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Veterinary Dermatology 2002, 13, 267 274

Case report

Blackwell Science, Ltd

Cutaneous lesions in dogs with Dirofilaria (Nochtiella) repens

infestation and concurrent tick-borne transmitted diseases

Pruritic dermatitis in dogs with D. repens infestation

WALTER TARELLO
Centro Veterinario Alessandrino, via Amendola 1, Alessandria, Italy
(Received 29 March 2001; accepted 20 June 2002)

Abstract A pruritic dermatitis characterized by the presence of erythema, papules, focal or multifocal alopecia,
crusting and nodules was seen in 28 dogs with Dirofilaria repens microfilariae infestation in an endemic area in
north-west Italy. Previous unsuccessful nonspecific antipruritic treatments, flea control and restricted diet were
recorded in 53.6% of the patients. Both the Knott and the antigen tests were negative for Dirofilaria immitis and
Acanthocheilonema reconditum. Concurrent babesiosis and/or canine granulocytic ehrlichiosis was also diagnosed in many affected dogs. Preliminary treatment of the concurrent diseases was followed by specific filaricide
treatment. The cutaneous lesions, although slightly improved with the initial treatment, resolved completely with
macro- and microfilaricide treatment. Although D. repens may be an opportunistic pathogen, this parasite should
not be considered as harmless as previously thought and its potential pathogenic role in causing cutaneous lesions
in dogs should be considered. Furthermore, it has a zoonotic importance as human cases have been reported
worldwide.
Keywords: dermatitis, Dirofilaria (Nochtiella) repens, dog, microfilaria, skin

INTRODUCTION
Subcutaneous dirofilariasis due to Dirofilaria repens
is a helminthic zoonosis, widely distributed throughout Europe, Asia and Africa,1 with higher prevalence
found in dogs from Sri Lanka (3060%),2 Iran (60.8%)3
and Italy (20.525%).4,5
Among the dirofilariases of zoonotic importance,
D. repens is the most frequent and widely distributed,
with 782 human cases recorded in 30 countries,6,7 compared with no more than 190 cases associated with
D. immitis and approximately 50 cases with D. tenuis.8
Italy appears to be the country most affected, with
the majority of cases centred in the north-west.7 In
humans, an uncommon host, microfilariasis is rare9
and the adult parasite causes either a benign subcutaneous cyst or oedema associated with pruritus, urticaria and painful lesions.1,6
Microfilariasis has been reported in dogs in those
areas of Italy4,5 in which the climate allows the
development of a large population of mosquitoes
(intermediate hosts).1 Dogs, cats, foxes and other wild
carnivores (definitive hosts) constitute the sources of
infection for humans.1 The adult worms reside in the
subcutaneous connective tissue,10,11 whereas the microfilariae are present in the blood without showing a
nocturnal periodicity.12

Correspondence: Walter Tarello, CP1644, 06129 Perugia, Italy.

E-mail: tarello@iol.it
2002 Blackwell Science Ltd

Subcutaneous dirofilariosis is endemic in some

Southern European countries such as Italy,5 France,13
Spain14 and Greece.15
In north-west Italy, 20.5 and 23.9% of dogs have
been found to host D. repens and D. immitis microfilariae.5 D. repens infection was also found in cats residing in the same area (20%).16 It has been suggested
that the apparent opportunistic role of D. repens might
well explain the presence of asymptomatic carriers,
the concurrent observation of nondermatological
clinical signs and the development of dermatitis
associated with D. repens microfilariasis in a subgroup
of parasitized dogs. 17 Since 1954,18,19 it has been
recognized that D. repens (previously believed to be
harmless and asymptomatic) is a possible cause of a
pruritic dermatitis in dogs. The embolization of microfilariae,13 the movement of adults in the subcutaneous
tissue,1 and the immunological response to parasitic
stages L3L5 and/or microfilariae20 are thought to
cause the cutaneous lesions observed in some affected
dogs, similar to what happens in dermatitis associated with aberrant locations of D. immitis.21 The
pathogenicity of the nematode is poorly understood,
because: (i) skin lesions appear only in a subset of
infected dogs and are not predictable; 11 (ii) the
gastrointestinal signs17,18 and poor performance17 in
symptomatic dogs are not strictly pathognomonic; (iii)
classic macro- and microfilaricide treatments seldom
produce complete recovery and no specific therapy has
been reported to date.21 There is increasing evidence
that the pathogenicity of the parasite may be influenced
267

