Pediatric Toxocariasis Follow-up

Updated: Mar 10, 2015
  • Author: Germaine L Defendi, MD, MS, FAAP; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

The therapeutic responses of patients with VLM are evaluated clinically and by following peripheral blood eosinophil counts. Toxocara titers may not reflect the response to treatment.

Follow-up of OLM relies on the recommendations of the treating ophthalmologist. The evaluation of vitreous anti-Toxocara titers is a practical way of diagnosing, but not monitoring, the treatment response.

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, expand on the differential diagnosis.

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Deterrence/Prevention

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  • The prevalence of human toxocariasis is a reflection of dogs' rates of infestation and their access to public places. Proper disposal of dog and cat feces is essential to lower infection rates.

  • Prevention of toxocariasis is a public health issue and is important for both animals and humans.

    • In developed countries, prevention involves regulations that obligate pet owners to have veterinarians examine their pets for parasites. Anthelmintic treatment of puppies and kittens at age 2, 4, 6, and 8 weeks of age prevents the excretion of Toxocara eggs by mature worms acquired transplacentally or through mother’s milk. Regular deworming of dogs and cats during annual veterinary visits.

    • Restricting dogs from assessing places, such as playgrounds, where children may come in contact with animal excrement.

    • Pet owners should to clean up after their pets, to properly dispose of waste, and to clean pet play areas of waste, weekly. Encourage children not to play in areas where animals defecate.

    • Covering children’s sandboxes when not in use to prevent pet access.

    • Foster and model good hygiene practices, such as washing hands with soap and water after playing outside and/or playing with pets. [33]

  • In underdeveloped countries, the situation is more complex due to poor basic sanitation infrastructure, such as access to clean water and functional sewage systems.

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Complications

Complications depend on the human organ 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. Blindness, usually unilateral, can result.

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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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