eMedicine Specialties > Pediatrics: General Medicine > Parasitology

Toxocariasis: Differential Diagnoses & Workup

Author: 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
Coauthor(s): Marcelo Laufer, MD, Division of Pediatric Infectious Diseases, Attending, Miami Children's Hospital
Contributor Information and Disclosures

Updated: Jan 27, 2009

Differential Diagnoses

Amebic Meningoencephalitis
Juvenile Rheumatoid Arthritis
Ancylostoma Infection
Loffler Syndrome
Angioedema
Lymphadenopathy
Ascariasis
Lymphoproliferative Disorders
Aspergillosis
Meningitis, Aseptic
Asthma
Myocarditis, Nonviral
Cardiac Tumors
Myocarditis, Viral
Cardiomyopathy, Dilated
Naegleria
Chorioretinitis
Pericardial Effusion, Malignant
Cognitive Deficits
Pericarditis, Bacterial
Cutaneous Larva Migrans
Pericarditis, Constrictive
Cysticercosis
Pericarditis, Viral
Dracunculiasis
Pleural Effusion
Echinococcosis
Pneumonia
Fascioliasis
Respiratory Failure
Fever in the Toddler
Retinoblastoma
Fever in the Young Infant
Schistosomiasis
Filariasis
Status Asthmaticus
Gnathostomiasis
Strongyloidiasis
Hookworm Infection
Systemic Lupus Erythematosus
Hypereosinophilic Syndrome
Taenia Infection
Hypersensitivity Pneumonitis
Trichinosis

Other Problems to Be Considered

The differential diagnosis of visceral larva migrans (VLM) overlaps that of eosinophilia.
Drug reactions
Capillaria hepatica infection
Eosinophilia-myalgia syndrome
Baylisascaris procyonis infection
Perinatal asphyxia

Workup

Laboratory Studies

  • Visceral larva migrans (VLM) is usually suspected in a young child with fever, wheezing, and hepatomegaly whose CBC count reveals leukocytosis and marked eosinophilia (£ 80%).
  • Other nonspecific laboratory findings are hypergammaglobulinemia (particularly IgM) and elevated isohemagglutinin titers for antigens in blood groups A and B.
  • Specific titers for Toxocara are assessed with enzyme-linked immunosorbent assay (ELISA). With a cutoff dilution of 1:32, the sensitivity of ELISA is approximately 75%, and its specificity is more than 90%. Specificity may be lower in tropical populations because of cross-reactivity with other helminthic diseases. Western blotting appears to be more specific but is more labor-intensive. The main pitfall of serologic tests is that they cannot be used to distinguish between current and past infections.
  • Antigen-capture assays with monoclonal antibodies may be helpful in diagnosing current infection but their sensitivity and specificity are not ideal.
  • The use of polymerase chain reaction (PCR) has been limited to the identification of Toxocara species in tissues in animal models.
  • The diagnosis of VLM can be definitively confirmed only by finding larvae in the affected tissue at histologic examination or by assessing the digestion of tissue. Biopsy is rarely performed, and the larvae are not always found.
  • The diagnosis of OLM usually relies on clinical findings. Patients with OLM have low or even negative titers. Toxocara titers in the vitreous and aqueous humor are elevated relative to serum levels.
  • A definitive test for covert toxocariasis does not exist. Positive anti-Toxocara titers in the presence of malaise, chronic weakness, abdominal pain, or allergic signs accompanied by eosinophilia and absence of response to allergens support the diagnosis of covert toxocariasis.
  • Because the intestinal form of toxocariasis does not occur in humans, stool studies for ova and parasites are not helpful in the diagnosis of toxocariasis. The presence of other parasites in the stool indicates environmental and behavior risk factors for parasitic diseases.

Imaging Studies

  • Imaging studies in toxocariasis depend on the location of the disease.
  • Chest radiography is indicated in patients with wheezing and eosinophilia in whom eosinophilic pneumonia is suspected. It can also be used to identify pleural effusions and cardiomegaly.
  • Echocardiography is used to evaluate myocardial function, which is depressed in myocarditis, and to identify pericardial fluid and intracardiac pseudotumors.
  • Abdominal ultrasonography is a good screening test to identify granulomas in the liver.
  • CT scanning and MRI have also been used, particularly for evaluating CNS disease.

Procedures

  • Biopsy of the involved tissue may be helpful.

