{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:38:09Z","timestamp":1787315889505,"version":"build-2736575974"},"reference-count":14,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Microorganisms"],"abstract":"<jats:p>We report the first confirmed case of persistent microfilaremia in a human host infected with Dirofilaria repens. A 54-year-old woman from an endemic area in Croatia presented with peripheral eosinophilia and dermatological symptoms. Over four months, microfilariae were repeatedly detected in her blood using thick smears and Knott\u2019s test, and the diagnosis was molecularly confirmed via COI gene sequencing and detection of Wolbachia endosymbionts. This case provides compelling evidence that D. repens can sustain a complete or near-complete life cycle in humans under specific conditions. Our findings have significant implications for clinical diagnostics, One Health surveillance, and public health interventions.<\/jats:p>","DOI":"10.3390\/microorganisms13102263","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T13:30:03Z","timestamp":1758893403000},"page":"2263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Not a Dead-End Host: First Confirmed Persistent Microfilaremia in Human Dirofilaria repens Infection"],"prefix":"10.3390","volume":"13","author":[{"given":"Martina Pere\u0161in","family":"Vranjkovi\u0107","sequence":"first","affiliation":[{"name":"University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamarija","family":"Vitko Havli\u010dek","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Kramar","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-7212","authenticated-orcid":false,"given":"Mirjana","family":"Balen Topi\u0107","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7901-3835","authenticated-orcid":false,"given":"David","family":"Beck","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3504-5271","authenticated-orcid":false,"given":"Daria","family":"Jurkovi\u0107 \u017dili\u0107","sequence":"additional","affiliation":[{"name":"Department for Bacteriology and Parasitology, Croatian Veterinary Institute, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6122-5958","authenticated-orcid":false,"given":"Ema","family":"Gagovi\u0107","sequence":"additional","affiliation":[{"name":"Department for Bacteriology and Parasitology, Croatian Veterinary Institute, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Relja","family":"Beck","sequence":"additional","affiliation":[{"name":"Department for Bacteriology and Parasitology, Croatian Veterinary Institute, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.pt.2023.12.007","article-title":"Zoonotic Dirofilariases: One, No One, or More than One Parasite","volume":"40","author":"Perlesn","year":"2024","journal-title":"Trends Parasitol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1186\/s13071-017-2434-8","article-title":"Subcutaneous Dirofilariosis (Dirofilaria repens): An Infection Spreading throughout the Old World","volume":"10","author":"Genchi","year":"2017","journal-title":"Parasites Vectors"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Fuehrer, H.-P., Morelli, S., Unterk\u00f6fler, M.S., Bajer, A., Bakran-Lebl, K., Dwu\u017cnik-Szarek, D., Farkas, R., Grandi, G., Heddergott, M., and Jokelainen, P. (2021). Dirofilaria spp. and Angiostrongylus Vasorum: Current Risk of Spreading in Central and Northern Europe. Pathogens, 10.","DOI":"10.3390\/pathogens10101268"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40249-025-01328-2","article-title":"Vectors, Host Range, and Spatial Distribution of Dirofilaria immitis and D. repens in Europe: A Systematic Review","volume":"14","author":"Hattendorf","year":"2025","journal-title":"Infect. Dis. Poverty"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"102482","DOI":"10.1016\/j.parint.2021.102482","article-title":"New Cases of Human Dirofilariosis on the Balkan Peninsula\u2014\u201cMasked Intruders\u201d Uncovered by a Surgeon","volume":"86","author":"Gabrielli","year":"2022","journal-title":"Parasitol. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"100306","DOI":"10.1016\/j.onehlt.2021.100306","article-title":"Dirofilaria repens Microfilaremia in Humans: Case Description and Literature Review","volume":"13","author":"Beck","year":"2021","journal-title":"One Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1017\/S0031182000007149","article-title":"A Phylogenetic Analysis of Filarial Nematodes: Comparison with the Phylogeny of Wolbachia Endosymbionts","volume":"122","author":"Casiraghi","year":"2001","journal-title":"Parasitology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.vetpar.2005.10.013","article-title":"Discrimination between Six Species of Canine Microfilariae by a Single Polymerase Chain Reaction","volume":"135","author":"Rishniw","year":"2006","journal-title":"Vet. 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Hyg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100153","DOI":"10.1016\/j.onehlt.2020.100153","article-title":"The Trends of Human Dirofilariasis in Croatia: Yesterday\u2014Today\u2014Tomorrow","volume":"10","author":"Capar","year":"2020","journal-title":"One Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1186\/s13071-018-3205-x","article-title":"Recent Advances on Dirofilaria repens in Dogs and Humans in Europe","volume":"11","author":"Capelli","year":"2018","journal-title":"Parasites Vectors"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"844","DOI":"10.4269\/ajtmh.19-0744","article-title":"Case report: Successful treatment of a patient with microfilaremic dirofilariasis using doxycycline","volume":"102","author":"Lechner","year":"2020","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1017\/S0031182013001108","article-title":"Anti-Wolbachia drug discovery and development: Safe macrofilaricides for onchocerciasis and lymphatic filariasis","volume":"141","author":"Taylor","year":"2014","journal-title":"Parasitology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s13071-017-2015-x","article-title":"Development of Dirofilaria immitis and Dirofilaria repens in Aedes japonicus and Aedes geniculatus","volume":"10","author":"Silaghi","year":"2017","journal-title":"Parasites Vectors"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/10\/2263\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T04:17:11Z","timestamp":1759119431000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/13\/10\/2263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":14,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["microorganisms13102263"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms13102263","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]}}}