{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:00:55Z","timestamp":1787029255065,"version":"build-2736575974"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Purpose: Dirofilariasis is a zoonotic infectious disease caused by a species belonging to the Dirofilaria genus. Human dirofilariasis cases have increased in Europe in the last few decades. Dogs and wild canids represent the definitive hosts and principal reservoirs of Dirofilaria repens, while mosquito species are biological vectors. Humans act as accidental hosts, and clinical manifestations depend on the location of the worm in the organs or tissues. We described the first case of ocular dirofilariasis in the Aosta Valley region (Italy). Case description: a 62-year-old Italian woman complained of recurrent ocular redness, pain and discomfort, accompanied by itching and foreign body sensation in the right eye. The slit lamp biomicroscopic examination revealed conjunctival congestion on the temporal region of bulbar conjunctiva, and a long whitish vermiform mobile mass was detected under the conjunctiva. The anterior chamber showed no flare or cells in either eye, and the dilated fundus examination was normal. The worm was immediately surgically removed to prevent further migration, and was diagnosed morphologically and molecularly as D. repens. Following surgical removal, the symptoms resolved completely and rapidly, with no recurrence of ocular symptoms recorded during 12-month follow-up visits. Conclusions: Ocular dirofilariasis can lead to misdiagnosis due to its rare ocular manifestations, and it is considered an emergent zoonosis in European countries. Accurate diagnosis and control of ocular dirofilariasis by D. repens require a multidisciplinary approach under the One Health framework to effectively address this emergent zoonosis.<\/jats:p>","DOI":"10.3390\/pathogens14050423","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T07:49:36Z","timestamp":1745912976000},"page":"423","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["First Case of Human Ocular Dirofilariasis in the Aosta Valley Region: Clinical Management and Morphological-Molecular Confirmation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6686-5749","authenticated-orcid":false,"given":"Erik","family":"Mus","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-7678","authenticated-orcid":false,"given":"Annalisa","family":"Viani","sequence":"additional","affiliation":[{"name":"S.C. Animal Health, Azienda USL della Valle d\u2019Aosta, Localit\u00e0 Amerique 7\/l, 11020 Quart, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3018-3149","authenticated-orcid":false,"given":"Lorenzo","family":"Domenis","sequence":"additional","affiliation":[{"name":"Experimental Zooprofilactic Institute of Piedmont, Liguria, and Aosta Valley National Reference Centre for Wildlife Diseases (CeRMAS), Loc. Amerique 7\/G, 11020 Quart, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Maradei","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Valastro","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1857-7062","authenticated-orcid":false,"given":"Gianluca","family":"Marucci","sequence":"additional","affiliation":[{"name":"European Union Reference Laboratory for Parasites (EURL-P), Unit of Foodborne and Neglected Parasitic Diseases, Istituto Superiore di Sanit\u00e0, Viale Regina Elena 299, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio Giuseppe","family":"Giacomazzi","sequence":"additional","affiliation":[{"name":"Microbiology Unit, U. Parini Hospital, Azienda USL della Valle d\u2019Aosta, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Carla Maria","family":"Magnani","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, U. Parini Hospital, Azienda USL della Valle d\u2019Aosta, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Imparato","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Cometto","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-7591","authenticated-orcid":false,"given":"Adriano","family":"Casulli","sequence":"additional","affiliation":[{"name":"European Union Reference Laboratory for Parasites (EURL-P), Unit of Foodborne and Neglected Parasitic Diseases, Istituto Superiore di Sanit\u00e0, Viale Regina Elena 299, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9027-1642","authenticated-orcid":false,"given":"Riccardo","family":"Orusa","sequence":"additional","affiliation":[{"name":"Experimental Zooprofilactic Institute of Piedmont, Liguria, and Aosta Valley National Reference Centre for Wildlife Diseases (CeRMAS), Loc. Amerique 7\/G, 11020 Quart, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ventre","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Beauregard Hospital, Azienda USL della Valle d\u2019Aosta, Via L. Vaccari 5, 11100 Aosta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101570","DOI":"10.1016\/j.ajoc.2022.101570","article-title":"Subconjunctival human dirofilariasis by Dirofilaria repens in the Mediterranean Basin","volume":"26","author":"Blasco","year":"2022","journal-title":"Am. J. Ophthalmol. Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1128\/CMR.00012-12","article-title":"Human and animal dirofilariasis: The emergence of a zoonotic mosaic","volume":"25","author":"Mellado","year":"2012","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","first-page":"2","article-title":"Human dirofilariasis: An emerging zoonosis","volume":"3","author":"Reddy","year":"2013","journal-title":"Trop. Parasitol."},{"key":"ref_4","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_5","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_6","doi-asserted-by":"crossref","unstructured":"Fuehrer, H.P., Auer, H., Leschnik, M., Silbermayr, K., Duscher, G., and Joachim, A. (2016). Dirofilaria in Humans, Dogs, and Vectors in Austria (1978\u20132014)-From Imported Pathogens to the Endemicity of Dirofilaria repens. PLoS Neglected Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004547"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3316","DOI":"10.1128\/JCM.00379-10","article-title":"Diagnosis of canine vector-borne diseases in young dogs: A longitudinal study","volume":"48","author":"Otranto","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1645\/GE-1042R.1","article-title":"Experimental infection of Dirofilaria immitis in raccoon dogs","volume":"93","author":"Nakagaki","year":"2007","journal-title":"J. Parasitol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1292\/jvms.68.693","article-title":"Nematodes from raccoon dogs (Nyctereutes procyonoides viverrinus) introduced recently on Yakushima Island, Japan","volume":"68","author":"Sato","year":"2006","journal-title":"J. Vet. Med. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1292\/jvms.10-0512","article-title":"Prevalence of Dirofilaria immitis infection in living raccoon dogs assessed by hematological examination","volume":"73","author":"Kido","year":"2011","journal-title":"J. Vet. Med. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1007\/s00436-015-4820-5","article-title":"No evidence of Dirofilaria repens infection in red foxes (Vulpes vulpes) and raccoon dogs (Nyctereutes procyonoides) from Brandenburg, Germany","volume":"115","author":"Schulze","year":"2016","journal-title":"Parasitol. Res."},{"key":"ref_12","first-page":"35","article-title":"Dirofilaria immitis and D. repens in sylvatic reservoirs of Krasnodar Krai (Russian Federation)","volume":"6","author":"Kravchenko","year":"2016","journal-title":"Vet. Parasitol. Reg. Stud. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.vetpar.2011.01.012","article-title":"Changing climate and changing vector-borne disease distribution: The example of Dirofilaria in Europe","volume":"176","author":"Genchi","year":"2011","journal-title":"Vet. Parasitol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Shaikh, Z., Kar, P., Mohanty, S., Dey, M., and Samal, D.K. (2023). Ocular dirofilariasis: A report from Odisha. Indian J. Med. Microbiol., 45.","DOI":"10.1016\/j.ijmmb.2023.100388"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.14202\/vetworld.2019.1630-1643","article-title":"Vector-borne nematode diseases in pets and humans in the Mediterranean Basin: An update","volume":"12","author":"Tahir","year":"2019","journal-title":"Vet. World"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1007\/s00436-012-3206-1","article-title":"Evidences of increasing risk of dirofilarioses in southern Italy","volume":"112","author":"Giangaspero","year":"2013","journal-title":"Parasitol. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1186\/1756-3305-2-S1-S2","article-title":"Changing distribution patterns of canine vector borne diseases in Italy: Leishmaniosis vs. dirofilariosis","volume":"2","author":"Otranto","year":"2009","journal-title":"Parasites Vectors"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/1756-3305-5-76","article-title":"Molecular xenomonitoring of Dirofilaria immitis and Dirofilaria repens in mosquitoes from north-eastern Italy by real-time PCR coupled with melting curve analysis","volume":"5","author":"Latrofa","year":"2012","journal-title":"Parasites Vectors"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1046\/j.1365-2559.2001.01099.x","article-title":"Dirofilariasis due to Dirofilaria repens in Italy, an emergent zoonosis: Report of 60 new cases","volume":"38","author":"Pampiglione","year":"2001","journal-title":"Histopathology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1365-2559.2008.03197_a.x","article-title":"Dirofilarial human cases in the Old World, attributed to Dirofilaria immitis: A critical analysis","volume":"54","author":"Pampiglione","year":"2009","journal-title":"Histopathology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.4269\/ajtmh.2011.10-0719","article-title":"Human