Histologic Findings

  • When performed, biopsy of the affected tissues reveals granulomatous lesions containing large numbers of eosinophils and neutrophils and, rarely, the remnants of dead larvae.

More on Toxocariasis

Overview: Toxocariasis
Differential Diagnoses & Workup: Toxocariasis
Treatment & Medication: Toxocariasis
Follow-up: Toxocariasis
Multimedia: Toxocariasis
References
[ CLOSE WINDOW ]

References

  1. Maruyama H, Nawa Y, Noda S, et al. An outbreak of visceral larva migrans due to Ascaris suum in Kyushu, Japan. Lancet. Jun 22 1996;347(9017):1766-7. [Medline].

  2. Lynch NR, Eddy K, Hodgen AN, et al. Seroprevalence of Toxocara canis infection in tropical Venezuela. Trans R Soc Trop Med Hyg. 1988;82(2):275-81. [Medline].

  3. Hurni MA, Gerbig AW, Braathen LR, Hunziker T. Toxocariasis and Wells' syndrome: a causal relationship?. Dermatology. 1997;195(4):325-8. [Medline].

  4. Wolfrom E, Chene G, Lejoly-Boisseau H, Beylot C, Geniaux M, Taieb A. [Chronic urticaria and toxocara canis infection. A case-control study]. Ann Dermatol Venereol. 1996;123(4):240-6. [Medline].

  5. Bachmeyer C, Lamarque G, Morariu R, et al. Visceral larva migrans mimicking lymphoma. Chest. Apr 2003;123(4):1296-7. [Medline].

  6. Amir J, Harel L, Eidlitz-Markus T, Varsano I. Lymphedema as a presenting sign of toxocariasis. Infection. Nov-Dec 1995;23(6):389-90. [Medline].

  7. Cruz AT, Franklin GY, Kaplan SL. Toxocariasis Causing Eosinophilic Ascites. Pediatr Infect Dis J. Apr 23 2008;27(6):563-4. [Medline].

  8. Hamidou MA, Gueglio B, Cassagneau E, et al. Henoch-Schonlein purpura associated with Toxocara canis infection. J Rheumatol. Feb 1999;26(2):443-5. [Medline].

  9. De Cock C, Lemaitre J, Deuvaert FE. Loeffler endomyocarditis: a clinical presentation as right ventricular tumor. J Heart Valve Dis. Nov 1998;7(6):668-71. [Medline].

  10. Herry I, Philippe B, Hennequin C, et al. Acute life-threatening toxocaral tamponade. Chest. Dec 1997;112(6):1692-3. [Medline]. [Full Text].

  11. Stewart JM, Cubillan LD, Cunningham ET. Prevalence, clinical features, and causes of vision loss among patients with ocular toxocariasis. Retina. Dec 2005;25(8):1005-13. [Medline].

  12. Abo-Shehada MN, Sharif L, el-Sukhon SN, et al. Seroprevalence of Toxocara canis antibodies in humans in northern Jordan. J Helminthol. Mar 1992;66(1):75-8. [Medline].

  13. Agudelo C, Villareal E, Caceres E, et al. Human and dogs Toxocara canis infection in a poor neighborhood in Bogota. Mem Inst Oswaldo Cruz. Jan-Mar 1990;85(1):75-8. [Medline].

  14. Akao N, Ohta N. Toxocariasis in Japan. Parasitol Int. Jun 2007;56(2):87-93. [Medline].

  15. Altcheh J, Nallar M, Conca M, et al. [Toxocariasis: clinical and laboratory features in 54 patients]. An Pediatr (Barc). May 2003;58(5):425-31. [Medline].

  16. Arango CA. Visceral larva migrans and the hypereosinophilia syndrome. South Med J. Sep 1998;91(9):882-3. [Medline].

  17. Arpino C, Gattinara GC, Piergili D, Curatolo P. Toxocara infection and epilepsy in children: a case-control study. Epilepsia. Jan-Feb 1990;31(1):33-6. [Medline].

  18. Ashwath ML, Robinson DR, Katner HP. A presumptive case of toxocariasis associated with eosinophilic pleural effusion: case report and literature review. Am J Trop Med Hyg. Dec 2004;71(6):764. [Medline]. [Full Text].

  19. Baldisserotto M, Conchin CF, Soares Mda G, et al. Ultrasound findings in children with toxocariasis: report on 18 cases. Pediatr Radiol. May 1999;29(5):316-9. [Medline].

