Romanian Doctors Extract Live Roundworm from Woman's Eyelid

In a striking medical case reported in the New England Journal of Medicine, Romanian doctors successfully extracted a living, writhing roundworm measuring 11 cm (4.3 inches) from a woman’s left eyelid.

The woman had initially noticed a hard lump on her right temple a month before the incident. Remarkably, she observed that the nodule disappeared just a day before the worm made its way to her eye. When she visited an ophthalmologist the following day, doctors identified a “mobile lesion” on her eyelid. The lesion had the distinctive suspicious shape of a worm curled beneath her skin, accompanied by some redness and swelling.

After its removal, the worm was identified as Dirofilaria repens, a parasite whose larvae are generally transmitted through mosquito bites. While its primary targets are dogs, it can also infect wild canids, such as wolves and foxes, and occasionally cats. In these animals, larvae deposited from mosquito bites develop into adult worms under the skin, producing larvae called microfilariae that enter the bloodstream. These larvae can then be picked up by mosquitoes, thereby continuing the cycle.

In humans, however, the infection is atypical and humans are considered dead-end hosts. Although larvae delivered by a mosquito can mature under the skin, they rarely produce microfilariae in the bloodstream. Such infections are often discovered as nodules or wandering worms beneath the skin, as was the case with the woman. Contributing to her infection, doctors noted that she was a dog owner, potentially increasing her exposure to the parasite.