- Author: Sun Huh, MD, PhD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA more...
Further Outpatient Care
Perform a follow-up examination of the lesion and a serum titer for TES-Ag using IgG, IgE with ELISA, or immunoblotting.
For significant lung involvement, obtain follow-up chest radiography to confirm the resolution of any acute infiltrate.
Serum transaminases and alkaline phosphatase can be used to monitor the degree of liver involvement.
For ocular involvement, monthly or bimonthly funduscopic examinations are recommended, according to the patient's state of remission.
Further Inpatient Care
In a patient with acute symptoms of toxocariasis (ie, dyspnea, chest tightness) due to lung involvement, hospitalization may be necessary.
In a patient with liver or ocular involvement, hospitalization may be needed for diagnostic and/or therapeutic procedures such as biopsy or laser surgery.
Inpatient & Outpatient Medications
Continue anthelmintic therapy for 1 month after completing a course of steroids. If symptoms persist after a full course of anthelmintic therapy, extend steroid administration and taper according to lung symptoms.
The eggs of Toxocara species are widespread in parks, playgrounds, yards, and in homes and apartments where the occupants have dogs or cats. Elimination of eggs from the environment is not possible; therefore, prevention depends on proper hygiene, including handwashing after contact with pets.
Dogs and cats can be de-wormed. However, this does not eliminate eggs from the larger environment.
Public policies that have attempted to eradicate Toxocara infection in dogs and cats have had limited success.
Puppies and kittens acquire Toxocara infection transplacentally and should be de-wormed at 2, 4, 6, and 8 weeks.
Sandboxes should be covered when not in use.
Dog and cat feces should be disposed of properly.
After playing in public parks and in sandboxes, children should wash their hands before eating.
Decreased visual acuity may occur if ocular toxocariasis is not identified and treated.
Retinal detachment due to ocular involvement may cause unilateral visual loss.
Seizures may result from cerebral involvement.
Toxocariasis is generally a self-limited disease. The prognosis is good when adequately treated, except in some patients with ocular or cerebral involvement.
Properly de-worm kittens and puppies.
Pets should undergo periodic stool examinations by a veterinarian, and they should be treated if examination findings are positive for Toxocara eggs.
Do not bring stray dogs or cats home. If such animals are brought home, they should be examined by a veterinarian for toxocariasis.
Focus on personal hygiene. If dogs or cats have been in the yard, consider it contaminated. Wash hands after lawn work or gardening.
Moreira GM, Telmo PD, Mendonça M, Moreira AN, McBride AJ, Scaini CJ, et al. Human toxocariasis: current advances in diagnostics, treatment, and interventions. Trends Parasitol. 2014 Sep. 30(9):456-464. [Medline].
Centers for Disease Control and Prevention. Ocular toxocariasis--United States, 2009-2010. MMWR Morb Mortal Wkly Rep. 2011 Jun 10. 60(22):734-6. [Medline].
Nelson S, Greene T, Ernhart CB. Toxocara canis infection in preschool age children: risk factors and the cognitive development of preschool children. Neurotoxicol Teratol. 1996 Mar-Apr. 18(2):167-74. [Medline].
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. 1993 Jun. 24(2):321-6. [Medline].
Magnaval JF, Michault A, Calon N, et al. Epidemiology of human toxocariasis in La Réunion. Trans R Soc Trop Med Hyg. 1994 Sep-Oct. 88(5):531-3. [Medline].
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.
CDC. Centers for Disease Control and Prevention (CDC). Available at http://www.cdc.gov/NCIDOD/DPD/PARASITES/toxocara/factsht_toxocara.htm.
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. 2012 Mar. 50(1):23-7. [Medline]. [Full Text].
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. 2011 Feb. 56(1):15-24. [Medline].
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. 2007 Mar. 45(1):19-26. [Medline].
Kwon SI, Lee JP, Park SP, Lee EK, Huh S, Park IW. Ocular toxocariasis in Korea. Jpn J Ophthalmol. 2011 Mar. 55(2):143-7. [Medline].
Magnaval JF. Comparative efficacy of diethylcarbamazine and mebendazole for the treatment of human toxocariasis. Parasitology. 1995 Jun. 110 (Pt 5):529-33. [Medline].
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].
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. 1992 Sep. 30(9):2269-74. [Medline].
Magnaval JF, Glickman LT, Dorchies P, et al. Highlights of human toxocariasis. Korean J Parasitol. 2001 Mar. 39(1):1-11. [Medline].
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. 2002 Dec. 76(4):335-9. [Medline].
Moiyadi A, Mahadevan A, Anandh B, et al. Visceral larva migrans presenting as multiple intracranial and intraspinal abscesses. Neuropathology. 2007 Aug. 27(4):371-4. [Medline].
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). 2010 May-Jun. 38(3):115-21. [Medline].
Park HY, Lee SU, Huh S, et al. A seroepidemiological survey for toxocariasis in apparently healthy residents in Gangwon-do, Korea. Korean J Parasitol. 2002 Sep. 40(3):113-7. [Medline].
Park SP, Huh S, Magnaval JF, et al. A case of presumed ocular toxocariasis in a 28-year old woman. Korean J Ophthalmol. 1999 Dec. 13(2):115-9. [Medline].
Park SP, Park I, Park HY, et al. Five cases of ocular toxocariasis confirmed by serology. Korean J Parasitol. 2000 Dec. 38(4):267-73. [Medline].
Smith HV. Antibody reactivity in human toxocariasis. 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.
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. 2007 Nov 30. 150(1-2):111-5. [Medline].
Won K, Kruszon-Moran D, Schantz P, et al. Abstract of the 56th American Society of Tropical Medicine and Hygiene. National seroprevalence and risk factors for zoonotic Toxocara spp. infection. Philadelphia, Pennsylvania; Nov 4-8, 2007.