ocular infection with Dirofilaria repens (Railliet and Henry, 1911) in an area endemic for canine dirofilariasis","volume":"84","author":"Otranto","year":"2011","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/1756-3305-5-55","article-title":"Vector-borne diseases--constant challenge for practicing veterinarians: Recommendations from the CVBD World Forum","volume":"5","author":"Baneth","year":"2012","journal-title":"Parasites Vectors"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/32160","article-title":"A molecular evolutionary framework for the phylum Nematoda","volume":"392","author":"Blaxter","year":"1998","journal-title":"Nature"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.ijpara.2003.10.004","article-title":"Mapping the presence of Wolbachia pipientis on the phylogeny of filarial nematodes: Evidence for symbiont loss during evolution","volume":"34","author":"Casiraghi","year":"2004","journal-title":"Int. J. Parasitol."},{"key":"ref_25","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_26","first-page":"ofz157","article-title":"The First Case of Elbow Bursitis Caused by Dirofilaria repens in Humans","volume":"6","author":"Szostakowska","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.parint.2015.03.001","article-title":"Dirofilariasis by Dirofilaria repens: An imported case and a brief review","volume":"64","author":"Rodrigues","year":"2015","journal-title":"Parasitol. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4103\/0974-777X.81702","article-title":"Subcutaneous human dirofilariasis due to dirofilaria repens: Report of two cases","volume":"3","author":"Permi","year":"2011","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1017\/S0022149X12000077","article-title":"Histological and molecular confirmation of the fourth human case caused by Dirofilaria repens in a new endemic region of Slovakia","volume":"87","author":"Ondriska","year":"2013","journal-title":"J. Helminthol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1089\/vbz.2019.2502","article-title":"Knowledge About Emerging Zoonotic Vector-Borne Parasites Dirofilaria immitis and Dirofilaria repens in Finland: Questionnaire Survey to Medical Doctors and Veterinarians","volume":"20","author":"Mikola","year":"2020","journal-title":"Vector-Borne Zoonotic Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3126\/nepjoph.v6i2.11712","article-title":"Sac over the sac-a rare case of subcutaneous dirofilariasis over the lacrimal sac area","volume":"6","author":"Shankar","year":"2014","journal-title":"Nepal. J. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"298","DOI":"10.4103\/0301-4738.114111","article-title":"Periorbital dirofilariasis-clinical and imaging findings: Live worm on ultrasound","volume":"61","author":"Gopinath","year":"2013","journal-title":"Indian J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E97","DOI":"10.1097\/IOP.0000000000001415","article-title":"Subconjunctival Dirofilariasis Presenting as Orbital Cellulitis","volume":"35","author":"Shambhu","year":"2019","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"76","DOI":"10.4103\/0301-4738.91343","article-title":"Subconjunctival dirofilariasis mimicking scleritis: First report from Western India","volume":"60","author":"Sangit","year":"2012","journal-title":"Indian J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S0255-0857(21)02475-0","article-title":"Subtenons infection by Dirofilaria repens","volume":"24","author":"Sathyan","year":"2006","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.4103\/ijo.IJO_79_19","article-title":"Rare cause of floaters: A motile live worm in vitreous cavity","volume":"67","author":"Rajan","year":"2019","journal-title":"Indian J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"349","DOI":"10.4103\/0974-9233.97965","article-title":"Dirofilaria in the anterior chamber: A rare occurrence","volume":"19","author":"Chopra","year":"2012","journal-title":"Middle East Afr. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"NP5","DOI":"10.1177\/1120672118803519","article-title":"There is a worm in my eye! Ocular dirofilariasis","volume":"29","author":"Montesel","year":"2019","journal-title":"Eur. J. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Mackenzie, J.S., and Jeggo, M. (2019). The One Health Approach-Why Is It So Important?. Trop. Med. Infect. Dis., 4.","DOI":"10.3390\/tropicalmed4020088"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/5\/423\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:23:03Z","timestamp":1760030583000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/5\/423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["pathogens14050423"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14050423","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}