{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:05:14Z","timestamp":1782932714252,"version":"3.54.5"},"reference-count":82,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Parasitology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0031182025000290_sec1a\"><jats:title\/><jats:p><jats:italic>Dirofilaria repens<\/jats:italic> is the primary etiological agent of human dirofilariosis in the Old World, with Italy reporting the highest number of cases in Europe. This study describes two new cases of <jats:italic>D. repens<\/jats:italic> infection in humans, in southern Italy, where canine dirofilariosis is endemic. The first case involved a 33-year-old man from Caserta (Campania, Southern Italy) who presented with a subcutaneous mass on the upper eyelid. Surgical excision revealed an immature female <jats:italic>D. repens<\/jats:italic> worm measuring 14 cm, lacking microfilariae in both the uterus and peripheral blood. The second case was a 67-year-old man from Pozzuoli (Metropolitan City of Naples, Southern Italy) with an oval-shaped nodule in the left frontal scalp region. A live gravid female <jats:italic>D. repens<\/jats:italic> worm measuring 15\u201316 cm was extracted, also without microfilariae in the peripheral blood and no male worm detected. PCR sequencing confirmed a 100% match with <jats:italic>D. repens<\/jats:italic>. Both patients tested positive for <jats:italic>D. repens<\/jats:italic> antibodies by IgG ELISA. These cases underscore the continuous spread of human dirofilariosis in southern Italy and highlight diagnostic challenges due to variable clinical presentations. The discovery of a gravid female without microfilaremia suggests complexities in the parasite\u2019s life cycle in humans, challenging the notion of humans as strict dead-end hosts. Given the rising prevalence in both humans and dogs, a comprehensive epidemiological study is recommended. Inclusion of dirofilariosis in the national surveillance system for notifiable diseases would improve case identification and tracking, aiding in better monitoring and control of this zoonotic infection.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0031182025000290","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T14:01:51Z","timestamp":1743775311000},"page":"399-408","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Uncovering human <i>Dirofilaria repens<\/i> infections: new cases in Southern Italy"],"prefix":"10.1017","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7242-8140","authenticated-orcid":false,"given":"Lavinia","family":"Ciuca","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Gabrielli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Forgione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaristo","family":"Di Napoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando","family":"Paciello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Panariello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Ascierto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Petrullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ortensia","family":"Montella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7564-3356","authenticated-orcid":false,"given":"Maria Paola","family":"Maurelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0975-2052","authenticated-orcid":false,"given":"Laura","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"S0031182025000290_ref24","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-018-0750-5"},{"key":"S0031182025000290_ref10","first-page":"234","article-title":"Subcutaneous human dirofilariosis by D. repens in South Italy: A case report","volume":"42","author":"Brindicci","year":"2019","journal-title":"New Microbiologica"},{"key":"S0031182025000290_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-018-3205-x"},{"key":"S0031182025000290_ref21","unstructured":"European Society of Dirofilariosis and Angiostrongylosis (ESDA) (2017) Guidelines for clinical management of human Dirofilaria infections. 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