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Omental dirofilariasis caused by Dirofilaria repens; visceralisation in a patient with diabetes mellitus

Authors:

C. J. Weerasekera ,

University of Sri Jayewardenepura, Nugegoda, LK
About C. J.
Department of Parasitology, Faculty of Medical Sciences
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C. Hapuachchige,

National Cancer Institute (Apeksha Hospital), Maharagama, LK
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Y. M. T. Y. Wijeratne,

National Cancer Institute (Apeksha Hospital), Maharagama, LK
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R. Goonesinghe,

National Cancer Institute (Apeksha Hospital), Maharagama, LK
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D. R. Wickremasinghe,

University of Sri Jayewardenepura, Nugegoda, LK
About D. R.
Department of Parasitology, Faculty of Medical Sciences
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T. C. Yahathugoda,

University of Ruhuna, Galle, LK
About T. C.
Filariasis Research Training and Services Unit, Faculty of Medicine
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S. Ranasinghe

University of Sri Jayewardenepura, Nugegoda, LK
About S.
Department of Parasitology, Faculty of Medical Sciences
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Abstract

Visceral manifestations due to zoonotic Dirofilaria repens have not been reported in Sri Lanka. A 46-year-old woman with type 2 diabetes mellitus presented with abdominal pain and ankle oedema. There was ultrasonographic evidence of ascites and laparoscopy was performed to exclude malignancy. Cytology of ascitic fluid revealed inflammatory cells, and histology of omental biopsy showed a cross-section of a worm within a granuloma. The presence of cuticular ridges, tall coelomyarian muscles, prominent lateral chords and the presence of developing eggs within a uterine tube was compatible with female Dirofilaria repens. Blood was negative for microfilariae. She was treated with halfdose diethylcarbamazine (DEC) for fourteen days. Ascites persisted, albeit treatment. Therefore, repeat laparoscopy and infracolic omentectomy were performed. Repeat cytology and histology revealed no abnormalities, which was attributed to the complete removal of the worm. Whether immunosuppression with diabetes mellitus led to visceralisation of dirofilariasis is a concern.
How to Cite: Weerasekera, C.J., Hapuachchige, C., Wijeratne, Y.M.T.Y., Goonesinghe, R., Wickremasinghe, D.R., Yahathugoda, T.C. and Ranasinghe, S., 2021. Omental dirofilariasis caused by Dirofilaria repens; visceralisation in a patient with diabetes mellitus. Journal of the Ceylon College of Physicians, 52(2), pp.105–108. DOI: http://doi.org/10.4038/jccp.v52i2.7936
Published on 31 Dec 2021.
Peer Reviewed

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