The fourth case of zoonoticDirofilaria repensinfection in Israel is reported, and the diagnostic morphologic characteristics of this filariid are reviewed. The importance of the exact anatomic diagnosis of this filaria is stressed in view of the fact that Israel has pockets of settlers from East Africa, a region endemic for lymphatic filariasis (Wuchereria bancrofti). Since the possibility of introduction of such an infection into the country exists, differentiating this zoonoticDirosilariafrom other silarial worms is essential. The clinicopathological features of aDirofilaria repensinfection are distinct. The patient initially has a painful subcutaneous or conjunctival swelling: the excisional biopsy shows the presence of a dead or alive, usually female worm that measures 220ndash;660 mu;m across: the central intenstine and the genital organs (two uteri) are located in the pseudocoelom; the thick, multilayered cuticle is provided with 95ndash;105 sharp, longitudinal ridges, the latter being separated from each other by a distance of 12 mu;m; the circumferential muscle cell layer, covering the inner side of the cuticle, is bilaterally interrupted by the large chord cells, two to five nuclei of which are discernible in each cross section.
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