Autochthonous human subconjunctival dirofilariasis in europe: a case report from Italy and literature review

Autochthonous human dirofilariasis cases have increased in Europe for the last few decades probably due to climate change, including increased temperature and a greater distribution of the biological vector. Dirofilariasis can present in different ways depending on the species, leading clinicians to incorrect diagnoses. Here we present a case of a 75-year-old man from Italy with no travel history presenting with a of subconjunctival nodule caused by Dirofilaria repens. We review European cases of the last ten years including 17 cases of subconjunctival dirofilariasis. In severe cases, the definitive diagnosis was reached late after initial erroneous hypotheses such as conjunctivitis or scleritis. In almost all cases the responsible agent was D. repens and only in one case D. immitis. We underline the importance of considering dirofilariasis as a possible diagnosis even in temperate regions. The One Health approach is increasingly necessary to manage the spread of dirofilariasis as well as other zoonoses.