Testicular schistosomiasis mimicking hydrocele in a child: a case report.

Schistosomiasis is a disease of profound public health importance worldwide. Testicular schistosomiasis (TS) is however still considered as a rare entity despite the burden of the disease. We report a case of a 9 year old male who presented with features suggestive of testicular hydrocele. The spermatic cord and testis were seen as thickened lesion on examination and a biopsy taken revealed calcified ova of Schistosoma haematobium. This is being reported to enhance increased suspicion amongst surgeons in cases of testicular masses within endemic settings like Nigeria.

Funiculitis due to Schistosoma haematobium: uncommon diagnosis using parasitologic analysis of semen.

Schistosomal funiculitis is one of the rare localizations of longstanding chronic infection with schistosomiasis. We report a case of a 24-year-old-man who experienced iliac fossa pain and weight loss eight years after his last trip to Mali. Clinical diagnosis of lesions in the genitourinary tract due to schistosomiasis and biologic analysis are required to diagnose this uncommon localization of schistosomiasis.

Human dirofilariasis in Italy: a new case in the spermatic cord.

A new case of human dirofilariasis associated with Dirofilaria (Nochtiella) repens (Nematoda, Filarioidea, Onchocercidae) located in the spermatic cord is reported in a 71-year-old man from the province of Campobasso (Central Italy). When clinical signs pointed to a testicular tumor, a monolateral orchifuniculectomy was performed. According to the scientific literature, this case appears to be exceptional in its location, being only the eighth such case recorded in the world until now. The nematode, as well as the presence of vectors suitable for its transmission, had already been observed both in dogs and in humans (3 subcutaneous cases) in the same geographical area.

[Clinical and parasitological diagnosis of human dirofilariasis]. / Klinicheskii i parazitologicheskii diagnoz dirofiliarioza cheloveka.

The paper reports two new cases of human dirofiliriasis (its causative agent is Dirofiliria repens) with a rare clinical diagnosis of funiculitis of the right scrotal spermatic cord in a 12-year-old boy from the Tambov Region and of erysipelatous inflammation of the outer side of the right leg in a 68-year-old woman who resides in Moscow and lives in her country house in the Shakhovsky District, Moscow Region, in summer. Both cases of invasion are regarded as local. The bodies of the D. repens females detected measured 110 x 0.476-0.48 and 135 x 0.56-0.60 mm, respectively, and the females were identified as impubertal and pubertal, but infecund. In the former case, dirofiliriasis was an etiological factor of spermatic cord funiculitis. In the latter case, the location of Dirofiliria provoked prolonged (7-month) erysipelatous inflammation. Emphasis is placed on the implication of dirofiliriasis in human pathology. To have a more intimate knowledge of parasitic etiology will help physicians in making a differential diagnosis of dirofiliriasis and in elaborating a correct treatment policy after a clinical and parasitological diagnosis is established.

Human Dirofilaria repens infection in Hungary: a case in the spermatic cord and a review of the literature.

Orchiectomy was performed in a 37-year-old Hungarian man exhibiting a swelling in his right testicle. Histology revealed a nodule attached to the spermatic cord, consisting of a granulomatous tissue around sections of a nematode. The worm was identified as Dirofilaria repens, an uncommon parasite in Hungary. As the patient had been abroad only in Italy where cases of dirofilariosis in dogs and humans are relatively frequent, it is assumed that the infection might have been acquired in that country 5 years earlier. This is the fifth case, published so far in the world, of such a localization in a human. The human cases of dirofilariosis reported in Hungary are reviewed.

Ultrasonographic detection of living adult Wuchereria bancrofti using a 3.5-MHz transducer.

Adult Wuchereria bancrofti can be readily detected by ultrasound in the lymphatic vessels of the spermatic cord with a 7.5-MHz transducer, but most ultrasound machines in developing countries are equipped with 3.5-MHz transducers. To assess the potential for ultrasound as a tool for diagnosis and epidemiologic assessment in lymphatic filariasis, we compared the performance of 3.5-MHz and 7.5-MHz transducers in 61 men in Recife, Brazil. All men had three ultrasound examinations using a 3.5 MHz transducer and an examination with a 7.5-MHz probe. Using the 7.5-MHz transducer, adult W. bancrofti were detected in 41 men; 81 adult worm nests were detected. Sixty-four (79%) nests were detected with the 3.5-MHz probe, each on all three examinations. The 3.5-MHz probe correctly identified 35 (85.4%) of 41 men as infected; sensitivity increased with lymphatic vessel diameter. Ultrasonographic examination with a 3.5-MHz transducer is a sensitive method for detection of adult W. bancrofti in men and merits consideration as a tool for rapid epidemiologic assessment.