  20. Bass JL, Mehta KA, Glickman LT, et al. Asymptomatic toxocariasis in children. A prospective study and treatment trial. Clin Pediatr (Phila). Sep 1987;26(9):441-6. [Medline].

  21. Bede O, Szénási Z, Danka J, Gyurkovits K, Nagy D. Toxocariasis associated with chronic cough in childhood: a longitudinal study in Hungary. J Helminthol. Dec 2008;82(4):357-63. [Medline].

  22. Beiran I, Cochavi O, Miller B. "Silent" ocular toxocariasis. Eur J Ophthalmol. Jul-Sep 1998;8(3):195-6. [Medline].

  23. Buijs J, Borsboom G, van Gemund JJ, et al. Toxocara seroprevalence in 5-year-old elementary schoolchildren: relation with allergic asthma. Am J Epidemiol. Nov 1 1994;140(9):839-47. [Medline].

  24. Chang S, Lim JH, Choi D, et al. Hepatic visceral larva migrans of Toxocara canis: CT and sonographic findings. AJR Am J Roentgenol. Dec 2006;187(6):W622-9. [Medline].

  25. Cianferoni A, Schneider L, Schantz PM, et al. Visceral larva migrans associated with earthworm ingestion: clinical evolution in an adolescent patient. Pediatrics. Feb 2006;117(2):e336-9. [Medline].

  26. Cilla G, Perez-Trallero E, Gutierrez C, et al. Seroprevalence of Toxocara infection in middle-class and disadvantaged children in northern Spain (Gipuzkoa, Basque Country). Eur J Epidemiol. Oct 1996;12(5):541-3. [Medline].

  27. Dauriac-Le Masson V, Chochon F, Demeret S, Pierrot-Deseilligny C. Toxocara canis meningomyelitis. J Neurol. Oct 2005;252(10):1267-8. [Medline].

  28. Despommier D. Toxocariasis: clinical aspects, epidemiology, medical ecology, and molecular aspects. Clin Microbiol Rev. Apr 2003;16(2):265-72. [Medline].

  29. Eberhard ML, Alfano E. Adult Toxocara cati infections in U.S. children: report of four cases. Am J Trop Med Hyg. Sep 1998;59(3):404-6. [Medline]. [Full Text].

  30. Eberhardt O, Bialek R, Nagele T, Dichgans J. Eosinophilic meningomyelitis in toxocariasis: case report and review of the literature. Clin Neurol Neurosurg. Aug 2005;107(5):432-8. [Medline].

  31. Elefant GR, Shimizu SH, Sanchez MC, et al. A serological follow-up of toxocariasis patients after chemotherapy based on the detection of IgG, IgA, and IgE antibodies by enzyme-linked immunosorbent assay. J Clin Lab Anal. 20(4):164-72. [Medline].

  32. Fenoy S, Cuellar C, Guillen JL. Serological evidence of toxocariasis in patients from Spain with a clinical suspicion of visceral larva migrans. J Helminthol. Mar 1997;71(1):9-12. [Medline].

  33. Fenoy S, Cuellar C, Guillen JL. Seroprevalence of toxocariasis in children and adults in Madrid and Tenerife, Spain. J Helminthol. Jun 1996;70(2):109-13. [Medline].

  34. Fortenberry JD, Kenney RD, Younger J. Visceral larva migrans producing static encephalopathy in an infant. Pediatr Infect Dis J. May 1991;10(5):403-6. [Medline].

  35. Gavignet B, Piarroux R, Aubin F, Millon L, Humbert P. Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. Dec 2008;59(6):1031-42. [Medline].

  36. Glickman LT, Schantz PM. Epidemiology and pathogenesis of zoonotic toxocariasis. Epidemiol Rev. 1981;3:230-50. [Medline].

  37. Good B, Holland CV, Taylor MR, et al. Ocular toxocariasis in schoolchildren. Clin Infect Dis. Jul 15 2004;39(2):173-8. [Medline].

  38. Gotistein B, Piarroux R. Current trends in tissue-affecting helminths. Parasite. Sep 2008;15(3):291-8. [Medline].

  39. Gould IM, Newell S, Green SH, George RH. Toxocariasis and eosinophilic meningitis. Br Med J (Clin Res Ed). Nov 2 1985;291(6504):1239-40. [Medline].