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268

W. Tarello

by concurrent infections, such as babesiosis, granulocytic

ehrlichiosis,17 leishmaniosis21 and haemobartonellosis.16
Our clinical report aims to increase knowledge of the
pathogenic role of D. repens in canine dermatology.

MATERIALS AND METHODS

Animals
Twenty-eight dogs, living in the province of Alessandria in north-west Italy, were presented at the authors
practice, over an eight-month period (spring to
autumn 1998) for a pruritic dermatitis. The history,
duration of the disease, previous treatments and
dermatological and general clinical signs were recorded.
Laboratory tests for Dirofilaria (Nochtiella) repens,
Dirofilaria immitis and Acanthocheilonema (Dipetalonema) reconditum were carried out.
All dogs included in this study had: (i) pruritus for
more than one week, (ii) presence of cutaneous lesions
and (iii) microfilariasis caused only by D. (Nochtiella)
repens. Thirty healthy dogs were also tested for infestation with Dilofilaria spp. as a control group.
Laboratory investigations
A blood sample was collected from each dog for Knott
concentration and canine heartworm antigen tests

(Wittness Dirofilaria, Merial). Microfilariae were

identified by fixation in 2% formalin and examination
using light microscopy. Six microscopy preparations
were made from each sample. A fresh blood smear,
Wright-stained, was also carried out for each dog to
check for other canine haemoparasites. A test for
leishmaniosis (Leishcan 16, ELISA) was carried out in
suspected cases.
Follow-up
Follow-up included a clinical re-examination and a
Knott test one month after the end of treatment; a
phone call to the owners was then made in January
2000.

RESULTS
Animals
The history, duration of the disease, previous treatments, dermatological and general clinical signs, and the
results of blood tests are reported in Table 1. The age
of the animals ranged between 4 months and 12 years.
Their gender was evenly distributed between male and
female (14/14).
No dog had received preventive medication for
heartworm during the last year.
Seven of 30 healthy dogs were found to be carriers
of D. repens microfilariae in absence of any sign of disease, at the time of their first examination (data not
shown). The owners of the infested dogs declined treatment at this time. However, three of the seven dogs
(identified in the study group as numbers 2, 13 and 22)
developed pruritic skin lesions, respectively, 5, 1 and
4 months later.

Figure 1. Nodule on the chest of dog 28 with a serpiginous lesion

representing a subcutaneous migration channel (Reproduced with
permission from Rev Md Vt 1999; 150: 691702).

Clinical findings
The clinical signs and the skin lesions are listed in
Table 1 and shown in Figs 13. All dogs had pruritus,
manifested by localized scratching, licking and biting.
Two dogs (numbers 5 and 9) showed lesions involving
the whole surface of the body. Gross lesions included
primarily erythema (86% of dogs), papules (50%),
alopecia (43%) crusts (29%), and nodules (25%).

Figure 2. Swelling, alopecia and crusting of the hind leg of dog 6.

Figure 3. Erythema and alopecia on the hind legs of dog 14.

