- Author: Sun Huh, MD, PhD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA more...
In general, blood eosinophilia combined with a positive serologic test result indicates active toxocariasis and requires treatment. Deciding whether to treat covert or subclinical toxocariasis that does not show eosinophilia is controversial. Consider treatment in patients with a total serum IgE level over 500 IU/mL. Mebendazole or diethylcarbamazine kills the nematode larvae. Prednisone can be used as an adjunct to antihelminthic therapy in patients with wheezing or other signs of tissue inflammation.
These agents are specific to nematode infection.
DOC. Adverse effects are negligible, except headaches during early therapy. These symptoms are from metabolites secreted from nematodes that are killed by the drug. Causes worm death by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestines where helminths dwell.
Second DOC if mebendazole is difficult to obtain. Decreases ATP production in the worm, causing energy depletion, immobilization, and, finally, death.
Synthetic organic compound highly specific for several common parasites. Does not contain any toxic metallic elements. Not recommended as the DOC because of more severe adverse effects. Recommended if therapy with mebendazole fails or mebendazole is not available.
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.