[Dirofilaria (Nochtiella) repens in the spermatic cord: a new human case in Italy]. / Dirofilaria (Nochtiella) repens dans le cordon spermatique: un nouveau cas humain en Italie.

A case of human dirofilariasis associated with Dirofilaria (Nochtiella) repens, localised in the spermatic duct, is reported in a 52-year-old man from Lugo di Romagna (Ravenna province, Northern Italy). It represents the 22nd case of human dirofilariasis occurring until now in the same region. According to the relevant world literature this appears to be the 2nd case with this rare localisation the first one occurring in Italy as well.

Ultrasound diagnosis of filarial funiculoepididymitis.

Genital presentation of filarial disease is not uncommon in endemic areas of the world. Acute, febrile illness involving the epididymis and spermatic cord (funiculoepididymitis) is one of many such presentations. With an internationally mobile society, physicians today, even in nonendemic areas, may encounter patients with filarial infestations. We report the first case of presumptive diagnosis of this disease using scrotal ultrasound.

Evaluation of a polymerase chain reaction-based assay for diagnosis of Wuchereria bancrofti infection.

To assess the utility of a polymerase chain reaction (PCR)-based method for diagnosis of Wuchereria bancrofti infection, blood, plasma, and paraffin-embedded tissue samples were tested using a PCR-based assay that detects a W. bancrofti-specific repetitive DNA sequence. The assay was positive in 100 microL of blood from 40 of 42 microfilaria-positive subjects, the 2 subjects with negative assays having microfilarial counts of 1. Samples from 127 uninfected subjects were PCR-negative. The assay was also positive in 7 of 10 daytime samples in regions where infection is nocturnally periodic; PCR amplification from paraffin-embedded sections established the diagnosis of W. bancrofti infection in another 2 cases. A microtiter ELISA plate-based method was developed for rapid evaluation of large numbers of samples. These results suggest that this PCR-based assay will be useful in diagnosis of W. bancrofti infection in a variety of clinical settings.

Occurrence of living adult Wuchereria bancrofti in the scrotal area of men with microfilaraemia.

To determine the frequency with which living adult Wuchereria bancrofti can be detected by ultrasound in the scrotal area of men with filarial infection, we used a 7.5 MHz transducer to perform weekly ultrasound examinations on 100 microfilaraemic men (18-34 years old) from Greater Recife, Brazil. The peculiar pattern of movement that characterizes the adult worm image on ultrasound (the filaria dance sign) was detected in the lymphatic vessels of the spermatic cord in 80 men (bilaterally in 29 men). Among 20 men with no filaria dance sign, the geometric mean microfilarial density was 68/mL, compared with 238/mL and 775/mL among those with unilateral and bilateral filaria dance signs, respectively (P = 0.0001). The lymphatic vessels of the spermatic cord appear to be a common, and perhaps the principal, site of adult W. bancrofti in men with asymptomatic microfilaraemia. Studies are needed to define the relationship between the presence of filarial worms in the scrotal area and the development of filaria-associated morbidity.

[A case of human dirofilariasis (D. repens) of the spermatic cord]. / Un caso di dirofilariasi umana (D. répens) del funicolo spermatico.

A 52 year old man, living in the province of Trapani (Sicily), presented with right hydrocele and slight orchialgia. The patient underwent epididymectomy and resection of T. vaginalis. The "tunica" was involved by a granulomatous process, containing a parasite of genus Dirofilaria (D. repens). Dirofilaria repens is a filarial nematode. Dogs, foxes and cats are the definitive hosts and principal reservoirs of the parasite. In humans the parasite dies before reaching sexual maturity and the result is an inconspicuous granulomatous reaction in the subcutaneous tissue. S. Pampiglione et al. (Cattedra di Parassitologia Veterinaria dell'Università di Bologna-Italy) reported from 1971 more than 30 cases of human Dirofilariasis in Italy, suggesting that the parasite is able to migrate from the inoculation site to other districts (lung, eye etc.). The case is exceptional for the localization of the parasite (never reported) and can contribute to a better knowledge of the disease.

Genital filariasis in Minnesota.

Genitourinary filariasis is a well-known entity in most tropical areas. However, filariasis cannot be eliminated from the differential diagnosis of testicular, epididymal, or spermatic cord masses in nontropical climes. We report a case of filariasis of the spermatic cord that manifested as an unexplained scrotal mass in a patient in Rochester, Minnesota.

[An exceptional location of oxyurids. Apropos of a case]. / Localisation exceptionnelle des oxyures. A propos d'un cas.

The authors present an unusual site of localization of the oxyurid in the spermatic vessels.