2002 Blackwell Science Ltd, Veterinary Dermatology, 13, 267 274

Duration of
disease

Previous tests and /or

treatment outcome

F, 12 years
Miniature Poodle
F, 8 years
English Setter
F, 2 years
German Shepherd Dog
, 4 years
Cocker Spaniel
F, 10 years
Crossbreed

2 years

Corticosteroids, restricted diet,

desonide lotion (no benefit)
3 DFR f at Knott test
5 months before
None

F, 8 years
Crossbreed

2 years

F, 9 years
German Shepherd Dog
, 10 months
Dog de Bordeaux
F, 9 years
Crossbreed

6 years

1
2
3
4
5

8
9

11
12

13
14
15
16
17

18
19

2 weeks
3 years
8 years

1 month
10 months

F, 7 months
Boxer
F, 2 and a half years
Crossbreed
, 9 years
German Shepherd Dog

3 months

, 6 months
Crossbreed
F, 12 years
German Shepherd Dog
, 8 months
Shih-tzu
, 1 and a half year
Siberian Husky
F, 4 years
Boxer
F, 2 years
German Shepherd Dog
, 10 years,
Boxer

Corticosteroids, flea control,

restricted diet (no benefit)
Corticosteroids, cephalosporin,
flea control, restricted diet
(transient relief; recurrence)
Corticosteroids, antibiotics,
restricted diet, benzodiazepine
(transient relief; recurrence)
Antibiotics, flea control,
restricted diet (no benefit)
Flea control, restricted diet
(no benefit)
Enrofloxacin, flea control
(no benefit)

Clinical signs

Erythema (FL, LS region)

Erythema (LS region, HL)
Erythema, papules, nodules,
alopecia (abdomen and HL)
Erythema, crusts, alopecia, papules,
acantosis (LS region & perineum)
Erythema, crusts, pustulae, alopecia,
lichenification (whole body)

Lethargy

Conjunctivitis
Conjunctivitis, diarrhoea
vomiting

Knott results* and

concurrent diseases
2 DFR f.
Babesiosis, CGE
10 DFR f.
Babesiosis, CGE
9 DFR f.
Babesiosis
6 DFR f.
Babesiosis, CGE
14 DFR f.
Babesiosis, CGE

Lumbar erythema, crusts, alopecia,

nodules (HL)

Fever (39.4C)

10 DFR f.
Babesiosis

Erythema, crusts, alopecia,

ulceration on LS region
Erythema, papules, alopecia,
nodules (LS region)
Erythema, crusts, nodules,
papules, lichenification
(whole body)
Erythema, nodules, papules
(neck, chest, abdomen, HL and FL)
Erythema, alopecia (chest and
ventral side of the neck)
Erythema, alopecia, papules,
pyoderma (HL)

Lethargy, conjunctivitis,
otitis
Conjunctivitis, otitis

6 DFR f.
Babesiosis, CGE
12 DFR f.
Babesiosis
15 DFR f.
Babesiosis, CGE

Anorexia, conjunctivitis
haematuria

3 months

Antibiotics, ivermectin
(no benefit)
None

4 months

Antibiotics (no benefit)

2 weeks
2 weeks

7 DFR f. at Knotts test

1 month before
None

Erythema, alopecia (HL)

1 month

None

Erythema, pustulae (abdomen)

Anorexia, conjunctivitis

1 month

None

Erythema, crusts (LS region)

Anorexia

1 years

Antibiotics, restricted diet

(no benefit)

Erythema on abdomen

2 weeks

None

1 month

None

Erythema, papules
(elbows, abdomen)
Papules (abdomen, LS region)

Lethargy, seizures,
asthma, fever (39.3 C),
conjunctivitis and otitis
Conjunctivitis, lymph
adenopathy, fever (41 C)
Polydipsia, asthma,
conjunctivitis

Papules on abdomen

Lethargy
Conjunctivitis and
coughing
Fever (39.5 C) and
lymphadenopathy
Anorexia, coughing
diarrhoea, vomiting

6 DFR f.
Babesiosis
9 DFR f.
Babesiosis
6 DFR f.
Babesiosis, CGE,
and TW
11 DFR f.
Babesiosis
6 DFR f.
Babesiosis
10 DFR f.
Babesiosis
6 DFR f.
Babesiosis
9 DFR f.
Babesiosis
7 DFR f.
CGE
10 DFR f.
Babesiosis, CGE

