Zoonotic filariasis in the Arabian Peninsula: autochthonous onchocerciasis and dirofilariasis

We describe zoonotic filariasis in two patients from Kuwait; one with Onchocerca spp. and one with Dirofilaria spp. Case 1, a 12-year-old Kuwaiti woman who had visited Saudi Arabia, initially reported ocular symptoms. She later reported a nodule that appeared in the suprapubic area, which was resected. A coiled worm was observed in histologic sections and was identified as an Onchocerca spp., but could not be definitively identified. This patient represents the 15th reported case of zoonotic onchocerciasis in a country that is not endemic for human onchocerciasis. Case 2, a 34-year-old Indian woman from Kuwait City, reported a moving object in her left eye. A live worm was extracted and tentatively identified as an immature female Dirofilaria (Nochtiella) repens. These two cases bring to four the number of reports of zoonotic filariasis in the Arabian Peninsula and suggest that zoonotic filariasis is not uncommon in the Arabian Gulf region.