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Visceral Larva Migrans

Toxocariasis


Presentation

Splenomegaly
  • Follow-up showed increased physical activity, improved respiratory status, and resolution of splenomegaly.[ncbi.nlm.nih.gov]
  • Clinical findings were pain, fever, anorexia, dizziness, dyspnea, weight loss, cough, hepatomegaly, splenomegaly and lymphadenopathy.[ijph.tums.ac.ir]
  • In the first half of the twentieth century as many as 42% of black schoolchildren in the Delta had splenomegaly indicative of active malaria infection, and almost twice as many blacks died from malaria as whites [2].[doi.org]
Mediastinal Lymphadenopathy
  • We report a case of visceral larva migrans in an adult with fever, night sweats, weight loss, hilar and mediastinal lymphadenopathy, bilateral pleural effusion, and eosinophilia-mimicking lymphoma.[ncbi.nlm.nih.gov]
  • There is no pleural thickening or effusion and no hilar or mediastinal lymphadenopathy. Download Figure Fig. 1 (A) Chest X-ray film showing an infiltrative shadow in both the middle and lower lung fields mainly in the right lung.[degruyter.com]
Fever
  • Visceral larva migrans may present with systemic symptoms such as fever, hepatomegaly, pneumonitis or ocular symptoms. A 7-year-old girl with fever, pain abdomen and persistent eosinophilia.[ncbi.nlm.nih.gov]
Veterinarian
  • Veterinarians must be prepared to take a leading role in the education of their clients as to the potential of the disease for the children associated with new puppies, and the measures parents can take to reduce the exposure potential.[ncbi.nlm.nih.gov]
  • Toxocara cati visceral larva migrans, man with presenting symptoms of eosinophilia, headache, and fatigue, high antibody titers to T. cati, worked as veterinarian and owned pet cat, improvement with thiabendazole Disease transmission, Animal to man Toxocara[agris.fao.org]
  • Zoonotic ascarids and hookworms: The role for veterinarians in preventing human disease. Compendium on continuing education for the practicing veterinarian 2002;24(1)(Suppl):47-52. Beaver PC.[web.archive.org]
  • I’m sitting in my usual study spot, at my favorite cafe, composing my final post for Merck Manuals Vet Student Stories as a student veterinarian. I’m in shock that these... More Featured[merckvetmanual.com]
Anemia
  • There was marked eosinophilia with leukocytosis, anemia, hypergammaglobulinemia and elevated serum Ig E titers. Toxocariasis was confirmed by anti-Toxocara IgG and Western blot.[ncbi.nlm.nih.gov]
  • Larvae of the parasite invade the liver, causing hepatomegaly with extreme eosinophilia, and usually fever and anemia. Migration of the larvae to other organs may result in pneumonitis, encephalitis or myocarditis.[pediatrics.aappublications.org]
  • In this study, the adult patient presented with eosinophilic cellulitis, hepatosplenomegaly, anemia, and a positive ELISA for T. canis. The incubation period for Toxocara canis and cati eggs depends on temperature and humidity.[en.wikipedia.org]
  • On admission, hematological examination of peripheral blood showed iron deficiency anemia (Hemoglobin 7.5 g/dl), leukocytosis (40,000 cells/mm 3 ) accompanied by marked eosinophilia (25,000 cells/mm 3 ).[degruyter.com]
  • […] larvae, or from infective larvae passed in their dam’s milk ( A. caninum ). 2 Hookworms suck large amounts of blood from their hosts and while infected animals may look healthy in the first week of life, they can develop a rapidly severe, often fatal, anemia[web.archive.org]
Pallor
  • On admission, the physical examination revealed hepatomegaly and pallor. There was marked eosinophilia with leukocytosis, anemia, hypergammaglobulinemia and elevated serum Ig E titers.[ncbi.nlm.nih.gov]
  • Patients can present with pallor, fatigue, weight loss, anorexia, fever, headache, rash, cough, asthma, chest tightness, increased irritability, abdominal pain, nausea, and vomiting.[en.wikipedia.org]
Pallor
  • On admission, the physical examination revealed hepatomegaly and pallor. There was marked eosinophilia with leukocytosis, anemia, hypergammaglobulinemia and elevated serum Ig E titers.[ncbi.nlm.nih.gov]
  • Patients can present with pallor, fatigue, weight loss, anorexia, fever, headache, rash, cough, asthma, chest tightness, increased irritability, abdominal pain, nausea, and vomiting.[en.wikipedia.org]
Cough
  • The patient received a 10-day course of albendazole (400 mg orally twice daily) and demonstrated significant clinical improvement with resolution of cough and pulmonary function abnormalities.[ncbi.nlm.nih.gov]
Dyspnea
  • The patient, a resident of the middle Kyushu area who was found of eating raw porcine liver, complained of dry cough without dyspnea. The chest radiography showed a migration of infiltrative shadow.[ncbi.nlm.nih.gov]
