Clinical Aspects of Dermatitis Associated with Dirofilaria repens in Pets: A Review of 100 Canine and 31 Feline Cases (1990–2010) and a Report of a New Clinic Case Imported from Italy to Dubai
Cutaneous dirofilariasis is a parasitic disease caused by the mosquito-borne filarial nematodes Dirofilaria (Nochtiella) repens, living in the subcutaneous tissue of dogs, cats, wild carnivores, and humans. Cases have been recently reported also from Germany, Czech Republic, Hungary, Ukraine, Russia, Austria, Switzerland, France, The Netherlands, and the Middle East. D. repens is not widely known to cause chronic pruritic dermatitis in animals. Dermatological signs observed in 100 canine clinic cases were pruritus (100%), erythema (79%), papulae (62%), focal or multifocal alopecia (55%), hyperkeratosis (18%), crusting (14%), nodules (12%), acantosis (5%), and eczema (3%). Signs other than dermatological were conjunctivitis (46%), anorexia (35%), vomiting (26%), fever (25%), lethargy (20%), and lymph-adenomegaly (10%). A case imported from Italy to Dubai is described. The opportunistic role of D. repens might explain the presence of asymptomatic carriers, the concurrent observation of nondermatological signs, and the development of dermatitis in a subgroup of parasitized dogs. 1. Introduction Two main filarial parasites affect domestic carnivorous in Europe: Dirofilaria immitis, a parasite of the cardiovascular system, and Dirofilaria (Nochtiella) repens, a parasite of the subcutaneous connective tissue of dogs, cats, wild carnivores, and humans [1]. Aside these, pets can be less frequently infected by Acanthocheilonema (syn. Dipetalonema) reconditum and Cercopithifilaria (syn. Acanthocheilonema) grassii [2]. Subcutaneous dirofilariasis due to Dirofilaria repens is endemic in Southern and Eastern Europe, and many parts of Africa and Asia [1]. Dogs, cats, and wild carnivores are final hosts of D. repens and constitute the only source of accidental infestation for humans, in the presence of a competent population of mosquito vectors, including the Asian tiger mosquito Aedes albopictus and Culex pipiens [3]. Human cases have been recorded mainly in Italy, France, Spain, and Sri Lanka [3]. During the recent years, animal and human infection with D. repens has been detected in new areas of the world, including the Alps [4], Ukraine [5], the Middle East [6–8], and Germany [9]. Strict quarantine regulations seldom prevent propagation of D. repens, because the infection becomes patent only after 6–10 months and the adult parasite can live 2–4 years in the subcutaneous tissues of dogs [10, 11]. In infected cats [12–14] and dogs [15–17], diagnosis is based upon the presence of pruritic skin lesions, the finding of D. repens microfilariae, and a negative test for
References
[1]
S. Pampiglione and F. Rivasi, “Human dirofilariasis due to Dirofilaria (Nochtiella) repens: an update of world literature from 1995 to 2000,” Parassitologia, vol. 42, no. 3-4, pp. 231–254, 2000.
[2]
W. Tarello, “Identification and treatment of Dipetalonema grassii microfilariae in a cat from central Italy,” Veterinary Record, vol. 155, no. 18, pp. 565–566, 2004.
[3]
S. Pampiglione, F. Rivasi, G. Angeli et al., “Dirofilariasis due to Dirofilaria repens in Italy, an emergent zoonosis: report of 60 new cases,” Histopathology, vol. 38, no. 4, pp. 344–354, 2001.
[4]
W. Tarello, “Retrospective study on the presence and pathogenicity of Dirofilaria repens in 5 Dogs and 1 Cat from Aosta Vally,” Schweizer Archiv fur Tierheilkunde, vol. 145, no. 10, pp. 465–469, 2003.
[5]
A. Mazurkevich, N. Vasylyk, T. Avramenko, S. Velichko, W. Tarello, and E. Varodi, “Adult Dirofilaria repens nematodes in a cat from Kiev, Ukraine,” Veterinary Record, vol. 155, no. 20, pp. 638–639, 2004.
[6]
W. Tarello, “Dermatitis associated with Dirofilaria repens microfilariae in a dog in Dubai,” Veterinary Record, vol. 151, no. 24, pp. 738–739, 2002.
[7]
W. Tarello, “Dermatitis associated with Dirofilaria repens microfilariae in three dogs in Saudi Arabia,” Journal of Small Animal Practice, vol. 44, no. 3, pp. 132–134, 2003.
[8]
W. Tarello, “Autochthonous Dirofilaria (Nochtiella) repens infection in dogs in Kuwait,” Zoonoses and Public Health, vol. 55, no. 6, pp. 328–330, 2008.
[9]
N. Pantchev, N. Norden, L. Lorentzen et al., “Current surveys on the prevalence and distribution of dirofilaria spp. in dogs in Germany,” Parasitology Research, vol. 105, no. 1, pp. S63–S74, 2009.
[10]
W. Tarello, “La dirofilariose sous-cutanee a Dirofilaria (Nochtiella) repens chez le chien,” Revue de Medecine Veterinaire, vol. 150, no. 8-9, pp. 691–702, 1999.
[11]
P. W. Tarello, “Subcutaneous canine dirofilariasis due to Dirofilaria (Nochtiella) repens of American origin in Italy: case report,” Revue de Medecine Veterinaire, vol. 151, no. 11, pp. 1053–1058, 2000.
