Toxocariasis is a tropical disease caused by the roundworm, toxocara. It is transmitted to humans with the accidental consumption of soil contaminated with the eggs of the parasite excreted in cat or dog feces [1]. The eggs release larvae which puncture the intestinal wall and migrate through the circulatory system to various organs of the human body (brain, eyes, heart, liver, lungs and muscle) where they cause inflammation leading to symptoms of toxocariasis.

The clinical presentation of toxocariasis depends upon the organ system involved and can be classified as:

• Visceral larva migrans (VLM) - involving all major organs
• Ocular larva migrans (OLM) - involving the eyes and the optic nerve
• A covert form which is difficult to diagnose.

VLM affects mainly children under the age of five [2] who present with fever, pain in abdomen, hepatosplenomegaly, eosinophilia, bronchospasm, seizures, neuropsychiatric or cognitive symptoms or encephalopathy depending on the organ system involved.

OLM, on the other hand, affects children in the five to ten year age group and is associated with unilateral visual impairment and, strabismus [3]. In severe cases of OLM, there may be retinal invasion with granuloma formation in the posterior pole, heteropia and macular detachment [4]. There may also be endophthalmitis, papillitis followed secondarily by glaucoma and blindness.

The covert form of toxocariasis can present insidiously with headache, coughing, abdominal pain and hepatosplenomegaly or symptoms resembling asthma e.g. dyspnea, wheezing and coughing [1] [5].

• Fever

  It causes a mild illness with fever. Other possible symptoms include cough, poor sleep, headaches, and abdominal pain. Children may show signs of infected lymph nodes, a swollen liver, or wheezing. [news-medical.net]

  Symptoms and Signs Visceral larva migrans (VLM) VLM consists of fever, anorexia, hepatosplenomegaly, rash, pneumonitis, and asthmatic symptoms, depending on the affected organs. [merckmanuals.com]

  Desaturation and fever suggested wider systemic involvement. CT scan associated to the anti toxocara antibodies strenghtened the hypothesis of parasitic infestation. 3.2. [file.scirp.org]

• Epilepsy

  Several studies have evidenced high seropositivity rates for T. canis among people with epilepsy suggesting that toxocariasis could play a role in the incidence of epilepsy in endemic areas. [ncbi.nlm.nih.gov]

  This increased for those with late-onset partial epilepsy to an OR of 18.22 (95% CI 2.10 to 158.10). [neurology.org]

  […] that toxocariasis may be an etiologic factor in epilepsy. 177 This hypothesis remains unsettled. [epilepsy.com]

  epilepsy has just developed ( 161 ), especially in regions where Toxocara occurs sympatrically with other epilepsy-causing infections ( 50 ). [cmr.asm.org]

• Fatigue

  A range of symptoms are connected with VLM: fatigue weight loss anorexia fever cough pneumonia bronchospasm abdominal pain headache rash seizures (rarely) A swollen liver, infected lymph nodes, and wheezing may also be present. [news-medical.net]

  Although most infected individuals are asymptomatic, clinical manifestations may include fever, fatigue, coughing, wheezing, or abdominal pain (visceral toxocariasis) or vision loss, retina damage, or eye inflammation (ocular toxocariasis). [ajtmh.org]

  However, some people experience mild symptoms such as: a cough a high temperature (fever) headaches stomach pain In rare cases, the roundworm larvae infect organs such as the liver, lungs, eyes or brain and cause severe symptoms such as: fatigue loss [your.md]

• Anorexia

  Symptoms and Signs Visceral larva migrans (VLM) VLM consists of fever, anorexia, hepatosplenomegaly, rash, pneumonitis, and asthmatic symptoms, depending on the affected organs. [merckmanuals.com]

  A range of symptoms are connected with VLM: fatigue weight loss anorexia fever cough pneumonia bronchospasm abdominal pain headache rash seizures (rarely) A swollen liver, infected lymph nodes, and wheezing may also be present. [news-medical.net]

  In VLM, which occurs mostly in preschool children, the larvae invade multiple tissues (liver, heart, lungs, brain, muscle) and cause various symptoms including fever, anorexia, weight loss, cough, wheezing, rashes, hepatosplenomegaly, and hypereosinophilia [cdc.gov]

  A constellation of symptoms develops, including fatigue, anorexia, weight loss, pneumonia, fever, cough, bronchospasm, abdominal pain, headaches, rashes, and, occasionally, seizures. [emedicine.medscape.com]