  • Clinical findings were pain, fever, anorexia, dizziness, dyspnea, weight loss, cough, hepatomegaly, splenomegaly and lymphadenopathy.[ijph.tums.ac.ir]
  • Previous studies mentioned that pulmonary involvement could cause cough, wheeze and dyspnea. These manifestations might mimic to bronchitis, pneumonia, or asthma.[degruyter.com]
  • When symptoms manifested, the following presenting symptoms were noted: cough or sputum ( n 9), chest tightness or pain ( n 3), dyspnea ( n 2), blood-tinged sputum ( n 1), upper right abdominal pain ( n 1), ocular symptoms ( n 1), skin lesions ( n 1),[ajronline.org]
Dry Cough
  • The patient, a resident of the middle Kyushu area who was found of eating raw porcine liver, complained of dry cough without dyspnea. The chest radiography showed a migration of infiltrative shadow.[ncbi.nlm.nih.gov]
  • His medical history was clear according to his parents, until 2 weeks before admission, when he developed severe dry cough without dyspnea, mild chest pain, generalized fatigue and abdominal pain.[degruyter.com]
Geophagia
  • Medical history included reactive airway disease and geophagia (pica). Serology for Toxocara canis revealed elevated IgG and IgM titers. Ophthalmologic evaluation ruled out ocular larva migrans.[ncbi.nlm.nih.gov]
  • Their definitive hosts are the domestic dog and cat, in which they live as adults within the lumen of the small intestine. 1 Humans become infected after ingesting embryonated eggs from soil (geophagia, pica) or after exposure to dirty hands, raw vegetables[n.neurology.org]
Acute Abdomen
  • Clinicians should remember that toxocaral visceral larva migrans may rarely mimic an acute abdomen and cause unnecessary operations.[ncbi.nlm.nih.gov]
  • 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]
Hepatomegaly
  • Visceral larva migrans may present with systemic symptoms such as fever, hepatomegaly, pneumonitis or ocular symptoms. A 7-year-old girl with fever, pain abdomen and persistent eosinophilia.[ncbi.nlm.nih.gov]
  • CT showed small multiple low-density areas up to 15 mm located mainly in the periportal region in the right lobe of liver with associated hepatomegaly ( Figure 2 ).[em-consulte.com]
Hepatosplenomegaly
  • In this study, the adult patient presented with eosinophilic cellulitis, hepatosplenomegaly, anemia, and a positive ELISA for T. canis. The incubation period for Toxocara canis and cati eggs depends on temperature and humidity.[en.wikipedia.org]
  • This parasite infection induces variable manifestations, including muscle pain, fever, hepatosplenomegaly, respiratory symptoms, and abdominal pain. However, most patients do not manifest definitive symptoms [ 1 - 3 ].[kjim.org]
  • Hepatosplenomegaly and evidence of multisystem disease and history of pica make the diagnosis of VLM more likely. Similarly, OLM should be suspected in any child with unilateral vision loss and strabismus.[doi.org]
Urticaria
  • Nineteen patients diagnosed with recidivous acute urticaria (RAU) caused by Anisakis simplex and 26 patients diagnosed with visceral larva migrans (VLM) caused by Toxocara canis were studied employing commercial diagnostic kits and "in house" assay kits[ncbi.nlm.nih.gov]
  • Guidelines for evaluation and management of urticaria in adults and children. Br J Dermatol . 2007 Dec. 157(6):1116-23. [Medline] . Petithory JC. [Visceral and cutaneous larva migrans]. Rev Prat . 2007 Nov 30. 57(18):1977-83. [Medline] . Lim JH.[emedicine.medscape.com]
  • [Chronic urticaria and toxocara canis infection. A case-control study]. Ann Dermatol Venereol. 1996. 123(4):240-6. [Medline]. Bachmeyer C, Lamarque G, Morariu R, et al. Visceral larva migrans mimicking lymphoma. Chest. 2003 Apr. 123(4):1296-7.[emedicine.com]
Night Sweats
  • We report a case of visceral larva migrans in an adult with fever, night sweats, weight loss, hilar and mediastinal lymphadenopathy, bilateral pleural effusion, and eosinophilia-mimicking lymphoma.[ncbi.nlm.nih.gov]
Myelopathy
  • CONCLUSION: Although all lesions show non-specific imaging findings like non-tumorous myelopathy mimicking transverse myelitis, single lesion, focal nodular enhancement on posterior or posterolateral segment of spinal cord, relatively short segmental[ncbi.nlm.nih.gov]
  • MR in Toxocara canis myelopathy. AJNR Am J Neuroradiol. 1994 Nov. 15(10):1918-20. [Medline]. Lassmann B, Tsigrelis C, Virk A. 33-year-old woman with marked eosinophilia. Mayo Clin Proc. 2007 Jan. 82(1):103-6. [Medline].[emedicine.com]
Testicular Swelling
  • One patient had deep edema that suggested thrombophlebitis of the right arm; the man in our series had right testicular swelling during followup. In 2 cases, panniculitis was documented by biopsy and in one, small vessel vasculitis.[ncbi.nlm.nih.gov]