[12]
W. Tarello, “La dirofilariose sous-cutanee a Dirofilaria (Nochtiella) repens chez le chat: symptomes, diagnostic et traitement sur 10 cas,” Revue de Medecine Veterinaire, vol. 151, no. 8-9, pp. 813–819, 2000.
[13]
W. Tarello, “Un cas de dirofilariose sous-cutanee chronique a Dirofilaria (Nochtiella) repens chez un chat,” Revue de Medecine Veterinaire, vol. 151, no. 10, pp. 969–971, 2000.
[14]
W. Tarello, “Infestation with the zoonotic nematode Dirofilaria repens in cats from central Italy,” Vet On-Line, November 2002, http://www.priory.com/vet/filiarisis.htm.
[15]
W. Tarello, “Dermatitis associated with Dirofilaria (Nochtiella) repens microfilariae in dogs from Central Italy,” Acta Veterinaria Hungarica, vol. 50, no. 1, pp. 63–78, 2002.
[16]
W. Tarello, “Cutaneous lesions in dogs with Dirofilaria (Nochtiella) repens infestation and concurrent tick-borne transmitted diseases,” Veterinary Dermatology, vol. 13, no. 5, pp. 267–274, 2002.
[17]
W. Tarello, “Dermatitis associated with Dirofilaria repens microfilariae in a dog from Rome,” Veterinary Journal, vol. 165, no. 2, pp. 175–177, 2003.
[18]
W. Tarello, “Importance in the dog of concentration tests for the diagnosis of heartworm disease in non-endemic area,” Vet On-Line, January 2001, http://www.priory.com/vet/cardioworm.htm.
[19]
D. W. Scott, “Nodular skin disease associated with Dirofilaria immitis infection in the dog,” The Cornell Veterinarian, vol. 69, no. 3, pp. 233–240, 1979.
[20]
A. M. Hargis, T. P. Lewis, D. D. Duclos, D. G. Loeffler, and R. L. Rausch, “Dermatitis associated with microfilariae (Filarioidea) in 10 dogs,” Veterinary Dermatology, vol. 10, no. 2, pp. 95–107, 1999.
[21]
D. Traversa, G. Aste, P. Milillo et al., “Autochthonous foci of canine and feline infections by Dirofilaria immitis and Dirofilaria repens in central Italy,” Veterinary Parasitology, vol. 169, no. 1-2, pp. 128–132, 2010.
[22]
M. Magi, L. Guardone, M. C. Prati et al., “Canine filarial infections in Tuscany, central Italy,” Journal of Helminthology. In press.
[23]
A. Tasi？, L. Rossi, S. Tasi？, N. Miladinovi？-Tasi？, T. Ili？, and S. Dimitrijevi？, “Survey of canine dirofilariasis in Vojvodina, Serbia,” Parasitology Research, vol. 103, no. 6, pp. 1297–1302, 2008.
[24]
A. M. Dzami？, I. V. Colovi？, V. S. Arsi？-Arsenijevi？ et al., “Human Dirofilaria repens infection in Serbia,” Journal of Helminthology, vol. 83, no. 2, pp. 129–137, 2009.
[25]
M. G. Papazahariadou, A. F. Koutinas, T. S. Rallis, and S. T. Haralabidis, “Prevalence of microfilaraemia in episodic weakness and clinically normal dogs belonging to hunting breeds,” Journal of Helminthology, vol. 68, no. 3, pp. 243–245, 1994.
[26]
P. Dingman, J. K. Levy, L. H. Kramer et al., “Association of Wolbachia with heartworm disease in cats and dogs,” Veterinary Parasitology, vol. 170, no. 1-2, pp. 50–60, 2010.
[27]
W. Tarello, “Remission of clinical signs of adult-onset generalized demodicosis after treatment for concurrent babesiosis and/or granulocytic ehrlichiosis in dogs,” Parasite, vol. 14, no. 4, pp. 339–341, 2007.
[28]
W. Tarello, “Concurrent cutaneous lesions in dogs with Babesia gibsoni infection in Italy,” Revue de Medecine Veterinaire, vol. 154, no. 4, pp. 281–287, 2003.
[29]
W. Tarello, “Canine granulocytic ehrlichiosis (CGE) in Italy,” Acta Veterinaria Hungarica, vol. 51, no. 1, pp. 73–90, 2003.
[30]
W. Tarello, “Babesiosis as an underlying factor influencing the severity and duration of perianal fistulas in three dogs,” Revue de Medecine Veterinaire, vol. 152, no. 1, pp. 83–88, 2001.
[31]
C. H. Pingen, S. Lorentz, J. Magnis, B. Menn, R. Schaper, and T. J. Nauche, “Successful treatment of Dirofilaria repens infections in dogs with melarsomine (Immiticide, Merial), against adults and a combination of moxidectin 2.5%/imidacloprid 10% (Advocate, Bayer) against microfilaria,” in Proceedings of the 8th International Conference of the World Association for the Advancement of Veterinary Parasitology (WAAP '09), Alberta, Canada, August 2009.
[32]
D. Traversa, G. Aste, A. Di Cesare et al., “Efficacy of a single administration of a spot-on solution containing imidacloprid 10%/moxidectin 2.5% in eliminating Dirofilaria repens microfilariae in naturally infected dogs,” Veterinary Parasitology, vol. 179, no. 1–3, pp. 107–112, 2011.