• Falling

  Whilst we are on the subject of empty falling into disrepair buildings..... [haddenham.net]

  Learn simple steps 2 Jul 2018 Aches and pains Diet and exercise, avoiding falls and tips for a quick recovery. [aviva.co.uk]

  The infection can occur from ingestion of undercooked or raw meat/poultry that is infected Many cases of Toxocariasis are asymptomatic; but, when symptoms do develop, they usually fall into several categories, depending on the migration of parasite and [dovemed.com]

  It has been in fact hypothesized that the abnormal behavior patterns (e.g. pica and hyperactivity) and the elevated number of falls to the ground of PWE (especially children or mentally retarded) could predispose them to Toxocara spp. exposure rather [ncbi.nlm.nih.gov]

  […] endophthalmitis. 12–15 Ocular larva migrans syndrome generally occurs in children older than 8 years. 10 These patients have a normal white blood count, normal serum IgE, and no eosinophilia. 12 Covert toxocariasis has been diagnosed in patients who do not fall [healio.com]

• Cough

  Other possible symptoms include cough, poor sleep, headaches, and abdominal pain. Children may show signs of infected lymph nodes, a swollen liver, or wheezing. [news-medical.net]

  Covert toxocariasis Non-specific symptoms such as cough, abdominal pain, headache, sleep disorder, vomiting, enlarged liver, and occasionally a rash. Blood tests show raised eosinophils in around half of all cases. [dermnetnz.org]

  Symptoms can include cough, difficulty sleeping, abdominal pain, headaches, and behavioral problems. Examination may reveal hepatomegaly, lymphadenitis, and/or wheezing. [emedicine.medscape.com]

  Signs and symptoms of covert toxocariasis are coughing, fever, abdominal pain, headaches, and changes in behavior and ability to sleep. [en.wikipedia.org]

• Abdominal Pain

  Other possible symptoms include cough, poor sleep, headaches, and abdominal pain. Children may show signs of infected lymph nodes, a swollen liver, or wheezing. [news-medical.net]

  The first case was a 5 year old male referred to hospital with the symptoms of abdominal pain, loosing appetite, tenderness, cashexia, fever and 9.5gr/dl haemoglobin. Abdominal sonography revealed an echohetrogeny 49×20×54mm in. [pjms.com.pk]

  We report a 13-year-old girl with recurrent abdominal pain who, despite positive toxocara serology, was extensively investigated for other abdominal pathology. [ncbi.nlm.nih.gov]

  Symptoms can include cough, difficulty sleeping, abdominal pain, headaches, and behavioral problems. Examination may reveal hepatomegaly, lymphadenitis, and/or wheezing. [emedicine.medscape.com]

  Covert toxocariasis Non-specific symptoms such as cough, abdominal pain, headache, sleep disorder, vomiting, enlarged liver, and occasionally a rash. Blood tests show raised eosinophils in around half of all cases. [dermnetnz.org]

• Loss of Appetite

  Symptoms were fever, inactivity, weakness, tiredness and loss of appetite. She was followed clinically and with blood samples throughout a period of three years and four months. [ncbi.nlm.nih.gov]

  Other symptoms are loss of appetite, fever, muscle and joint pains, abdominal pain, skin rashes and eye problems. These symptoms are due to migration of the larvae through the organs and tissues. [medigoo.com]

  Other symptoms may include abdominal pain, enlarged liver or spleen, loss of appetite, rash, and enlarged lymph nodes *. Toxocariasis can also affect the eyes and cause decreased vision, swelling around the eyes, and a cross-eyed appearance. [humanillnesses.com]

  Other symptoms are loss of appetite, muscle and joint pains, abdominal pain, skin rashes and eye problems. These symptoms are due to migration of the larvae through the organs and tissues. [conditions.health.qld.gov.au]

  Infection causes a transient illness with fever, lassitude, loss of appetite, pallor and often coughing and wheezing. [medical-dictionary.thefreedictionary.com]

• Acute Abdomen

  Visceral larva migrans presenting as acute abdomen in a child. J Pediatr Surg. 41(3):e7-9. [Medline]. Inatomi Y, Murakami T, Tokunaga M, et al. Encephalopathy caused by visceral larva migrans due to Ascaris suum. [emedicine.com]

• Pruritus

  Furthermore patients with chronic urticaria, pruritus, or prurigo may have lower antibody levels than those with standard VLM. In these patients the Western blot serology method may be more suitable to diagnose toxocariasis. [dermnetnz.org]

