A Case of Subconjunctival Dirofilariasis in Bulgaria

Abstract We report a case of subconjunctival invasion of Dirofilaria repens in a woman from Southern Bulgaria. Dirofilariasis is an extremely rare parasitic disease for Bulgaria. It occurs as an endemic parasitosis in the Mediterranean countries. It is caused by helminths of the genus Dirofilaria, which are parasites in dogs, cats, foxes, wolves – the final hosts of the parasite. It may very rarely occur in humans, the infection triggered by a bite of bloodsucking mosquitoes, which are the intermediate hosts of Dirofilaria. The clinical forms of dirofilariasis in humans are subcutaneous, pulmonary and ocular, the brain, testes and mammary glands being rarely affected. A 51-year-old patient presented with migrating edema in the area of the left temple and upper eyelid, with redness and swelling of the conjunctiva, as well as a subjective sense of movement under the eyelid of the left eye, lasting for about ten days. The subconjunctival localization of a moving 9.5-cm nematode was established, it was surgically removed and histologically studied. This case of ocular subconjunctival dirofilariasis is of clinical interest due to the rarely observed pathology.