Abdominal Subcutaneous Dirofilariasis Due to Dirofilaria repens in a 34-Year-Old Sicilian Woman: Diagnostic Challenges and Molecular Confirmation

Human subcutaneous dirofilariasis caused by Dirofilaria repens is an emerging zoonotic parasitic infection increasingly observed in southern Europe. We report a case of a woman from western Sicily, who likely acquired the infection locally through a mosquito bite. The high prevalence of D. repens in the local canine population (up to 20.4%) suggests a role of dogs as a probable reservoir for transmission to humans in the local population. With ultrasound analysis being inconclusive, only after surgical removal was the presence of an adult worm evident, and only after molecular analysis through DNA sequencing of the cytochrome oxidase subunit I gene (COI) could a definitive D. repens infection diagnosis be obtained. This case highlights the need for enhanced vector control, animal health surveillance and public awareness to limit the transmission to humans of D. repens. A correct parasitological diagnosis would be imperative for the recognition of human cases.