  Features Weakness Pruritus (Itching) Rash Difficulty breathing Abdominal pain / Hepatosplenomegaly Hyper-eosinophilia Increased total serum Immunoglobulin E (IgE) level Elevated antibody titers to T. canis Diagnosis In suspected cases, diagnosis is confirmed [wikidoc.org]

  Discussion The most frequent clinical manifestation of toxocariasis are VLM and OLM; clinical features are nonspecific symptoms such as fever, weakness, pruritus, dyspnoea, anorexia, headache, abdominal pain, nausea, vomiting, drowsiness [4]. [file.scirp.org]

  No statistical excess of risk was observed for patients with atopic dermatitis, pruritus or non-atopic eczema. Conclusion: The authors conclude that patients suffering from urticaria or prurigo should be tested for Toxocara infection. [karger.com]

• Cutaneous Manifestation

  Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. 2008;59:1031-42 On DermNet NZ: Urticaria Prurigo Other websites: Toxocariasis – Medscape Reference Books about skin diseases: See the DermNet NZ bookstore [dermnetnz.org]

  Cutaneous Manifestations Cutaneous symptoms are relatively frequent in patients with Toxocara infection, especially those with VLM and common toxocariasis [ 44 ]. [link.springer.com]

  & Staughton, R. ( 1972 ) The cutaneous manifestations of toxocariases. Dermatologica 144, 129 – 143. [cambridge.org]

  Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. 2008 Dec. 59(6):1031-42. [Medline]. Glickman LT, Schantz PM. Epidemiology and pathogenesis of zoonotic toxocariasis. Epidemiol Rev. 1981. 3:230-50. [Medline]. [emedicine.com]

• Eczema

  Skin manifestations such as itch, eczema / dermatitis, and urticaria are sometimes present. Covert toxocariasis Non-specific symptoms such as cough, abdominal pain, headache, sleep disorder, vomiting, enlarged liver, and occasionally a rash. [dermnetnz.org]

  No statistical excess of risk was observed for patients with atopic dermatitis, pruritus or non-atopic eczema. Conclusion: The authors conclude that patients suffering from urticaria or prurigo should be tested for Toxocara infection. [karger.com]

  Other cutaneous manifestations include chronic pruritus, chronic prurigo, transient rash, different forms of eczema, hypodermic nodules and vasculitis [ 44 ]. [link.springer.com]

  The clinical manifestation of covert toxocariasis varies widely, with pulmonary involvement, such as asthma, acute bronchitis, pneumonia with or without Loeffler's syndrome, 90,91 skin problems, such as chronic urticaria or eczema, 92 lymphadenopathy, [scielo.br]

• Eruptions

  Buslau M, Marsh WC: Papular eruption in helminth infestation: A hypersensitivity phenomenon? Report of four cases. Acta Derm Venereol (Stockh) 1990;70:526–529. [karger.com]

  These larval migrations are characterized by the appearance of progressive, intensely pruritic, linear eruptive lesions, which are usually more extensive with A. braziliense infections. [web.archive.org]

  Zeitschrift fur Augenheilkunde 238(3) 163-171 2017 [Refereed] Three cases of pigmented cosmetic dermatitis-like eruptions associated with primary Sjögren's syndrome or anti-SSA antibody. [researchmap.jp]

• Strabismus

  For OLM, unilateral vision loss and strabismus (misalignment of the eyes), are key symptoms. A definitive diagnosis of VLM can be made by testing for common roundworm antigens and blood group substance A. [news-medical.net]

  Chronic endophthalmitis Posterior granuloma Peripheral granuloma Frequency 25% 25-46% 20-40% Average age at onset 2-8 years 6-14 years 6-40 years Clinical features Severe granulomatous vitreitis Cyclitic membranes Retinal detachment Leucokoria Strabismus [medsci.org]

  OLM, on the other hand, affects children in the five to ten year age group and is associated with unilateral visual impairment and, strabismus. [symptoma.com]

  […] primarily to liver and lung, but also brain, eye, etc, causing inflammation and tissue damage in transit Clinical Fever, pulmonary complaints–eg, cough, wheezing, seizures, rash, ↓ visual acuity due to migration through ocular structures–periorbital edema, strabismus [medical-dictionary.thefreedictionary.com]

  OLM generally affects children between 2 and 10 years old, presenting as unilateral decreased visual acuity with or without strabismus. [aao.org]