  40. Havasiova K, Dubinsky P, Stefancikova A. A seroepidemiological study of human Toxocara infection in the Slovak Republic. J Helminthol. Dec 1993;67(4):291-6. [Medline].

  41. Hayashi K, Tahara H, Yamashita K, et al. Hepatic imaging studies on patients with visceral larva migrans due to probable Ascaris suum infection. Abdom Imaging. Sep-Oct 1999;24(5):465-9. [Medline].

  42. Heldrich FJ, Garg PP. Eosinophilic meningitis. Md Med J. Feb 1988;37(2):138-40. [Medline].

  43. Hill IR, Denham DA, Scholtz CL. Toxocara canis larvae in the brain of a British child. Trans R Soc Trop Med Hyg. 1985;79(3):351-4. [Medline].

  44. Humbert P, Niezborala M, Salembier R, et al. Skin manifestations associated with toxocariasis: a case-control study. Dermatology. 2000;201(3):230-4. [Medline].

  45. Iddawela RD, Rajapakse RP, Perera NA, Agatsuma T. 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].

  46. Inan M, Sakru N, Vatansever U, Bilgi S. Visceral larva migrans presenting as acute abdomen in a child. J Pediatr Surg. 41(3):e7-9. [Medline].

  47. Inatomi Y, Murakami T, Tokunaga M, et al. Encephalopathy caused by visceral larva migrans due to Ascaris suum. J Neurol Sci. Apr 1 1999;164(2):195-9. [Medline].

  48. Jain R, Sawhney S, Bhargava DK, et al. Hepatic granulomas due to visceral larva migrans in adults: appearance on US and MRI. Abdom Imaging. May-Jun 1994;19(3):253-6. [Medline].

  49. Jeanfaivre T, Cimon B, Tolstuchow N, et al. Pleural effusion and toxocariasis. Thorax. Jan 1996;51(1):106-7. [Medline].

  50. Kaushik SP, Hurwitz M, McDonald C, Pavli P. Toxocara canis infection and granulomatous hepatitis. Am J Gastroenterol. Jul 1997;92(7):1223-5. [Medline].

  51. Kayes SG. Human toxocariasis and the visceral larva migrans syndrome: correlative immunopathology. Chem Immunol. 1997;66:99-124. [Medline].

  52. Kraus A, Valencia X, Cabral AR, de la Vega G. Visceral larva migrans mimicking rheumatic diseases. J Rheumatol. Mar 1995;22(3):497-500. [Medline].

  53. Krcmery V Jr, Gould I, Sobota K, Spanik S. Two cases of disseminated toxocariasis in compromised hosts successfully treated with mebendazole. Chemotherapy. 1992;38(5):367-8. [Medline].

  54. Kumar J, Kimm J. MR in Toxocara canis myelopathy. AJNR Am J Neuroradiol. Nov 1994;15(10):1918-20. [Medline].

  55. Lassmann B, Tsigrelis C, Virk A. 33-year-old woman with marked eosinophilia. Mayo Clin Proc. Jan 2007;82(1):103-6. [Medline].

  56. Li MW, Lin RQ, Song HQ, Wu XY, Zhu XQ. The complete mitochondrial genomes for three Toxocara species of human and animal health significance. BMC Genomics. May 16 2008;9:224. [Medline].

  57. Lim JH. Toxocariasis of the liver: visceral larva migrans. Abdom Imaging. Mar-Apr 2008;33(2):151-6. [Medline].

  58. Magnaval JF, Galindo V, Glickman LT, Clanet M. Human Toxocara infection of the central nervous system and neurological disorders: a case-control study. Parasitology. Nov 1997;115(Pt 5):537-43. [Medline].

  59. Matos M de F, Militao DN, Brum MA, et al. Presence of anti-Toxocara antibodies in children selected at Hospital Universitario, Campo Grande, MS, Brazil. Rev Inst Med Trop Sao Paulo. Jan-Feb 1997;39(1):49-50. [Medline].

  60. Matsuki Y, Fujii T, Nakamura-Uchiyama F, et al. Toxocariasis presenting with multiple effusions in the pericardial space, thoracic cavity, and Morrison's pouch. Intern Med. 2007;46(12):913-4. [Medline].

  61. Mikhael NZ, Montpetit VJ, Orizaga M, et al. Toxocara canis infestation with encephalitis. Can J Neurol Sci. May 1974;1(2):114-20. [Medline].

