Peculiar Presentation: Dirofilariasis Unveiled in the Temporalis Muscle of a Teenager

Dirofilariasis, a parasitic infection typically affecting animals, occasionally presents in humans, transmitted through mosquito bites. This article explores an unusual case of dirofilariasis affecting the temporalis muscle, a rare occurrence. With 40 identified Dirofilaria species, human infections are primarily attributed to Dirofilaria repens and Dirofilaria immitis, causing pulmonary and subcutaneous lesions. While deep tissue infections are exceptionally rare, we present a unique case in a 15-year-old girl.

The patient exhibited a 3-month history of a slowly growing swelling in the left temporal region, accompanied by intermittent pain and limited jaw movement. Initial differential diagnoses included benign tumors, cysts, or abscesses. Ultrasound revealed a hypoechoic mass, leading to surgical excisional biopsy. Histopathological examination confirmed Dirofilaria, prompting a combination of antiparasitic medication and surgical intervention.

Dirofilariasis in deep tissues, especially muscles, is uncommon. Diagnosis challenges arise due to its rarity and similarity to other conditions. Imaging may not be specific, necessitating histopathological examination. Treatment involves antiparasitic medications like ivermectin, supplemented with surgery in specific cases. Our patient’s favorable outcome underscores the importance of early recognition and a multidisciplinary approach for effective management.