269

2002 Blackwell Science Ltd, Veterinary Dermatology, 13, 267274

10

2 weeks

Dermatological findings

Pruritic dermatitis in dogs with D. repens infestation

Sex, age
breed

Dog

VDE_305.fm Page 269 Friday, September 20, 2002 1:14 PM

Table 1. Signs, history, clinical findings and results of the laboratory tests in 28 dogs with Dirofilaria (Nochtiella) repens infestation

Dog
20
21
22
23

25

26
27
28

Duration of
disease

Previous tests and /or

treatment outcome

, 2 and a half year

Yorkshire Terrier
F, 6 years,
Crossbreed
, 4 years,
Dachsund
, 1 years
Pittbull Terrier

6 months

Antibiotics, restricted diet

(no benefit)
Antibiotics, omeprazole
(no benefit)
6 DFR f. at Knott test
4 months before
Enrofloxacin, flea control
restricted diet, amitraz
(no benefit)
Corticosteroids, flea control,
restricted diet, phenobarbital
Costicosteroids, antihelmintics,
(no benefit)

Erythema, papules
(abdomen and LS region)
Erythema (neck and chest),
pyoderma intertrigo, acne
of the chin
Erythema, alopecia, papules,
(elbows, chest, perineum)
Erythema, alopecia (head,
chest, LS region, HL)

1 month
2 weeks
3 months

Dermatological findings

Clinical signs

Erythema, crusts, alopecia,

papules (LS region, hocks)
Erythema (FL, perineal)

Anorexia, vomiting,
fresh blood on stool, Conjunctivitis
Conjunctivitis and
lameness

Conjunctivitis and otitis

F, 4 years
Fox Terrier
, 5 years
Pomeranian

4 years

F, 4 months
Bloodhound
, 5 years
Bichon Fris
, 4 years
Bloodhound

2 weeks

None

Papules, nodules, crusts (HL)

2 weeks

None

Erythema (abdomen, HL)

Polydipsia

2 weeks

None

Papules, nodules, serpiginous

lesion on neck and chest
(subcutaneous migration channel)

Lethargy, anorexia,
conjunctivitis

3 months

Epilepsy, chronic otitis,

conjunctivitis
Epilepsy, vomiting,
conjunctivitis

CGE, Canine granulocytic ehrlichiosis; DFR, Dirofilaria repens; FL, forelimbs; HL, hindlimbs; LS, lumbosacral; f, microfilariae; TW, tapeworm.
*All dogs were Dirofilaria immitis negative using both the Knott and the antigen test.

Knott results* and

concurrent diseases
9 DFR f.
Babesiosis, CGE
8 DFR f.
Babesiosis
9 DFR f.
CGE
19 DFR f.
CGE and
Leishmaniosis
9 DFR f.
Babesiosis, TW
6 DFR f.
Babesiosis,
CGE and TW
16 DFR f.
Babesiosis
7 DFR f.
Hepatozoonosis and CGE
12 DFR f.
Babesiosis
Adult nematode
and 2 larvae in a nodule

W. Tarello

24

Sex, age
breed

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270

2002 Blackwell Science Ltd, Veterinary Dermatology, 13, 267 274

Table 1. continued

VDE_305.fm Page 271 Friday, September 20, 2002 1:14 PM

Pruritic dermatitis in dogs with D. repens infestation

Figure 4. Dirofilaria repens microfilaria (Knott test, 10).

Figure 5. A living adult female and two L4 larvae of Dirofilaria

repens from a nodule on the neck of dog 28 (Reproduced with
permission from Rev Md Vt 1999; 150: 691702).