  62. Mimoso MG, Pereira MC, Estevao MH, et al. Eosinophilic meningoencephalitis due to Toxocara canis. Eur J Pediatr. Sep 1993;152(9):783-4. [Medline].

  63. 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].

  64. Monsel G, Caumes E. Recent developments in dermatological syndromes in returning travelers. Curr Opin Infect Dis. Oct 2008;21(5):495-9. [Medline].

  65. Montalvo AM, Espino AM, Escalante G, Finlay CM. [Study of the seroprevalence of toxocariasis in an infantile population in the City of Havana]. Rev Cubana Med Trop. 1994;46(3):156-8. [Medline].

  66. Moreira-Silva SF, Leao ME, Mendonca HF, Pereira FE. Prevalence of anti-Toxocara antibodies in a random sample of inpatients at a children's hospital in Vitoria, Espirito Santo, Brazil. Rev Inst Med Trop Sao Paulo. Jul-Aug 1998;40(4):259-61. [Medline].

  67. Nathwani D, Laing RB, Currie PF. Covert toxocariasis--a cause of recurrent abdominal pain in childhood. Br J Clin Pract. Winter 1992;46(4):271. [Medline].

  68. 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].

  69. Oteifa NM, Moustafa MA, Elgozamy BM. Toxocariasis as a possible cause of allergic diseases in children. J Egypt Soc Parasitol. Aug 1998;28(2):365-72. [Medline].

  70. Patel H, Goldstein D. Pediatric uveitis. Pediatr Clin North Am. Feb 2003;50(1):125-36. [Medline].

  71. Petithory JC. [Immunologic diagnosis of ocular larva migrans syndrome]. Ophtalmologie. May-Jun 1990;4(3):298-300. [Medline].

  72. Rai SK, Uga S, Ono K, et al. Seroepidemiological study of Toxocara infection in Nepal. Southeast Asian J Trop Med Public Health. Jun 1996;27(2):286-90. [Medline].

  73. Rayes AA, Lambertucci JR. Visceral larva migrans and pyogenic liver abscess. Am J Gastroenterol. Apr 1999;94(4):1116. [Medline].

  74. Reilly A, Becker J, Meyer J, Rackoff W. Hypereosinophilia [clinical conference]. Med Pediatr Oncol. 1992;20(3):232-9. [Medline].

  75. Roig J, Romeu J, Riera C, et al. Acute eosinophilic pneumonia due to toxocariasis with bronchoalveolar lavage findings. Chest. Jul 1992;102(1):294-6. [Medline].

  76. Romeu J, Roig J, Bada JL, et al. Adult human toxocariasis acquired by eating raw snails. J Infect Dis. Aug 1991;164(2):438. [Medline].

  77. Sabrosa NA, de Souza EC. Nematode infections of the eye: toxocariasis and diffuse unilateral subacute neuroretinitis. Curr Opin Ophthalmol. Dec 2001;12(6):450-4. [Medline].

  78. Sabrosa NA, Zajdenweber M. Nematode infections of the eye: toxocariasis, onchocerciasis, diffuse unilateral subacute neuroretinitis, and cysticercosis. Ophthalmol Clin North Am. Sep 2002;15(3):351-6. [Medline].

  79. Sakai S, Shida Y, Takahashi N, et al. Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: imaging of six cases. AJR Am J Roentgenol. 186(6):1697-702. [Medline].

  80. Sane AC, Barber BA. Pulmonary nodules due to Toxocara canis infection in an immunocompetent adult. South Med J. Jan 1997;90(1):78-9. [Medline].

  81. Saporito L, Scarlata F, Colomba C, Infurnari L, Giordano S, Titone L. Human toxocariasis: a report of nine cases. Acta Paediatr. Sep 2008;97(9):1301-2. [Medline].

  82. Sharkey JA, McKay PS. Ocular toxocariasis in a patient with repeatedly negative ELISA titre to Toxocara canis. Br J Ophthalmol. Apr 1993;77(4):253-4. [Medline].

  83. Small KW, McCuen BW 2d, de Juan E Jr, Machemer R. Surgical management of retinal traction caused by toxocariasis. Am J Ophthalmol. Jul 15 1989;108(1):10-4. [Medline].

  84. Sturchler D, Schubarth P, Gualzata M, et al. Thiabendazole vs. albendazole in treatment of toxocariasis: a clinical trial. Ann Trop Med Parasitol. Oct 1989;83(5):473-8. [Medline].

