Pulmonary Dirofilaria immitis infection and concurrent pleural lymphangiomatosis in a young woman from Costa Rica: a diagnostic challenge after twenty years of silence
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| Autoren: | , , , , , , |
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| Format: | artículo preliminar |
| Publikationsdatum: | 2026 |
| Beschreibung: | Human dirofilariasis is an underreported, vector-borne disease produced by the filarioid Dirofilaria immitis. A case of pulmonary dirofilariasis is reported in a woman from Costa Rica, manifesting respiratory distress, marked eosinophilia of 47%, and severe chylothorax. Pleura biopsies showed a lymphoplasmacytic reaction with eosinophils and bronchoalveolar fluid analysis revealed 28S and ITS1 fragments 100% and 99.3% similar to D. immitis, respectively, and a coxA sequence identical to Wolbachia from D. immitis. Other infectious, autoimmune and malignant causes were excluded through an extensive diagnostic work-up. Initial treatment included methylprednisolone, albendazole and a subsequent course of albendazole plus doxycycline, but the chylothorax recurred. Biopsy of the left upper lobe confirmed a pleural lymphangiomatosis. The patient was discharged with continued treatment, but clinically stable. This case illustrates the diagnostic complexity in which filariasis and underlying lymphadenopathies may coexist in endemic regions, and highlights the value of an integrated clinical, molecular and histopathological approach. |
| Land: | Kérwá |
| Institution: | Universidad de Costa Rica |
| Repositorio: | Kérwá |
| Sprache: | Inglés |
| OAI Identifier: | oai:kerwa.ucr.ac.cr:10669/104876 |
| Online Zugang: | https://www.ajtmh.org/ https://hdl.handle.net/10669/104876 |
| Stichwort: | Enfermedades transmitidas por vectores Diagnóstico molecular Histopatología Enfermedades pulmonares Costa Rica |