title: Man's best friend: How humans can develop Dirofilaria immitis infections.
abstract: Canine heartworm, Dirofilaria immitis, is a nematode parasite that infects dogs by way of mosquito bite. Rarely, humans play accidental hosts to this parasite and are not a suitable environment for the nematode to live. As the parasite dies in the pulmonary vessels it embolizes the vessels causing infarction and eventual nodule formation in the lungs. In the right clinical context, a nodule can be considered malignant prompting invasive tissue sampling. We describe a case of a 48-year-old man who was found to have multiple asymptomatic scattered pulmonary nodules during imaging workup for an insulinoma. Fine needle biopsy of the largest nodule revealed a necrotic granuloma, lab testing and culture ruled out fungal and bacterial causes. Clinically, this picture was consistent with D. immitis infection.
authors.affiliation: Department of Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States.
authors.forename: Devin
authors.initials: D
authors.lastname: Malik
authors.affiliation: Department of Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States.
authors.forename: Akshay
authors.initials: A
authors.lastname: Amaraneni
authors.affiliation: Department of Family Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States.
authors.forename: Sukhpreet
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Roach
keywords: Canine host; Dirofilaria immitis; Parasite; Zoonosis