Affected regions included the lumbosacral area

(43%), abdomen (40%), hind limbs (40%), chest (25%),
neck (21%), forelimbs (18%), perineum (18%), elbows
(14%), head (14%) and hocks (10%).
The principal additional clinical signs included
conjunctivitis (57%), anorexia (21%), lethargy (18%),
vomiting (14%) and pyrexia (14%).
Laboratory investigations
Microscopy examination of six slides from every Knott
concentration test was carried out and D. (Nochtiella)
repens microfilariae were found in the blood of all
dogs (Fig. 4), their count ranging from 2 to 19 per sample.
An adult female and two L4 larvae were recovered
from a nodule on the neck of dog 28 (Fig. 5). D. immitis
and A. reconditum were not found and the test for
heartworm antigen was negative in all dogs.
Concurrent infection with babesiosis was diagnosed
in 25 dogs (89%), canine granulocytic ehrlichiosis
(CGE) in 14 (50%), tapeworm in 3 (11.4%), hepatozoonosis in 1 (3.5%) and leishmaniosis in 1 (3.5%).
Therapy
Therapy for the concurrent conditions (Babesia spp.,
Ehrlichia spp. and Hepatozoon canis infections) was
carried out before treating the dogs with the filaricide

271

Figure 6. Complete dermatological remission 6 months after the

end of therapy for Dirofilaria repens infection in dog 14.

therapy, using a combination of imidocarb dipropionate

(Carbesia, Schering-Plough Animal Health, 7.13 mg kg1,
subcutaneously, once a week, for four treatments) and
doxycycline (Ronaxan, Merial, 10 mg kg1, orally, for
21 days). A dog with a concurrent infection with
Leishmania spp. was initially treated with amminosidine
(Amminofarma, Centralvet-Vetem, 10 mg kg1, subcutaneously, twice a day for 10 days). Three dogs also
infested with Taenia spp. were initially treated with
praziquantel (Droncit, Bayer, 5 mg kg1, subcutaneously).
Treatment with imidocarb dipropionate and doxycycline resolved the systemic clinical signs, such as
lethargy, conjunctivitis, anorexia, vomiting and fever. A
significant, concurrent improvement of the cutaneous
lesions and pruritus was also observed in all dogs
including that one treated for leishmaniosis.
The macrofilaricide treatment using melarsomine
(Immiticide, Rhone-Mrieux, 2.5 mg kg1, intramuscularly, twice every 24 h) was initiated 23 days after
completing the therapy for babesiosis and ehrlichiosis
and this led to further improvement of the cutaneous
lesions including pruritus (Fig. 6). The speed of the
recovery depended on the duration of the disease and
the severity of the lesions. Ten days later, treatment
was completed with the microfilaricide, ivermectin
(Ivomec, Merial, 50 g kg1 given subcutaneously as a
single injection).
Follow-up
Clinical re-examination and a Knott test, carried out
one month after the completion of treatment, showed
the resolution of the cutaneous lesions and the absence
of D. repens microfilariae in the blood.
Recurrences of cutaneous lesions and pruritus were
reported, during the following year (1999) in only three
dogs (numbers 11, 19 and 26) whose owners neglected to
carry out the preventive treatment with oral ivermectin.

DISCUSSION
This study describe 28 cases of canine pruritic dermatitis associated with Dirofilaria repens microfilariae in
2002 Blackwell Science Ltd, Veterinary Dermatology, 13, 267274

