Toxocariasis Clinical Presentation

  • Author: Sun Huh, MD, PhD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Apr 18, 2012
 

History

Inquire about pets in the home. Ask if children play in a sandbox. Ask about pica and handwashing practices and determine if hygiene practices are poor. Symptoms during the acute phase may include the following:

  • Abdominal pain
  • Decreased appetite
  • Restlessness
  • Fever
  • Coughing
  • Wheezing
  • Hives
  • History of seizures
  • Ocular involvement - Decreased visual acuity, seeing floaters or bubblelike images
Next

Physical

  • Tenderness in the right upper quadrant or hepatomegaly may be present in patients with liver involvement.
  • With pulmonary involvement, wheezing may be heard. Breath sounds may be decreased if a pleural effusion is present.
  • Patients with ocular involvement may present with the following:
    • Retinal detachment due to traction caused by retinal fibrosis Funduscopic examination of the right eye of a patiFunduscopic examination of the right eye of a patient with ocular toxocariasis showing rhegmatogenous retinal detachment.
    • Peripapillary inflammation
    • Peripheral retinal exudates
    • Gliotic mass in peripheral retina
    • Vitreoretinal traction band in peripheral retina
Previous
Next

Causes

  • Living with or raising dogs and cats
  • Eating without handwashing
  • Infection via contact with soil from a yard, sandbox, park, or playground
Previous
Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Sun Huh, MD, PhD  Chairman, Professor, Department of Parasitology, College of Medicine, Hallym University, Korea

Disclosure: Nothing to disclose.

Coauthor(s)

Sooung Lee, PhD  Team Manager, Research and Development, Chuncheon Bioindustry Foundation, Chuncheon-do, Korea

Disclosure: Nothing to disclose.

Specialty Editor Board

Pranatharthi Haran Chandrasekar, MBBS, MD  Professor, Department of Internal Medicine, Director of Infectious Disease Fellowship, Harper Hospital, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gordon L Woods, MD  Consulting Staff, Department of Internal Medicine, University Medical Center

Gordon L Woods, MD is a member of the following medical societies: Society of General Internal Medicine

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

  1. Centers for Disease Control and Prevention. Ocular toxocariasis--United States, 2009-2010. MMWR Morb Mortal Wkly Rep. Jun 10 2011;60(22):734-6. [Medline].

  2. Nelson S, Greene T, Ernhart CB. Toxocara canis infection in preschool age children: risk factors and the cognitive development of preschool children. Neurotoxicol Teratol. Mar-Apr 1996;18(2):167-74. [Medline].

  3. Chomel BB, Kasten R, Adams C, et al. Serosurvey of some major zoonotic infections in children and teenagers in Bali, Indonesia. Southeast Asian J Trop Med Public Health. Jun 1993;24(2):321-6. [Medline].

  4. Magnaval JF, Michault A, Calon N, et al. Epidemiology of human toxocariasis in La Réunion. Trans R Soc Trop Med Hyg. Sep-Oct 1994;88(5):531-3. [Medline].

  5. CDC. 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.

  6. CDC. Centers for Disease Control and Prevention (CDC). Available at http://www.cdc.gov/NCIDOD/DPD/PARASITES/toxocara/factsht_toxocara.htm.

  7. Choi D, Lim JH, Choi DC, et al. Transmission of Toxocara canis via Ingestion of Raw Cow Liver: A Cross-Sectional Study in Healthy Adults. Korean J Parasitol. Mar 2012;50(1):23-7. [Medline]. [Full Text].

  8. Choi D, Lim JH, Choi DC, Paik SW, Kim SH, Huh S. Toxocariasis and ingestion of raw cow liver in patients with eosinophilia. Korean J Parasitol. Sep 2008;46(3):139-43. [Medline].

  9. Congdon P, Lloyd P. Toxocara infection in the United States: the relevance of poverty, geography and demography as risk factors, and implications for estimating county prevalence. Int J Public Health. Feb 2011;56(1):15-24. [Medline].

  10. Iddawela RD, Rajapakse RP, Perera NA, et al. Characterization of a Toxocara canis species-specific excretory-secretory antigen (TcES-57) and development of a double sandwich ELISA for diagnosis of visceral larva migrans. Korean J Parasitol. Mar 2007;45(1):19-26. [Medline].

  11. Kwon SI, Lee JP, Park SP, Lee EK, Huh S, Park IW. Ocular toxocariasis in Korea. Jpn J Ophthalmol. Mar 2011;55(2):143-7. [Medline].

  12. Lee SU, Yu JR, Huh S. Ultrastructural localization of Toxocara canis larval antigen reacted with a seropositive human serum. Korean J Parasitol. Mar 2009;47(1):65-8. [Medline]. [Full Text].

