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toxocariasis
Infection with nematodes of the genus Toxocara.
Etiology:
1) Toxocara canis
2) Toxocara catis
Epidemiology:
- acquired through ingestion of contaminated soil or infected meat
- one of top 5 neglected parasitic infections in the U.S.
- ~ 14% of people in the U.S. have been exposed [2]
Pathology:
1) visceral larva migrans (Toxocara canis)
- larvae hatch in the human intestine & migrate through the bloodstream to multiple organs, including the liver, spleen, lungs, & eye
2) ocular involvement
a) solitary granuloma in the retina
b) inflammatory masses in the periphery of the eye
c) chronic endophthalmitis
Clinical manifestations:
- Loffler's syndrome
- cough, wheezing, pneumonia
- fever
- hepatomegaly
- urticaria, pruritus
- manifestations of hypereosinophilic syndrome
Laboratory:
- complete blood count
- eosinophilia
- anemia
- Toxocara serology
Complications:
- Loffler's endocarditis with thromboembolism, embolic stroke
Management:
- albendazole
- ivermectin
Related
Toxocara
General
helminth infection
References
- Stedman's Medical Dictionary 27th ed, Williams &
Wilkins, Baltimore, 1999
- Jones SL et al
Special Section on Neglected Parasitic Infections.
American Journal of Tropical Medicine and Hygiene special
section on neglected parasitic infections.
http://www.ajtmh.org/content/90/5.toc#SpecialSectiononNeglectedParasiticInfections
- Parise ME et al
Neglected Parasitic Infections in the United States: Needs and
Opportunities.
Am J Trop Med Hyg 2014 90(5):783-785
http://www.ajtmh.org/content/90/5/783.full
- Centers for Disease Control and Prevention (CDC)
Press Release. May 8, 2012
Parasitic Infections also occur in the United States.
http://www.cdc.gov/media/releases/2014/p0508-npi.html
- Feske SK et al
Case 29-2015 - A 38-Year-Old Pregnant Woman with Headache
and Visual Symptoms.
N Engl J Med 2015; 373:1154-1164. September 17, 2015
PMID: 26376139
http://www.nejm.org/doi/full/10.1056/NEJMcpc1404335