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272

W. Tarello

the blood. The animals were examined in north-west

Italy where dirofilariasis is endemic. The province of
Alessandria has the highest number of human subcutaneous dirofilariasis cases of all Italian provinces1,6
and is apparently the most affected area in the world.7
Clinical signs of D. repens infestation are claimed to
be present in only a small percentage of parasitized
dogs.11 However, three of the seven control dogs developed pruritic skin lesions within 5 months, indicating
that parasitized dogs can eventually develop disease
and that the occurrence of cutaneous lesions in infested
dogs in frequent in endemic areas.
Dogs show seasonal variations in the number of
microfilariae in the blood, with the highest concentrations in August and September.22,23
The large number of microfilariae may be associated
with clinical signs19 probably caused by mechanical,
toxic and immunomediated mechanisms.23,24 The development of allergic and auto-immune reactions, including cutaneous lesions, is possible in helminthoses,
depending on the number of parasites, the recurrence
of infestation, and the age and nutrition status of the
animal.24
In northern Italy, the potential vectors for dogs
appear to be Aedes caspius, Aedes vexans, Anipheles
maculipennis, Culex modestus and Culex pipiens.1
Mosquitoes suck the blood of definitive hosts (dogs,
cats and wild carnivores) ingesting microfilariae (L1),
which develop into L2 and infesting L3 larvae within
1520 days. The larvae migrate into the head, reach the
labium and penetrate successively, during a blood meal,
into the subcutaneous tissues of a dog, where they
remain for 6 months before developing into adults.17
The pathogenesis of cutaneous lesions caused by
D. repens in humans is attributed to the migration of
the adult nematodes in the subcutaneous tissue, thus
causing itching and pain.1,6 The same mechanism has
been suspected, but not proven, in dogs. 25 In this
case series, disappearance of pruritus (scratching, licking
and/or biting) was the most striking feature of the
benefical macrofilaricide treatment in all animals.
In 24 (85%) of the 28 cases, the part of the body most
affected by the dermatitis were the lumbo-sacral and
the perineal areas and the hind legs. The flanks, back
and the rear limbs are commonly considered the preferential sites of dwelling for both the larvae and adults
which may concentrate in large numbers in a single
area.25
Concurrent infection with other pathogens in dogs
with D. repens infestation has been reported.3,13,21
Babesiosis and CGE were the most common in this
study and all animals were found to be infected with at
least one of these agents. It is questionable whether the
cutaneous lesions are due only to the dirofilariasis as
the other protozoal and bacterial diseases have been
reported either anecdotically or in scientific studies
to be associated with cutaneous lesions.26 Concurrent
infections with different pathogens may contribute
to the severity of the clinical signs, thus making the
clinical presentation unusual.
2002 Blackwell Science Ltd, Veterinary Dermatology, 13, 267 274

It is not possible to prove that the skin lesions seen

in the dogs in this study were directly caused by the
microfilariae or by the adult stages of D. repens, but it
should be noted that: (i) 15 dogs had previously been
unsuccessfully treated with several antipruritic therapies; (ii) none had been treated for the concurrent
diseases; (iii) all patients recovered after specific treatment initially against the concurrent diseases but with
further improvement following treatment of the dirofilariosis. The dermatological signs found in the canine
cases described here were similar to the few other cases
of subcutaneous dirofilariasis reported sporadically
over the past 50 years.10,11,13,1719,21,25
Mixed infections with Dirofilaria immitis, which is
seen in 11.7% of the cases in the geographical area in
which this study was carried out, were not included
in this study. It is possible that an aberrant migration of
D. immitis larvae could not be completely ruled out, as
D. immitis-associated dermatitis have been reported
in dogs. 20 An occult disease, due to the absence of
circulating microfilariae and /or false negative D. immitis
antigen test, may occur when the number of adults is
low. The combination of the Knott test and the antigen
test improves accuracy, as demonstrated by Hoover
et al.27 Thus, the possibility of misdiagnosis in this
study is unlikely.
The endemic distribution of D. repens in the study
area is well known to clinicians,7 but its pathogenic role
is still poorly understood, as most textbooks describe
it as a harmless worm residing in the subcutaneous
connective tissue.28,29
In endemic areas concentration tests (Knott and
filtration) to look for D. immitis and D. repens microfilariae should be carried out routinely, possibly coupled
with serological tests.
Differentiation among D. immitis, D. repens and
Acanthocheilonema reconditum is based mainly on
the morphology of the microfilariae. The microfilariae
observed in this study had the typical wide aspect
of D. repens larvae. On the Knott test, the tails of
A. reconditum are hook-shaped and normally thin like
those of D. immitis.30 The caudal end of D. repens
microfilariae is much wider. The concentration test
is thus very useful to clinicians in order to assess the
presence of D. repens in dogs with pruritic dermatitis.
In such cases, dirofilariosis should always be included
in the differential diagnosis of dogs with pruritic
dermatitis in endemic areas. The potential role of
D. repens infestation in the development of pruritic
dermatitis requires reappraisal and further study.

