Visceral Larva Migrans Medication

  • Author: Raymond D Pitetti, MD, MPH; Chief Editor: Russell W Steele, MD   more...
 
Updated: Aug 19, 2011
 

Medication Summary

Children can be treated with an anthelmintic agent. Severe infections should be treated with systemic corticosteroids.

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Anthelmintics

Class Summary

Historically, the treatment of visceral larva migrans (VLM) in adults and children was primarily symptomatic. However, the identification of anthelmintics (eg, thiabendazole, diethylcarbamazine) in the 1960s offered an effective therapeutic choice. Anthelmintics act against the migrating larvae.

Parasite biochemical pathways are different from the human host; thus, toxicity is directed to the parasite, egg, or larvae. The mechanism of action varies within the drug class. Antiparasitic actions may include the following:

  • Inhibition of microtubules causes irreversible block of glucose uptake
  • Tubulin polymerization inhibition
  • Depolarizing neuromuscular blockade
  • Cholinesterase inhibition
  • Increased cell membrane permeability, resulting in intracellular calcium loss
  • Vacuolization of the schistosome tegument
  • Increased cell membrane permeability to chloride ions via chloride channels alteration
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Mebendazole (Vermox)

 

Selectively and irreversibly blocks the uptake of glucose and other nutrients in susceptible intestine-dwelling helminths.

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Thiabendazole (Mintezol)

 

Inhibits mitochondrial formate reductase, which is specific for helminth.

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Albendazole (Albenza)

 

Acts primarily by inhibiting tubulin polymerization, resulting in the loss of cytoplasmic microtubules. Tends to be most effective against larval forms.

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Contributor Information and Disclosures
Author

Raymond D Pitetti, MD, MPH  Associate Professor, Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Pittsburgh School of Medicine; Associate Division Chief, Division of Pediatric Emergency Medicine; Associate Medical Director, Emergency Department; Medical Director, Sedation Services; Medical Director, Express Care; Medical Director, Patient Safety; Consulting Staff, University of Pittsburgh Physicians

Raymond D Pitetti, MD, MPH is a member of the following medical societies: Allegheny County Medical Society, American Academy of Pediatrics, Pennsylvania Medical Society, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Sanofi Pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Leslie L Barton, MD  Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

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Diagram of the Toxocara canis life cycle image. Courtesy of the Centers for Disease Control and Prevention.
 
 
 
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