Introduction. The presence of mosquitoes and the abundance of microfilariae in dogs are considered of great risk for invading humans with dirofilariasis. We present an extremely rare case of Dirofilaria repens in the periorbital subcutaneous area, diagnosed for the first time in Bulgaria by magnetic resonance imaging (MRI).
Case presentation. A 39-year-old woman presented for swelling of the eyelid and eye redness, sensation of movement, irritation and pain. MRI was performed in the axial, coronary and sagittal planes, with pulse sequences T1 W, T2 tse_dix, T2 vibe_fs. On the base of the anamnestic data and pathologic changes identified by MRI, which indicated the presence of Dirofilaria, the patient was referred to an eye surgeon. After the parasitological studies, two immature female parasites of the species Dirofilaria repens (larvae; Onchocercidae; Nematoda) were identified.
Conclusions. MRI is a non-invasive and effective diagnostic method for assessing changes in the proximity and the affected areas of Dirofilaria repens, to determine the exact location, for subsequent surgical access and rapid removal of the parasite.
Keywords: diagnostic algorithm, Dirofilaria repens, magnetic resonance imaging.
Mitko A. MITEV
Department of Medical Physics, Biophysics, Roentgenology and Radiology, Faculty of Medicine, Department of Diagnostic Imaging, University Hospital ‘Prof. St. Kirkovich’, Trakia University, Bulgaria
Address: Stara Zagora, 6000 Stara Zagora, Bulgaria
E-mail: email@example.com; Phone +359 88 770 6079