Subconjunctival and Submucosal Dirofilariasis

A 61-year-old male presented to the infectious disease clinic with a 3-day history of pain, redness, and sensation of irritation in his left eye. On physical examination, there was severe conjunctival congestion in the left eye. A slit-lamp exam showed a long white worm in the subconjunctiva. Surgical removal of the worm could not be done at the initial presentation as the worm moved out of the subconjunctiva. A course of albendazole and diethylcarbamazine was given. A few weeks later, the same patient presented with a history of nodular sensation in the oral cavity; on physical examination, there was a firm-hard nodular lesion in the left buccal mucosa, suspecting migrated worm, surgical excision was done, and histopathology demonstrated an adult nematode worm with a thick cuticle, muscle striations, and genital tubules consistent with Dirofilaria. A diagnosis of subconjunctival and submucosal dirofilariasis was made. One month later, the patient reported no new lesions. Dirofilaria, a filarial nematode that infects animals, accidentally infects humans through the bite of mosquitoes or black flies. Subcutaneous dirofilariasis is caused mainly by Dirofilariarepens. Ophthalmic involvement may be periorbital, subconjunctival, or intraocular. Identifying the worm in biopsy confirms the diagnosis and surgical removal of the worm is the treatment of choice. Anti-parasitic agents are of uncertain efficacy. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.