Serologic diagnosis of zoonotic pulmonary dirofilariasis

Four symptomatic and four asymptomatic patients with histologically confirmed zoonotic pulmonary dirofilariasis caused by Dirofilaria immitis (dog heartworm) were evaluated serologically. Five patients had diagnostic indirect hemagglutination titers to D. immitis and six had positive findings by enzyme-linked immunosorbent assay. Of the two patients that had nondiagnostic titers by both enzyme-linked immunosorbent assay and indirect hemagglutination, one had an encapsulated necrotic adult worm that appeared to have been dead for some time, and the serum specimen for the second patient had been obtained five months following surgical removal of the granuloma. These findings suggest good sensitivity for these serologic methods in active cases, but declining antibody titers and decreased sensitivity following worm death. In general, cross-reactivity of the enzyme-linked immunosorbent assay with serum from patients with other nonfilarial parasitic infections or neoplasms was not observed.