  13. Magnaval JF. Comparative efficacy of diethylcarbamazine and mebendazole for the treatment of human toxocariasis. Parasitology. Jun 1995;110 (Pt 5):529-33. [Medline].

  14. Magnaval JF, Fabre R, Maurieres P, et al. Application of the western blotting procedure for the immunodiagnosis of human toxocariasis. Parasitol Res. 1991;77(8):697-702. [Medline].

  15. Magnaval JF, Fabre R, Maurieres P, et al. Evaluation of an immunoenzymatic assay detecting specific anti-Toxocara immunoglobulin E for diagnosis and posttreatment follow-up of human toxocariasis. J Clin Microbiol. Sep 1992;30(9):2269-74. [Medline].

  16. Magnaval JF, Glickman LT, Dorchies P, et al. Highlights of human toxocariasis. Korean J Parasitol. Mar 2001;39(1):1-11. [Medline].

  17. Magnaval JF, Malard L, Morassin B, et al. Immunodiagnosis of ocular toxocariasis using Western-blot for the detection of specific anti-Toxocara IgG and CAP for the measurement of specific anti-Toxocara IgE. J Helminthol. Dec 2002;76(4):335-9. [Medline].

  18. Moiyadi A, Mahadevan A, Anandh B, et al. Visceral larva migrans presenting as multiple intracranial and intraspinal abscesses. Neuropathology. Aug 2007;27(4):371-4. [Medline].

  19. Muñoz-Guzmán MA, del Río-Navarro BE, Valdivia-Anda G, Alba-Hurtado F. The increase in seroprevalence to Toxocara canis in asthmatic children is related to cross-reaction with Ascaris suum antigens. Allergol Immunopathol (Madr). May-Jun 2010;38(3):115-21. [Medline].

  20. Oryan A, Sadjjadi SM, Azizi S. Longevity of Toxocara cati larvae and pathology in tissues of experimentally infected chickens. Korean J Parasitol. Mar 2010;48(1):79-80. [Medline]. [Full Text].

  21. Park HY, Lee SU, Huh S, et al. A seroepidemiological survey for toxocariasis in apparently healthy residents in Gangwon-do, Korea. Korean J Parasitol. Sep 2002;40(3):113-7. [Medline].

  22. Park SP, Huh S, Magnaval JF, et al. A case of presumed ocular toxocariasis in a 28-year old woman. Korean J Ophthalmol. Dec 1999;13(2):115-9. [Medline].

  23. Park SP, Park I, Park HY, et al. Five cases of ocular toxocariasis confirmed by serology. Korean J Parasitol. Dec 2000;38(4):267-73. [Medline].

  24. Smith HV. Antibody reactivity in human toxocariasis. In: Lewis JW, Maizels RM, eds. Toxocara and Toxocariasis: Clinical, Epidemiological, and Molecular Perspectives. London: Institute of Biology and the British Society for Parasitology; 1993:91-109.

  25. Sun T, Bellosa ML, Lucio-Forster A, et al. A comparison of the protein constituents of the major body compartments of the dog roundworm, Toxocara canis. Vet Parasitol. Nov 30 2007;150(1-2):111-5. [Medline].

  26. Won K, Kruszon-Moran D, Schantz P, et al. Abstract of the 56th American Society of Tropical Medicine and Hygiene. In: National seroprevalence and risk factors for zoonotic Toxocara spp. infection. Philadelphia, Pennsylvania; Nov 4-8, 2007.

  27. Won KY, Kruszon-Moran D, Schantz PM, Jones JL. National seroprevalence and risk factors for Zoonotic Toxocara spp. infection. Am J Trop Med Hyg. Oct 2008;79(4):552-7. [Medline]. [Full Text].

 
Previous
Next
 
The image on the left is a posteroanterior chest radiograph in a patient with toxocariasis. The image on the right is a CT scan of the patient with toxocariasis showing multiple pulmonary nodules with surrounding ground-glass opacities at first visit.
Funduscopic examination of the right eye of a patient with ocular toxocariasis showing rhegmatogenous retinal detachment.
Immunogold finding of Toxocara canis larva reacted with a seropositive human serum. Arrows indicate each particle. (A) High-density immunogold particles are distributed in the large columnlike secretory cell (LCSC), excretory duct (ED), and cuticle(C); (B) high-density immunogold particles are shown in the secretory cell (SC), excretory duct (ED), and cuticle; (C) immunogold particles are distributed in the excretory duct (ED); (D) high-density particles are displayed in the microvilli of the intestine (MI); (E) immunogold particles are shown in the excretory duct; and (F) high-density immunogold particles are distributed in the cuticle(C).
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.