Zoonotic Filariasis Caused by Novel Brugia sp. Nematode, United States, 2011 (http://wwwnc.cdc.gov/eid/article/20/7/13-1654)

摘要

To the Editor: Zoonotic brugian filariasis is an incidental infection of humans with Brugia spp. nematodes that primarily parasitize nonhuman vertebrates, rarely humans (1–3). In contrast to classical lymphatic filariasis caused by B. malayi and B. timori, which are found in Asia, most zoonotic Brugia infections have been reported from the northeastern United States (2,3) or South America (3). We report a case of symptomatic brugian infection in a New York City resident who had not traveled to the Eastern Hemisphere. In 2011, a 53-year-old White man first noted tenderness and swelling behind his penis and in his right groin after having fallen 3 months earlier. The tenderness was relieved by nonsteroidal antiinflammatory drugs, but the swelling continued; an oral antimicrobial drug, prescribed for presumed cellulitis, produced no improvement. At the time of examination, the patient had no fever or other signs or symptoms. Only a 3.0-cm × 3.0-cm firm, nonfixed right inguinal nodule without warmth or tenderness was noted. Laboratory findings were remarkable for total leukocytes of 6.4 × 109, eosinophilia (12%, 600 cells/mm3), decreased hemoglobin level (10.0 g/dL), and low hematocrit of 31.2%. An excisional biopsy sample revealed intralymphatic adult nematodes with viable-appearing microfilaria (online Technical Appendix Figure, wwwnc.cdc.gov/EID/ article/20/7/13-1654-Techapp1.pdf).