• Eye Pain

  A 6-year-old girl presented to Suzhou Municipal Children's Hospital with a complaint of right eye redness, minimal white discharge, no photophobia, eye pain, visual impairment, fever or arthralgia. [ncbi.nlm.nih.gov]

  Depending on where the worms spread, symptoms can include: a high temperature coughing or wheezing stomach ache an itchy rash eye pain or redness changes to your sight, such as seeing small dots or lines (floaters) or flashes of light loss of vision [nhs.uk]

  Abdominal pain. Skin rash. Enlarged liver. Enlarged spleen. Pneumonia. Ocular toxocariasis usually only affects one eye. Symptoms of ocular toxocariasis may include: Eye pain and redness. Retina scarring and damage. Vision problems. [my.clevelandclinic.org]

  Case presentation: This paper presents the case of a 22-year-old woman from Caquetá, with a three-month history of vision loss in her left eye, eye pain, diplopia, photophobia and bilateral red eye. [revistas.unal.edu.co]

  Pediatric patients also may present with leukocoria, strabismus, photophobia, eye pain, or eye redness. [academic.oup.com]

• Behavior Disorder

  Symptoms can include cough, difficulty sleeping, abdominal pain, headaches, and behavioral problems. Examination may reveal hepatomegaly, lymphadenitis, and/or wheezing. [emedicine.medscape.com]

  Following these manifestations, the patients complain about headache, weakness, confusion, epileptic seizure, neuropsychological disturbances, depression, sensory disturbances, reduced long and short term memory and probably cognitive and behavioral disorders [esciencecentral.org]

  Xinou et al. ( 118 ) described a woman aged 54 years presenting with gait disturbance, clumsiness in the left arm, behavioral disorders, and an eosinophilia of 36%. [cmr.asm.org]

• Abnormal Behavior

  These abnormal behavioral changes are likely related to the site where T. canis larvae are located in the brain, the immune response directed against T. canis larvae, and, more importantly, pathological effects rather than parasite-altered host behavior [cmr.asm.org]

  It has been in fact hypothesized that the abnormal behavior patterns (e.g. pica and hyperactivity) and the elevated number of falls to the ground of PWE (especially children or mentally retarded) could predispose them to Toxocara spp. exposure rather [ncbi.nlm.nih.gov]

• Headache

  Other possible symptoms include cough, poor sleep, headaches, and abdominal pain. Children may show signs of infected lymph nodes, a swollen liver, or wheezing. [news-medical.net]

  Mebendazole does not usually cause side effects although some people may experience headaches at the start of their treatment. [hse.ie]

  Symptoms can include cough, difficulty sleeping, abdominal pain, headaches, and behavioral problems. Examination may reveal hepatomegaly, lymphadenitis, and/or wheezing. [emedicine.medscape.com]

  A 46-year-old man developed intermittent headache, diplopia, and visual obscuration for two months. Funduscopic examination showed optic disk swelling in both eyes. [ncbi.nlm.nih.gov]

• Neglect

  U2 - 10.1371/journal.pntd.0001382 DO - 10.1371/journal.pntd.0001382 M3 - Article VL - 2012 SP - e1382 JO - PLoS Neglected Tropical Diseases T2 - PLoS Neglected Tropical Diseases JF - PLoS Neglected Tropical Diseases SN - 1935-2735 IS - 2 M1 - 6 ER - [research.vu.nl]

  These results identify an important association that may reflect morbidity attributable to a genuine neglected infection. [ncbi.nlm.nih.gov]

  Hotez PJ (2008) Neglected infections of poverty in the United States of America. PLoS neglected tropical diseases 2: e256. View Article Google Scholar 6. [journals.plos.org]

• Cognitive Disorder

  The CNS migration may lead to a variety of neurological disorders such as meningo-encephalitis, myelitis, cerebral vasculitis, optic neuritis [23], [24] and probably cognitive [25] and behavioural [26] disorders. [ncbi.nlm.nih.gov]

  Cerebral toxocariasis: a rare cause of cognitive disorders. A contribution to differential dementia diagnosis. Nervenarzt. 2002;73:458–62. (in German) Article PubMed CAS Google Scholar Bachli H, Minet JC, Gratzl O. [idpjournal.biomedcentral.com]

  Clearly, further research on the possible mechanistic relationship between Toxocara brain involvement and schizophrenia, depressive, and cognitive disorders is required. [cmr.asm.org]

The diagnosis of the disease is based mainly on the history and symptoms of multi-organ or ocular involvement. Serological testing and biopsy or autopsy specimens showing larvae help to confirm the diagnosis.

