PMC8592590_01
Progressive erythema of the left periorbital area. 1, 2, and 3 March 2018.
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A week later, the pain and discomfort regressed, leaving a small nodule above the left eyelid, with intermittent redness (Figure 1).
Progression after initiation of oral penicillin. Initially the forehead swelled, accompanied by generalized oedema of the face and the appearance of a red protrusion in the same area.
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Five months later, a small 1.5 x 1 cm well-defined, firm nodule developed in the mid-forehead (Figure 2).
An ultrasound image of the motile nematode.
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High-resolution ultrasound imaging was then performed which revealed a hypoechoic clarification with a nematode-like structure (Figure 3).
Images (A, B) showing fragments of the Dirofilaria nematode being removed from the erupted nodule.
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At home, the patient removed nematode fragments measuring approximately 7-8 cm in total (Figure 4(A,B)).
Schematic illustration of the timeline from onset of symptoms. Michelle Alexandra Mistry .
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Under local anaesthesia, an 8-mm incision was made above the tip of the erupted defect, and remnants were sent for microbiological examination (Figure 5).