Heart Worm
Heart Worm
Heart Worm
Abstract
Dirofilaria immitis is a filariid worm which typically lives as adult in the right ventricle of
the heart and the pulmonary arteries of the dog, causing the canine heartworm disease.
Therapy of canine dirofilariosis due to Dirofilaria immitis is indicated for dogs suffering
from clinical signs of the disease (such as chronic cough). The present paper describes
diagnostic and treatment features of a D. immitis affected dog in Ahvaz district, Southwest of
Iran. The dog had coughing, tachypnea, labored breathing, panting, hind limb edema,
weakness, and exercise intolerance, at the time of referral. Auscultation revealed grade III/VI
systolic murmur over the left apex of the heart. Giemsa stained blood smears containing
microfilaria was morphologically identified as D. immitis. CBC revealed an inflammatory
leukogram and mild anemia. Combined therapy with ivermectin (440 μg/kg as single dose),
levamisol (10 mg/kg q 24 h for 10 days) and aspirin (10 mg/kg q 12 h for 10 days), during 2
stages, was effective. The number of microfilaria dropped from 1250±50/ml blood pre-
treatment to 150±10/ml (following the first treatment stage, after 10 days) and reached 0 a day
after the second treatment. The animal remained negative regarding D. immitis microfilaremia
during a follow-up period of 180 days. This record confirms the efficacy of ivermectin with
levamisol and aspirin in the treatment of adult heartworm infection in a dog.
ﺗﺸﺨﻴﺺ و درﻣﺎن
2
ﻣﺤﻤﺪ ﺣﺴﻴﻦ راﺿﻲ ﺟﻼﻟﻲ ،*1ﺑﻬﻤﻦ ﻣﺼﻠﻲ ﻧﮋاد ،2رﺿﺎ آوﻳﺰه