Toxocariasis should be suspected in a child with a history of pica, contact with dogs or cats, clinical signs of unexplained febrile illness with hepatosplenomegaly, eosinophilia or ocular symptoms. A complete blood count will reveal eosinophilia, although it may be absent in some cases of OLM and covert toxocariasis.

Confirmation of the diagnosis relies on the laboratory demonstration of specific anti-toxocara antibodies in either the serum or aqueous or vitreous fluid of the infected individual. The enzyme-linked immunosorbent assay (ELISA) test which uses antigens from the second stage larva is the best indirect test for the diagnosis of toxocariasis. Although histopathology of tissue samples with the identification of larvae or the detection of larval DNA in tissues is definitive, it is difficult to obtain such infected tissue samples [6] [7].

The diagnosis of OLM is based on clinical criteria and ophthalmic examination as immunodiagnostic tests are not as reliable as for VLM [8]. Neuroimaging, especially magnetic resonance imaging (MRI) is recommended to detect granulomas in the cortical or subcortical layers of the brain in patients with neuropsychiatric symptoms. MRI findings combined with cerebrospinal detection of eosinophil is indicative of toxocara infection.

• Toxoplasma Gondii

  Previous diagnostic investigation by polymerase chain reaction and GWC for Herpes simplex virus, Varicella zoster virus, and Toxoplasma gondii had not provided a cause of the posterior uveitis. [ncbi.nlm.nih.gov]

  Antibodies against Toxoplasma gondii and Taenia solium cysticercus were negative, as well as the VDRL. The ELISA test for Toxocara canis was positive, with IgG titers of 1:64 (positive ≥1:32, specificity >90%). [revistas.unal.edu.co]

  & Liesenfeld, O. ( 2012 ) Seroepidemiology of Toxoplasma gondii infection in Tepehuanos in Durango, Mexico. Vector Borne and Zoonotic Diseases 12, 138 – 142. [cambridge.org]

• Taenia Solium

  Abstract Objective: To assess the relationship between epilepsy and infection with Taenia solium and Toxocara canis with a case-control study, in the rural area of the Cordillera Province, Bolivia. [neurology.org]

  Antibodies against Toxoplasma gondii and Taenia solium cysticercus were negative, as well as the VDRL. The ELISA test for Toxocara canis was positive, with IgG titers of 1:64 (positive ≥1:32, specificity >90%). [revistas.unal.edu.co]

  If the patient has recently travelled abroad, differential diagnosis of eosinophilic meningitis/myelitis is more extensive and includes Taenia solium, Gnathostoma spinigerum, Angiostrongylus cantonensis, and Baylisascaris procyonis [ 8 – 10 ]. [hindawi.com]

  Hancock K, Pattabhi S, Whitfield FW, Yushak ML, Lane WS, et al. (2006) Characterization and cloning of T24, a taenia solium antigen diagnostic for cysticercosis. Mol Biochem Parasitol 147(1): 109–117. 10.1016/j.molbiopara.2006.02.004. [journals.plos.org]

Treatment The standard treatment for toxocariasis is a five-day course of albendazole. This is sometimes supplemented with corticosteroids to suppress the allergic reaction to the roundworms. [news-medical.net]

For systemic infections, practitioners use the antiparasitic drug mebendazole; it is not clear whether this is an effective ocular treatment. More aggressive treatments include laser photocoagulation and cryoretinopexy. [medigoo.com]

Furthermore, for patients suspected of eosinophilia of unknown origin who have positive results for T. canis, albendazole treatment may be considered a valuable treatment option. [kjim.org]

Treatment Albendazole or mebendazole Symptomatic treatment Asymptomatic patients and patients with mild symptoms do not require anthelmintic therapy because infection is usually self-limited. [merckmanuals.com]

Treatment in humans varies according to symptoms and location of the larvae. Anthelmintics, including albendazole, thiabendazole and mebendazole may be given together with anti-inflammatory corticosteroids. [ncbi.nlm.nih.gov]

Those that require surgical intervention typically have a poorer prognosis and visual acuity. [eyewiki.aao.org]

We suggest that the visual prognosis need not be so poor as commonly believed, and outline a suggested plan of management. [ncbi.nlm.nih.gov]

Prognosis Toxocariasis is generally a self-limited disease. The prognosis is good when adequately treated, except in some patients with ocular or cerebral involvement. Patient Education Properly de-worm kittens and puppies. [emedicine.medscape.com]

