Surgery for a thoracic gunshot wound reveals pleural infection with dirofilaria repens

Dirofilaria repens (D. repens) is a vector-borne filaroid helminth of carnivores, with dogs representing the major reservoirs of infestation. Humans are accidental hosts in which D. repens usually do not reach sexual maturity but may induce local inflammation, mainly in subcutaneous or ocular tissues. Here, we present the rare case of an incidental pleural D. repens infection in a young patient with a gunshot wound to the right upper chest. During thoracoscopy to remove the bullet from the dorsal chest wall, a small solitary worm was discovered in the pleural cavity on the diaphragm and later identified as D. repens. Our patient was asymptomatic regarding the parasite. D. repens is considered an emergent zoonotic pathogen in northern and central Europe and may be increasingly relevant for animals and human health. Spreading of the parasite is facilitated by climate changes and globalization.