global climate change. Despite advances in our knowledge of D. immitis and D. repens and the pathologies that they inflict on different hosts, there are still many unknown aspects of dirofilariasis. This review is focused on human and animal dirofilariasis, including the basic morphology, biology, protein composition, and metabolism of Dirofilaria species; the climate and human behavioral factors that influence distribution dynamics; the disease pathology; the host-parasite relationship; the mechanisms involved in parasite survival; the immune response and pathogenesis; and the clinical management of human and animal infections.
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            Lymphatic filariasis and onchocerciasis.

            Mark Taylor, Achim Hoerauf, Moses J. Bockarie (2010)
            Lymphatic filariasis and onchocerciasis are parasitic helminth diseases that constitute a serious public health issue in tropical regions. The filarial nematodes that cause these diseases are transmitted by blood-feeding insects and produce chronic and long-term infection through suppression of host immunity. Disease pathogenesis is linked to host inflammation invoked by the death of the parasite, causing hydrocoele, lymphoedema, and elephantiasis in lymphatic filariasis, and skin disease and blindness in onchocerciasis. Most filarial species that infect people co-exist in mutualistic symbiosis with Wolbachia bacteria, which are essential for growth, development, and survival of their nematode hosts. These endosymbionts contribute to inflammatory disease pathogenesis and are a target for doxycycline therapy, which delivers macrofilaricidal activity, improves pathological outcomes, and is effective as monotherapy. Drugs to treat filariasis include diethylcarbamazine, ivermectin, and albendazole, which are used mostly in combination to reduce microfilariae in blood (lymphatic filariasis) and skin (onchocerciasis). Global programmes for control and elimination have been developed to provide sustained delivery of drugs to affected communities to interrupt transmission of disease and ultimately eliminate this burden on public health. Copyright © 2010 Elsevier Ltd. All rights reserved.
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              Wolbachia bacterial endosymbionts of filarial nematodes.

              Mark Taylor, Claudio Bandi, Achim Hoerauf (2005)
              Filarial nematodes are important helminth parasites of the tropics and a leading cause of global disability. They include species responsible for onchocerciasis, lymphatic filariasis and dirofilariasis. A unique feature of these nematodes is their dependency upon a symbiotic intracellular bacterium, Wolbachia, which is essential for normal development and fertility. Advances in our understanding of the symbiosis of Wolbachia bacteria with filarial nematodes have made rapid progress in recent years. Here we summarise our current understanding of the evolution of the symbiotic association together with insights into the functional basis of the interaction derived from genomic analysis. Also we discuss the contribution of Wolbachia to inflammatory-mediated pathogenesis and adverse reactions to anti-filarial drugs and describe the outcome of recent field trials using antibiotics as a promising new tool for the treatment of filarial infection and disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Am J Trop Med Hyg
                Journal ID (iso-abbrev): Am. J. Trop. Med. Hyg
                Journal ID (publisher-id): tpmd
                Journal ID (hwp): tropmed
                Title: The American Journal of Tropical Medicine and Hygiene
                Publisher: The American Society of Tropical Medicine and Hygiene
                ISSN (Print): 0002-9637
                ISSN (Electronic): 1476-1645
                Publication date (Print): April 2020
                Publication date (Electronic): 10 February 2020
                Publication date PMC-release: 10 February 2020
                Volume: 102
                Issue: 4
                Pages: 844-846
                Affiliations
                [1 ]Division Medizinische Mikrobiologie, Paracelsus Medizinische Privatuniversität Salzburg, Universitätsinstitut für Medizinisch-Chemische Labordiagnostik, Salzburg, Austria;
                [2 ]General Practioner, Salzburg, Austria;
                [3 ]Abteilung für Medizinische Parasitologie, Institut für Spezifische Prophylaxe und Tropenmedizin, Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Wien, Vienna, Austria;
                [4 ]Nationales Referenzzentrum für Tropische Infektionserreger, Bernhard-Nocht-Institut für Tropenmedizin, Hamburg, Germany
                Author notes
                [* ]Address correspondence to Arno M. Lechner, Division Medizinische Mikrobiologie, Paracelsus Medizinische Privatuniversität Salzburg, Universitätsinstitut für Medizinisch-Chemische Labordiagnostik, Müllner Hauptstrasse 48, Salzburg A-5020, Austria. E-mail: a.lechner@ 123456salk.at

                Authors’ addresses: Arno M. Lechner and Jan Marco Kern, Division Medizinische Mikrobiologie, Paracelsus Medizinische Privatuniversität Salzburg, Universitätsinstitut für Medizinisch-Chemische Labordiagnostik, Salzburg, Austria, E-mails: a.lechner@ 123456salk.at and j.kern@ 123456salk.at . Herbert Gastager, General Practioner, Salzburg, Austria, E-mail: dr.gastager@ 123456aon.at . Birgit Wagner, Abteilung für Medizinische Parasitologie, Institut für Spezifische Prophylaxe und Tropenmedizin, Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Wien, Austria, E-mail: birgit.wagner@ 123456meduniwien.ac.at . Dennis Tappe, Nationales Referenzzentrum für tropische Infektionserreger, Bernhard-Nocht-Institut für Tropenmedizin, Hamburg, Germany, E-mail: tappebnitm@ 123456de .

                Article
                Publisher ID: tpmd190744
                DOI: 10.4269/ajtmh.19-0744
                PMC ID: 7124902
                PubMed ID: 32043447
                SO-VID: 8099fb11-a491-4cbf-bf5a-b29a6277fa1f
                Copyright © © The American Society of Tropical Medicine and Hygiene
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 08 October 2019
                Date accepted : 15 December 2019
                Page count
                Pages: 3
                Categories
                Subject: Articles

                ScienceOpen disciplines: Infectious disease & Microbiology
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology

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