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Rsum Une dermatite prurigineuse, caractrise par la prsence drythme, de papules, dalopcie focale ou
multifocale, de crotes et de nodules est rapporte chez 28 chiens du Nord Ouest de lItalie prsentant une
infestation par Dirofilaria repens. Des traitements antiprurigineux, un contrle antipuces et un rgime dviction
avaient t mis en place antrieurement sans succs chez 53.6% des patients. Le test de Knott et lantignmie
taient ngatifs pour Dirofilaria immitis et Acanthocheilonema reconditum. Une babsiose et/ou une ehrlichiose
concommitante ont t diagnostiques chez de nombreux animaux. Le traitement des maladies concommitantes
a t suivi par un traitement filaricide spcifique. Les lsions cutanes ont t modrment amliores avec le
traitement initial, et ont totalement disparu avec le traitement macro et microfilaricide. Bien que D. repens puisse
ntre quun pathogne opportuniste, ce parasite ne devrait pas tre considr comme inoffensif, et son rle
pathogne dans les dermatoses canines mriterait dtre envisag. De plus, il sagit dune zoonose, car des cas chez
lhomme ont t rapports dans le monde entier.
Resumen Una dermatitis prurtica caracterizada por la presencia de eritema, ppulas, alopecia focal o multifocal, costras y ndulos fue observada en 28 perros con infestacin por microfilarias Dirofilaria repens, en una
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W. Tarello
zona endmica del Nor-Oeste de Italia. En el 53,6% de los pacientes existan registros de tratamientos previos
sin xito con productos antiprurticos inespecficos, control de pulgas y dieta de restriccin. Tanto el test de Knott
como el de antigeno fueron negativos a Dirofilaria immitis y Acanthocheilonema reconditum. Se diagnostic
tambin en muchos perros afectados una babesiosis y/o erliquiosis canina granuloctica concurrentes. Tras el
tratamiento de las enfermedades concurrentes se estableci un tratamiento filaricida especfico. Las lesiones
cutneas, aunque mejoraron levemente con el tratamiento inicial, desaparecieron completamente con el tratamiento
macro y microfilaricida. Aunque D. repens puede ser un patgeno oportunista, este parsito no debera ser
considerado completamente inocuo, como se crea hasta el momento, y debera considerarse su posible papel
como patgeno potencial como causa de lesiones cutneas en el perro. Adems tiene una importancia zoontica
ya que se han descritos caso en todo el mundo.
Zusammenfassung Eine durch Hautrtung, Papeln, fokale oder multifokale Alopezie, Krusten und Knoten
charakterisierte juckende Dermatitis wurde bei 28 Hunden mit Mikrofilarieninfestation von Dirofilaria repens
in einer endemischen Gegend in Nordwestitalien festgestellt. Bei 53.6% der Patienten waren unspezifische
Behandlungen des Juckreizes, Flohkontrolle und Eliminationsditen erfolglos. Sowohl Knott als auch Antigentest
waren fr Dirofilaria immitis und Acanthocheilonema reconditum negativ. Gleichzeitige Babesiose und oder
granulozytre Ehrlichiose wurde bei vielen der betroffenen Hunde diagnostiziert. Spezifische filarizide Behandlung
folgte einer vorlufigen Behandlung der gleichzeitig bestehenden Erkrankungen. Die Hautlsionen, die mit der
Initialbehandlung leichte Besserung zeigten, verschwanden mit der Behandlung der Makro- und Mikrofilarien
vollstndig. Obwohl D. repens ein opportunistischer Erreger sein kann, sollte dieser Parasit als nicht so harmlos
angesehen werden wie frher angenommen wurde; eine mgliche pathogene Rolle bei der Verursachung von
Hautlsionen des Hundes sollte in Betracht gezogen werden. Weiterhin hat der Erreger zoonotisches Potential,
da weltweit Verffentlichungen von humanmedizinischen Fllen vorliegen.

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