Workup

  • This difference in follow-up interval was unavoidable because no guideline for imaging workup and follow-up of pulmonary toxocariasis has been established to date.[ajronline.org]
Pericardial Effusion
  • We describe a case of visceral larva migrans syndrome complicated by liver abscess, pericardial effusion and ascites. To our knowledge, these findings have not been reported previously.[ncbi.nlm.nih.gov]
Toxocara Canis
  • PURPOSE: The purpose of this study is to investigate the MRI findings of visceral larva migrans (VLS) of Toxocara canis in spinal cord.[ncbi.nlm.nih.gov]
  • Convert to ICD-10-CM : 128.0 converts directly to: 2015/16 ICD-10-CM B83.0 Visceral larva migrans Approximate Synonyms Infection by Toxocara canis Infection due to Toxocara Toxocara canis infection Applies To Larva migrans visceralis Toxocara (canis)[icd9data.com]
Toxocara Cati
  • Toxocara cati visceral larva migrans, man with presenting symptoms of eosinophilia, headache, and fatigue, high antibody titers to T. cati, worked as veterinarian and owned pet cat, improvement with thiabendazole Disease transmission, Animal to man Toxocara[agris.fao.org]
  • Toxocariasis is an infection caused by the ingestion of larvae of the dog Toxocara canis or the cat Toxocara cati. A 2.5 year old boy was admitted to our clinics with fever, abdominal pain and loss of appetite.[ncbi.nlm.nih.gov]
  • From Wikidata Jump to navigation Jump to search illness of humans caused by larvae (immature worms) of the dog roundworm (Toxocara canis), the cat roundworm (Toxocara cati) or the fox roundworm (Toxocara canis) Infection by Toxascaris (disorder) Toxocara[wikidata.org]
  • Toxocariasis is an illness of humans caused by larvae (immature worms) of either the dog roundworm (Toxocara canis), the cat roundworm (Toxocara cati) or the fox roundworm (Toxocara canis). Toxocariasis is often called visceral larva migrans (VLM).[en.wikipedia.org]
White Matter Lesions
  • Brain magnetic resonance (MR) imaging revealed multiple cerebral cortical and white matter lesions. Serological tests indicated recent infection with A. suum.[ncbi.nlm.nih.gov]

Treatment

  • One of the patients underwent liver resection while post-treatment follow-up scan at 6 months in the remaining two displayed regression of the lesions with antihelminthic treatment.[ncbi.nlm.nih.gov]
  • Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. More on: Resources For Health Professionals: Treatment[web.archive.org]

Etiology

  • Clinicians should consider hepatic toxocariasis as a possible diagnosis in any individual who presents with eosinophilia of unknown etiology and an ill-defined hepatic lesion on CT imaging.[ncbi.nlm.nih.gov]
  • A consistent chapter format enables you to rapidly and effortlessly locate the most current protocols on manifestations, etiologies, triggers, approaches to treatment, complications, and preventative strategies.[books.google.com]
  • The etiology of visceral larva migrans. J Parasitol 1956;42:349–362 Google Scholar Copyright information Springer-Verlag New York Inc 1994 Authors and Affiliations R. Jain 1 S. Sawhney 1 D. K. Bhargava 2 S. K. Panda 3 M. Berry 1 1.[link.springer.com]

Epidemiology

  • Neurohelminthiasis as a cause of multiple abscesses, though rare, should be entertained as a differential diagnosis particularly in tropical South-east Asian countries where helminthiasis is still an epidemiological concern prevalent in the pediatric[ncbi.nlm.nih.gov]
  • Epidemiology of allergic disorders in early childhood. Pediatr. Pulmonol. Suppl. 16 : 69. 58. 59. Tost, F., A. Hellman, and G. Ockert. 1998 . Toxocara canis infection. Environmental, parasitologic and epidemiologic studies.[doi.org]
Sex distribution
Age distribution

Pathophysiology

  • The results were considered to represent the pathophysiology of this entity.[ncbi.nlm.nih.gov]
  • 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 Children contract Toxocara infections by ingesting embryonated eggs. The larvae hatch in the small intestine, invade the mucosa, and enter the portal system.[emedicine.medscape.com]
  • Pathophysiology Most frequently, human toxocariasis is caused by T. canis, a nematode roundworm of the family Ascaridae. Adult T. canis female worms are usually found in young puppies and lactating female dogs.[emedicine.com]

Prevention

  • Prevention is the most important strategy because of the high prevalence of T. canis in urban areas.[ncbi.nlm.nih.gov]
  • However studies by the US Centers for Disease Control and Prevention (CDC) have found that, among all age groups, toxocariasis is more common in non-Hispanic blacks than in Mexican Americans and non-Hispanic whites.[emedicine.com]
  • Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. More on: Resources For Health Professionals: Treatment[web.archive.org]

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