Pediatric Toxocariasis Follow-up

  • Author: Robert W Tolan Jr, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Jan 9, 2012
 

Further Outpatient Care

  • The therapeutic responses of patients with visceral larva migrans (VLM) are evaluated clinically and by assessing peripheral blood eosinophil counts. Toxocara titers may not reflect the response to treatment.
  • Follow-up of ocular larva migrans (OLM) relies on the recommendations of the ophthalmologist. The evaluation of vitreous anti-Toxocara titers is a practical way of diagnosing, but not monitoring, the response to treatment.
  • Because the signs and symptoms of covert toxocariasis lack specificity, diagnosis may be confirmed by the disappearance of symptoms after anthelmintic treatment. If the patient's symptoms do not improve after treatment, seek an alternative diagnosis.
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Deterrence/Prevention

  • The prevalence of human toxocariasis is a reflection of dogs' rates of infestation and their access to public places.
  • The prevention of toxocariasis is a public health issue.
    • In developed countries, prevention involves regulations that obligate pet owners to have their veterinarians examine their pets for parasites and restrict dogs from assessing places, such as playgrounds, where children may come in contact with animal excrement.
    • In underdeveloped countries, the situation is more complex because the main problem is the lack of a basic sanitation infrastructure, such as running water and proper sewer systems.
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Complications

Complications depend on the sites to which the larvae migrate.

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Prognosis

  • In general, the prognosis for VLM and covert toxocariasis is good. Prognosis in OLM depends on the pathology at the time of diagnosis, but blindness, usually unilateral, is not uncommon.
  • The prognosis for OLM depends on the pathologic findings at the time of diagnosis. Blindness, usually unilateral, is not uncommon.
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Patient Education

  • Proper hygiene and sanitation are probably the least expensive and most effective means of reducing parasitic diseases.
  • In countries in which the creation of good water and sewer systems is unrealistic, every effort should be made to educate the citizens about basic sanitation to diminish the rates of parasitic diseases.
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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: Novartis 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.

Specialty Editor Board

Ashir Kumar, MD, MBBS, FAAP  Professor Emeritus, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine

Ashir Kumar, MD, MBBS, FAAP is a member of the following medical societies: American Association of Physicians of Indian Origin and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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.

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.

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

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: Nothing to disclose.

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Diagram of the Toxocara canis life cycle image. Courtesy of the Centers for Disease Control and Prevention.
Toxocara canis eggs are passed in dog feces, especially puppies' feces. Humans do not produce or excrete eggs; therefore, the presence of these eggs is not a diagnostic finding in human toxocariasis. The egg to the left is fertilized but not yet embryonated, whereas the egg to the right contains a well-developed larva. The latter egg is infectious if it is ingested by a human (frequently, a child). Courtesy of the Centers for Disease Control and Prevention.
 
 
 
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