Well-timed vitrectomy is a suitable therapy for vitro-retinal complications in ocular toxocariasis to improve prognosis and to confirm the diagnosis. [8] Ophthalmologists need to be made aware of the ocular toxocariasis - especially in children and young [ijmm.org]

RESULTS: Of 238 patients with uveitis of unknown etiology, 71 (29.8%) were diagnosed with OT, and 80 (33.6%) had positive ELISA results for serum anti-Toxocara IgG. [ncbi.nlm.nih.gov]

The development of molecular tools should lead to new and improved strategies for the treatment, diagnosis and control of toxocariasis and the role of other ascaridoid species in the epidemiology of Toxocara spp. [ncbi.nlm.nih.gov]

Keywords: epidemiology, human, toxocariasis, dogs. [youngscientistusa.com]

Glickman LT, Schantz PM (1981) Epidemiology and pathogenesis of zoonotic toxocariasis. Epidemiol Rev 3: 230–250. View Article Google Scholar 25. [journals.plos.org]

In addition, risk factors for acquiring infection need to be better defined, and research needs to be conducted to better understand the pathophysiology and clinical course of toxocariasis. [ncbi.nlm.nih.gov]

Pathophysiology The eggs of Toxocara canis, T. cati, and other animal ascarid helminths mature in soil and infect dogs, cats, and other animals. [merckmanuals.com]

Pathophysiology Adult worms of the Toxocara family often live in the small intestine of dogs and cats. They range from 4-12 cm in length. Almost all puppies are infected at or soon after birth. During the summer, Toxocara infective eggs are shed. [wikidoc.org]

Pathophysiology: Human infection with Toxocara, the parasitic larvae of canine or feline roundworms, is known as visceral larval migrans (VLM) systemically and ocular larva migrans (OLM) when it affects the eye. [web.archive.org]

Pathophysiology In humans, after contact with infected fecal material, the roundworm migrates throughout various organs but is unable to sexually mature. Reactive inflammatory processes lead to the organism's encapsulation. [eyewiki.aao.org]

OLM should be distinguished from retinoblastoma to prevent unnecessary surgical enucleation of the eye. [merckmanuals.com]

Preventive Measures: Wash your hands with soap and warm water after playing with your pets or other animals, after outdoor activities, and before handling food. Teach children the importance of washing hands to prevent infection. [medigoo.com]

Vitreoretinal surgery is useful and indicated to remove vitreous opacities and epiretinal membranes, to prevent and to treat retinal detachment. [medsci.org]

CDC Guidelines for Veterinarians: Prevention of Zoonotic Transmission of Ascarids and Hookworms of Dogs and Cats. Available at http://www.cdc.gov/NCIDOD/DPD/PARASITES/ascaris/prevention.htm. CDC. Centers for Disease Control and Prevention (CDC). [emedicine.medscape.com]

Washing all fruits and vegetables, keeping pets out of gardens and thoroughly cooking meats can also prevent transmission. [en.wikipedia.org]

1. Global Health - Division of Parasitic Diseases and Malaria (2013) Parasites - Toxocariasis (also known as Roundworm Infection). Atlanta, GA: Centers for Disease Control and Prevention.
2. Worley G, Green IA, Frothingham TE. Toxocara canis infection: clinical and epidemiological associations with seropositivity in kindergarten children. J. Infect. Dis. 1984;149:591-597.
3. Dinning WJ, Gillespie SH, Cooling RI, Maizels RM. Toxocariasis: a practical approach to management of ocular disease. Eye. 1988; 2:580-582.
4. Small KW, McCuen BW, De Juan E, Machemer R. Surgical management of retinal retraction caused by toxocariasis. Am. J. Ophthalmol.1989; 108:10-14.
5. Barry MA, Weatherhead JE, Hotez PJ, Woc-Colburn L. Childhood parasitic infections endemic to the United States. Pediatric clinics of North America. 2013; 60: 471–485.
6. Magnaval JF, Glickman LT, Dorchies P, Morassin B. Highlights of human toxocariasis. Korean J. Parasit.2001; 39:1-11.
7. Smith HV. Antibody reactivity in toxocariasis. In: LEWIS, J.W. & MAIZELS, R.M., ed.Toxocara and toxocariasis: clinical, epidemiological and molecular perspectives. London, Institute of Biology.1993; p. 91-109.
8. Schantz PM. Toxocara larva migrans now. Am J Trop Med Hyg. 1989;41(Suppl.):21-34.