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Visceral Larva Migrans Workup

  • Author: Raymond D Pitetti, MD, MPH; Chief Editor: Russell W Steele, MD  more...
Updated: Nov 02, 2015

Laboratory Studies

See the list below:

  • A CBC count often reveals leukocytosis and eosinophilia in patients with visceral larva migrans (VLM); however, eosinophilia may not always be present. Children may be anemic.
  • Obtain stool cultures to rule out other parasitic infections.
  • Elevated titers of isohemagglutinins to the A and B blood group antigens support the diagnosis of visceral larva migrans.
  • Enzyme-linked immunosorbent assay (ELISA) is the most commonly used serologic test physicians use to diagnose visceral larva migrans, with a reported sensitivity of 78.3% and specificity of 92.3%. Positive results should be confirmed using Western blotting.
  • Hypergammaglobulinemia may be present.

Imaging Studies

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  • Children with visceral larva migrans may exhibit an abnormal liver parenchymal pattern on both abdominal ultrasonography and CT scanning.[4]
  • MRI may reveal multiple cerebral lesions in patients with CNS visceral larva migrans.
  • Pulmonary infiltrates due to visceral larva migrans generally manifests as a transient form of Löffler syndrome or simple eosinophilic pneumonia on a chest radiograph.

A study described the characteristic radiologic findings of pulmonary toxocariasis on initial and follow-up chest CT. The study found that pulmonary toxocariasis manifested as multiple lesions in four radiologic patterns with subpleural and lower lung predominance on initial and follow-up CT. The study further reported that a linear opacity may be one of many clues in the diagnosis of pulmonary toxocariasis on CT.[5]



See the list below:

  • In unusual circumstances, liver biopsy may aid in diagnosing visceral larva migrans; however, microscopic identification of larvae from biopsy samples is infrequent.
  • Negative liver biopsy findings do not exclude visceral larva migrans.

Histologic Findings

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  • Multiple eosinophilic abscesses and allergic-type granulomas are often found in affected tissues.
Contributor Information and Disclosures

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, Children's Hospital of Pittsburgh of UPMC and University of Pittsburgh Physicians

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

Disclosure: Nothing to disclose.

Specialty Editor Board

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.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

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, Southern Medical Association

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.

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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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