1ﮔﺮوه ﭘﺎﺗﻮﺑﻴﻮﻟﻮژي ،داﻧﺸﻜﺪه داﻣﭙﺰﺷﻜﻲ ،داﻧﺸﮕﺎه ﺷﻬﻴﺪ ﭼﻤﺮان اﻫﻮاز ،اﻫﻮاز ،اﻳﺮان
2ﮔﺮوه ﻋﻠﻮم درﻣﺎﻧﮕﺎﻫﻲ ،داﻧﺸﻜﺪه داﻣﭙﺰﺷﻜﻲ ،داﻧﺸﮕﺎه ﺷﻬﻴﺪ ﭼﻤﺮان اﻫﻮاز ،اﻫﻮاز ،اﻳﺮان
ﭼﻜﻴﺪه
دﻳﺮوﻓﻴﻼرﻳﺎ اﻳﻤﻴﺘﻴﺲ ﻳﻚ ﻣﻴﻜﺮوﻓﻴﻠﺮ اﺳﺖ ﻛﻪ ﻓﺮم ﺑﺎﻟﻎ آن ﺑﻪ ﻃﻮر ﻣﻌﻤﻮل در ﺑﻄﻦ راﺳﺖ ﻗﻠﺐ و ﺳﺮﺧﺮگ ﻫﺎي ﺗﻨﻔﺴﻲ ﺳﮓ ﻫـﺎ زﻧـﺪﮔﻲ
ﻣﻲ ﻛﻨﺪ و ﻣﻲ ﺗﻮاﻧﺪ ﻣﻮﺟﺐ ﺑﻴﻤﺎري ﻗﻠﺒﻲ در ﺳﮓ ﻫﺎ ﮔﺮدد .درﻣﺎن دﻳﺮوﻓﻴﻼرﻳﻮز ﺳﮓ ﺳﺎﻧﺎن ﻧﺎﺷﻲ از دﻳﺮوﻓﻴﻼرﻳﺎ اﻳﻤﻴﺘﻴﺲ ﺑـﺮاي ﺳـﮓ ﻫـﺎﻳﻲ
ﻛﻪ از ﻋﻼﺋﻢ ﺑﺎﻟﻴﻨﻲ اﻳﻦ ﺑﻴﻤﺎري رﻧﺞ ﻣﻲ ﺑﺮﻧﺪ )ﻧﻈﻴﺮ ﺳﺮﻓﻪ ﻣﺰﻣﻦ( ﺗﻮﺻﻴﻪ ﻣﻲ ﺷﻮد .در اﻳﻦ ﻣﻘﺎﻟﻪ ،ﻳﺎﻓﺘﻪ ﻫﺎي ﺗﺸﺨﻴﺼﻲ و درﻣﺎﻧﻲ در ﻳﻚ ﻗـﻼده
ﺳﮓ ﻣﺒﺘﻼ ﺑﻪ ﻋﻔﻮﻧﺖ ﻧﺎﺷﻲ از دﻳﺮوﻓﻴﻼرﻳﺎ اﻳﻤﻴﺘﻴﺲ ،در ﻣﻨﻄﻘﻪ اﻫﻮاز ،واﻗﻊ در ﺟﻨﻮب ﻏﺮب اﻳﺮان ﺗﻮﺻﻴﻒ ﻣﻲ ﺷﻮد .ﺳـﮓ دﭼـﺎر ﺳـﺮﻓﻪ ،ﺗـﺎﻛﻲ
ﭘﻨﻪ ،ﺗﻨﻔﺲ ﺻﺪادار ،ﻟﻪ ﻟﻪ زدن ،ادم اﻧﺪام ﺧﻠﻔﻲ ،ﺿﻌﻒ و ﻋﺪم ﺗﺤﻤﻞ ﺗﻤﺮﻳﻦ ،ﺑﻪ ﻫﻨﮕﺎم ﻣﺮاﺟﻌﻪ ﺑﻮد .ﺳﻤﻊ ﻗﻠﺐ ﻳﻚ ﻣﺮﻣﺮ ﺳﻴﺴﺘﻮﻟﻴﻚ درﺟﻪ 3/6
را در ﺳﻤﺖ ﭼﭗ ﻧﻮك ﻗﻠﺐ ﻧﺸﺎن داد .ﮔﺴﺘﺮش ﻫﺎي ﺧﻮﻧﻲ ﺣﺎوي ﻣﻴﻜﺮوﻓﻴﻠﺮ رﻧﮓ آﻣﻴﺰي ﺷﺪه ﺑﺎ ﮔﻴﻤـﺴﺎ ،از ﻧﻈـﺮ ﻣﻮرﻓﻮﻟـﻮژﻳﻜﻲ دﻳﺮوﻓﻴﻼرﻳـﺎ
اﻳﻤﻴﺘﻴﺲ ﺗـﺸﺨﻴﺺ داده ﺷـﺪﻧﺪ .در ،CBCﻟﻜـﻮﮔﺮام آﻣﺎﺳـﻲ و آﻧﻤـﻲ ﺧﻔﻴـﻒ آﺷـﻜﺎر ﺷـﺪ .درﻣـﺎن ﺗﺮﻛﻴﺒـﻲ ﺑـﺎ داروﻫـﺎي آﻳـﻮرﻣﻜﺘﻴﻦ )440
ﻣﻴﻜﺮوﮔﺮم/ﻛﻴﻠﻮﮔﺮم و ﺑﻪ ﺻﻮرت ﺗﻚ دوز( ،ﻟﻮاﻣﻴﺰول ) 10ﻣﻴﻠﻲ ﮔﺮم/ﻛﻴﻠﻮﮔﺮم ،روزاﻧﻪ و ﺑﻪ ﻣﺪت 10روز( و آﺳﭙﻴﺮﻳﻦ ) 10ﻣﻴﻠﻲ ﮔـﺮم/ﻛﻴﻠـﻮﮔﺮم،
ﻫﺮ 12ﺳﺎﻋﺖ و ﺑﻪ ﻣﺪت 10روز( ،در ﻃﻲ 2ﻣﺮﺣﻠﻪ ،در ﺑﺮ ﻃﺮف ﺷﺪن ﻋﻔﻮﻧﺖ در ﻳﻚ ﻗﻼده ﺳﮓ داﺷﻬﻮﻧﺪ ،ﻣﻮﺛﺮ ﺑﻮدﻧﺪ .ﺗﻌﺪاد ﻣﻴﻜﺮوﻓﻴﻠﺮﻫﺎي
ﺧﻮن از ) 1250±50ﻗﺒﻞ از درﻣﺎن( ﺑﻪ 150±10رﺳﻴﺪه ﺑﻮد )ﻣﺘﻌﺎﻗﺐ اوﻟﻴﻦ ﻣﺮﺣﻠﻪ درﻣﺎﻧﻲ ،ﺑﻌـﺪ از 10روز( و ﻳـﻚ روز ﺑﻌـﺪ از دوﻣـﻴﻦ ﻣﺮﺣﻠـﻪ
درﻣﺎﻧﻲ ،ﺑﻪ ﺻﻔﺮ رﺳﻴﺪ .ﺣﻴﻮان از ﻧﻈﺮ ﻣﻴﻜﺮوﻓﻴﻠﺮ دﻳﺮوﻓﻴﻼرﻳﺎ اﻳﻤﻴﺘﻴﺲ ،در ﻃﻲ ﻳﻚ دوره 180روزه ﻣﻨﻔﻲ ﺑﻮد .اﻳﻦ ﻣﻄﺎﻟﻌﻪ ﻛـﺎراﻳﻲ آﻳـﻮرﻣﻜﺘﻴﻦ
ﻫﻤﺮاه ﺑﺎ ﻟﻮاﻣﻴﺰول و آﺳﭙﻴﺮﻳﻦ را در درﻣﺎن ﻋﻔﻮﻧﺖ ﻧﺎﺷﻲ از ﻛﺮم ﺑﺎﻟﻎ در ﺳﮓ ﺗﺎﻳﻴﺪ ﻣﻲ ﻛﻨﺪ.