Zaporozhyan state medical university departement of infectious diseases

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abscess in vitreous body, neuritis of visual nerve, keratitis or existence of migrate 

larva in vitreous body are developed.  

Complications. At migration of Toxocara larvas into brain epileptiform 

attacks, paresis, paralysis are observed. At affection of visual nerve blindness may 

occur.  

Diagnosis are made on the base of histological examination of bioptates of 

affected tissues. For serologic diagnosis the method is used immunofermental 

analysis is used.  

Treatment. For treatment Albendazol (10 mg / kg of the patients weight) 

during 10 -20 days. Ditrazin citras is prescribed 3 mg / kg of the patients weight a 

day 2-4 weeks. Antihistaminic medicines are prescribed simultaneously. At ocular 

Toxocarosis the same schemes of treatment are used as at visceral Toxocarosis. In 

some cases surgical methods are used.  

Sanitaruim examination are made during 1 year. 

Prevention and measures. Measures directed to the source of invasion 

(dogs examination and treatment, catching the stray dogs, equipping the special 

places for domestic dogs etc.). Observance of the rules of personal hygiene 

(washing hands after contact with soil or animals, cleansing of greenery, 

vegetables and other food-stuffs, which may contain parts of soil etc.). Observance 

of the rules public hygiene (defense kids places for play from stray dogs). 

 

DIROPHYLARIOSIS is a transmissible zoonotic biohelminthosis, 

nematodosis, characterized by parasiting of nematode Dirophylaria in 

subcutaneous fat of a man and is manifested by migratory tumor on the different 

parts of the body. 

Etiology. The agent belongs to the round worms Nematoda class, Spirurina 

group, Spiruromorpha subgroup, Filarioidea family, Dirofilaria. Some worm types 

are described, from which D. Repens and D. Immitis are widely spread. Nematode 

has the filament body, covered with cuticle. The males proportion are 47-70x0,37-

0,45 mm. Females proportion are 100-170x0,46-0,55 mm. Dogs are the obligate 

owners. They have such helminthes under their skin. Intermediate owners and 

vectors are Aedes, Culex and Anorheles mosquitoes. Which suck in the blood of 

the infected dogs and swallow the Microfilariae. In dogs organism Microfilariae 

grow at the temperature 24-28° C and in 15-20 days they migrate into the lower lip 

of the mosquito.  

Epidemiology. Reservoir and source is canis family. Contamination of a 

man takes places by transmissible way through the mosquito-bite genus Aedes, 

Culex and Anorheles. The source of mosquito contamination are invasive dogs. 

The men for Dirophylariosis is in accidental owner. In the man’s organism female 

doesn’t give birth to microfilariae. A man is a biological deadlock and isn’t the 

source of infection. 

Pathogenesis. While mosquito sucks blood the invasive Microfilariae 

elements get into the skin. Here they begin to develop and active move in 

subcutaneous fat. Sometimes around helminths is formed thin connective tissue 

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capsule. In the pathogenesis base is a toxicoallergic reactions and mechanical 

influence of helminths on tissues of subcutaneous fat. Diseases may last for a long 

time asymptomatic. Allergic manifestation are observed rare and only in the acute 

period.  

Symptoms and course. Incubation period is from 1-2 months up to 2 years. 

The clinical picture depends on the place where helminths is located. The first sign 

of disease is appearance on the place of a bite. Sometimes it accompanied by 

itching, burning. The skin over it is slightly hyperemic and slightly adematic. 

Typical symptom of dirophylariosis is the migration of agent – movement of swell-

like formation or helminth itself under skin, especially after the local treatment. 

Distance of the movement is more than 10 sm. Speed of movement up to 30 sm for 

1-2 days. At parasite migration through subcutaneous fat to the new place new 

induration appears and the former place no marks are left. Specific sign of 

dirophylariasis is sensation of motionless and crawling in induration or tumor. 

Headache, nausea, weakness, fever, pain in the place of helminth localization with 

irradiating along nerve trunk may be the symptoms of this desease. Eosinophillia is 

not typical. 

At ocular dirophylariosis eyelids, conjunctiva, anterior chamber, sclera, orbit 

are affected. At affection of eyebrows skin and eyelids Quincke edema is 

developed. The eyelids are swollen, there is itching, watery eyes. Under the skin 

dense nodules or tumor are formed. The vision acuity doesn’t go down. If the 

conjunctiva is affected, conjunctivitis develops accompanied with intense pains, 

tearness and itching. Conjunctiva is edematic and during some days, through it you 

may see curved helminth body. All sing disappear completely after it migrates into 

orbit or is removed surgically.  

Complications. Pyosis of subcutaneous nodes, secondary inflammatory 

processes at eyes affection.  

Diagnosis. Clinical diagnosis is difficult. The important meaning has the  

epidemiological anamnesis – mosquito-bites. Parasitological diagnosis is also 

difficult because of absent of Microfilaria in blood microfilariae, eosinophillia is 

not typical. Diagnosis of dirophylariosis is set retrospectively as the result of 

surgery of removing of subcutaneous node, in which the dirophylaria is found.  

Treatment. The optimal method of treatment is surgical removing of 

helminth. If the correct diagnosis was set without surgery, diaethylcarbamazine 2 

mg / kg per a day 10-30 days, antiallergic drugs, glucocorticoids are prescribed. 

Antibacterial drugs are prescribed at suppuration (pyosis) of nodes and appearance 

secondary bacterial infection. The prognosis of disease is favorable.  

Sanitarium observation is set for 6 months. Recovered after are taken off 

registration at the clinical recovery and absence of formation of new subcutaneous 

nodes.  

Prophylaxis. Control of mosquitoes, discovery and dehelmenthisation of 

invased dogs, the measures of personal prophylaxis, defence from mosquito bites. 

 

 

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