ToxocariasisB83.0
Synonym(s)
visceral larva migrans; visceral larva migrans syndrome
DefinitionThis section has been translated automatically.
Nematode infection that causes visceral or ocular larva migrans syndrome.
PathogenThis section has been translated automatically.
Toxocara canis (nematode, dog roundworm). Infection through oral ingestion of embryonated Toxocara eggs, including through contaminated food (transport hosts such as rabbits) and drinking water.
Occurrence/EpidemiologyThis section has been translated automatically.
Worldwide occurence, partly infestation of dogs up to 50%.
ManifestationThis section has been translated automatically.
Mainly occurring in children (playing in sandboxes).
Clinical featuresThis section has been translated automatically.
- Most infections are asymptomatic.
- A parainfectious triggered generalized urticaria can occur at the integument. Skin involvement is rather the exception.
- In cases of higher parasitemia fever, abdominal pain, hepatomegaly, pulmonary symptoms such as cough, bronchial spasms, lung infiltrates, lymphadenopathy, splenomegaly, pleuritis, cardiac symptoms and focal neurological symptoms such as seizures, pareses and transverse myelitis, usually only uncharacteristic symptoms.
- Ocular infections are usually unilateral and painless. Occurrence of peripheral retinal inflammation foci or central macular lesions with visual disturbances, retinal detachment, uveitis or diffuse chronic endophthalmitis up to complete blindness.
LaboratoryThis section has been translated automatically.
Eosinophilia.
DiagnosisThis section has been translated automatically.
- Microscopy of organ biopsies, liquor and pleural effusions.
- Detection of antibodies in blood, cerebrospinal fluid and aqueous humor (ELISA, immunoblot).
- Detection of granulomas in the MRT.
Differential diagnosisThis section has been translated automatically.
Larva migrans syndrome caused by Toxocara cati and Baylisascaris procyonis; vasculitic and paraneoplastic hypereosinophilic syndromes; retinoblastoma.
Complication(s)This section has been translated automatically.
Deaths, blindness, cardiac complications.
TherapyThis section has been translated automatically.
Remember! Ocular involvement should be excluded before antihelmintic treatment.
- Albendazole (Escazole): 2 times/day 400 mg p.o. over 2-4 weeks.
- Alternatively, diethylcarbamazepine 6-9 mg/kg bw/day in 3 doses over 2-3 weeks.
- Systemic glucocorticoids for inflammatory reactions and to reduce granuloma formation.
Progression/forecastThis section has been translated automatically.
- Self-limiting disease.
- Symptoms can persist or recur for months and years.
- Individual deaths from cerebral or cardiac complications have been described.
ProphylaxisThis section has been translated automatically.
Regular deworming of dogs and cats, keeping pets away from playgrounds.
LiteratureThis section has been translated automatically.
- Despommier D (2003) Toxocariasis: clinical aspects, epidemiology, medical ecology, and molecular aspects. Clin Microbiol Rev 265-272.