  85. Szczepanski T, Sonta-Jakimczyk D, Janik-Moszant A, Olejnik I. Generalized lymphadenopathy as initial presentation of toxocariasis in a seven-year-old boy. Pediatr Infect Dis J. Aug 1996;15(8):717-8. [Medline].

  86. Taylor MR, Keane CT, O'Connor P, Mulvihill E, Holland C. The expanded spectrum of toxocaral disease. Lancet. Mar 26 1988;1(8587):692-5. [Medline].

  87. Taylor MR, O'Connor P, Hinson AR, Smith HV. Toxocara titres in maternal and cord blood. J Infect. May 1996;32(3):231-3. [Medline].

  88. Uhlikova M, Hubner J. Seroprevalence of Toxocara canis infection in Czech Republic. Cent Eur J Public Health. Aug 1998;6(3):195-8. [Medline].

  89. Vidal JE, Sztajnbok J, Seguro AC. Eosinophilic meningoencephalitis due to Toxocara canis: case report and review of the literature. Am J Trop Med Hyg. Sep 2003;69(3):341-3. [Medline].

  90. Villano M, Cerillo A, Narciso N, et al. A rare case of Toxocara canis arachnoidea. J Neurosurg Sci. Jan-Mar 1992;36(1):67-9. [Medline].

  91. Walker MD, Zunt JR. Neuroparasitic infections: nematodes. Semin Neurol. Sep 2005;25(3):252-61. [Medline].

  92. Walsh SS, Robson WJ, Hart CA. Acute transient myositis due to Toxocara. Arch Dis Child. Sep 1988;63(9):1087-8. [Medline].

  93. Wells DL. Public understanding of toxocariasis. Public Health. Mar 2007;121(3):187-8. [Medline].

  94. Wolfrom E, Chene G, Boisseau H, et al. Chronic urticaria and Toxocara canis. Lancet. Jan 21 1995;345(8943):196. [Medline].

  95. Xinou E, Lefkopoulos A, Gelagoti M, et al. CT and MR imaging findings in cerebral toxocaral disease. AJNR Am J Neuroradiol. Apr 2003;24(4):714-8. [Medline].

  96. Zachariah SB, Zachariah B, Varghese R. Neuroimaging studies of cerebral "visceral larva migrans" syndrome. J Neuroimaging. Jan 1994;4(1):39-40. [Medline].

  97. Zygulska-Mach H, Krukar-Baster K, Ziobrowski S. Ocular toxocariasis in children and youth. Doc Ophthalmol. 1993;84(2):145-54. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

toxocariasis, allergic asthma, anemia, arthralgia, aseptic meningitis, chronic idiopathic urticaria, covert toxocariasis, cystoid macular edema, encephalitis, eosinophilia, eosinophilic cellulitis, eosinophilic meningitis, eosinophilic pneumonia, epilepsy, granulomatous hepatitis, Henoch-Schönlein purpura, hepatomegaly, Loeffler endomyocarditis, lymphadenopathy, lymphedema, lymphoma, migratory cutaneous lesions, monoarthritis, myocarditis, ocular larva migrans, OLM, parasitic infection, pericardial tamponade, pica, pleural effusions, pyogenic liver abscess, respiratory failure, small-vessel vasculitis, Toxocara canis, T canis, Toxocara catis, T catis, toxocarosis, traction retinal detachment, uveitis, visceral larva migrans, VLM, vitreitis, Well syndrome

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

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 Consulting; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; sanofi pasteur Grant/research funds Unrestricted research grant; sanofi pasteur  Consulting; sanofi pasteur Honoraria Speaking and teaching; Tap Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching

Coauthor(s)

Marcelo Laufer, MD, Division of Pediatric Infectious Diseases, Attending, Miami Children's Hospital
Marcelo Laufer, MD is a member of the following medical societies: American Academy of Pediatrics and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Medical Editor

Ashir Kumar, MBBS, MD, FAAP, Professor, Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University; Consulting Staff, Department of Pediatrics, EW Sparrow Hospital
Ashir Kumar, MBBS, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Association of Physicians of Indian Origin, American Federation for Clinical Research, American Society for Microbiology, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Leslie L Barton, MD, Professor, Program Director, Department of Pediatrics, University of Arizona School 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.

CME Editor

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; Pfizer 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: None None None

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
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.