ABSTRACT
INTRODUCCIÓN: La toxocariasis es una enfermedad parasitaria ampliamente distribuida. Las formas clínicas descritas son la asintomática (TA), larva migrans visceral (LMV), larva migrans ocular (LMO) y encubierta (TE). OBJETIVOS: Describir las características clínicas, de laboratorio, evolución y tratamiento de los casos y comparar las diversas formas clínicas de presentación. PACIENTES Y MÉTODOS: Análisis retrospectivo de todos los pacientes pediátricos con diagnóstico de toxocariasis atendidos en el Servicio de Infectología del Hospital General de Niños Pedro de Elizalde entre 2012 y 2019. RESULTADOS: Se incluyeron 85 pacientes. El 63,5 % fueron varones y la mediana de edad fue de 60 meses. Cuarenta y nueve pacientes presentaron TA, 14 LMV, 15 LMO y 7 TE. Los pacientes con LMV presentaron menor edad y recuento de eosinófilos más altos. Todos los casos de LMO presentaron mal pronóstico visual. Se indicó tratamiento con albendazol en todos los casos de LMV, en los casos activos de LMO, en 4 TE y en 3 TA. CONCLUSIÓN: Este estudio representa uno de los más grandes llevados a cabo en el país. Todas las formas clínicas excepto las LMO tuvieron buena evolución. Resulta fundamental enfatizar en la prevención y en el diagnóstico precoz de la enfermedad para instaurar de manera oportuna el tratamiento y evitar secuelas.
BACKGROUND: Toxocariasis is a widely spread parasitic disease. The most frequent clinical form is asymptomatic (AT) although it may present with visceral larva migrans (VLM), ocular larva migrans (OLM) or covert (TE) involvement. Aims: To describe the clinical presentation, laboratory, evolution and treatment characteristics of the cases and to compare the various clinical forms of presentation. PATIENTS AND METHODS: Retrospective analysis of all children diagnosed with toxocariasis attended at the Infectology Service of the Pedro de Elizalde Children's General Hospital between 2012-2019. RESULTS: We included 85 patients. 63.5% were males and the median age was 60 months. 49 patients presented AT, 14 VLM, 15 OLM and 7 TE. Children with LMV had lower age and higher eosinophil count. All the cases of OLM evolved with a poor visual prognosis. Treatment with albendazole was indicated in all cases of LMV, in active cases of LMO, in 4 TE and in 3 AT. CONCLUSION: This study represents one of the largest conducted in our country. The ocular forms had bad prognosis, while the visceral and covert forms had good evolution. It is essential to emphasize the prevention and early diagnosis of the disease in order to establish timely treatment and avoid sequelae.
Subject(s)
Humans , Animals , Male , Female , Child, Preschool , Child , Larva Migrans, Visceral , Toxocariasis/diagnosis , Toxocariasis/drug therapy , Toxocariasis/epidemiology , Argentina/epidemiology , Toxocara , Retrospective Studies , Hospitals, PediatricABSTRACT
Toxocariasis is an infection in a human host caused by Toxocara canis or Toxocara cati larvae. Clinical manifestations are classified according to the organs affected, such as visceral larva migrans (VLM) and ocular larva migrans (OLM). Epidemiological evidence suggests that OLM tends to occur in the absence of systemic involvement and vice versa, which has led to two manifestations of this infection being reclassified as VLM and OLM. No case of a patient with VLM combined with OLM has been reported in Korea. Here, we report a case of VLM combined with OLM in a 51-year-old female caused by massive ingestion of raw cow meat, manyplies, and liver.
Subject(s)
Female , Humans , Middle Aged , Eating , Korea , Larva , Larva Migrans , Larva Migrans, Visceral , Liver , Meat , Toxocara , Toxocara canis , ToxocariasisABSTRACT
To study the frequency of ocular lesions in 30 gerbils infected with 100 embryonated eggs of Toxocara canis, indirect binocular ophthalmoscopy was performed 3, 10, 17, 24, 31 and 38 days after infection. All the animals presented larvae in the tissues and 80 percent presented ocular lesions. Hemorrhagic foci in the choroid and retina were present in 92 percent of the animals with ocular lesions. Retinal exudative lesions, vitreous lesions, vasculitis and retinal detachment were less frequent. Mobile larvae or larval tracks were observed in four (13.3 percent) animals. Histological examination confirmed the ophthalmoscopic observations, showing that the lesions were focal and sparse. In one animal, there was a larva in the retina, without inflammatory reaction around it. The results demonstrated that gerbils presented frequent ocular lesions after infection with Toxocara canis, even when infected with a small number of embryonated eggs. The lesions observed were focal, consisting mainly of hemorrhages with signs of reabsorption or inflammation in different segments of eye, and differing from the granulomatous lesions described in ocular larva migrans in humans.
Para verificar a freqüência de lesões oculares em 30 gerbils infectados com 100 ovos larvados de Toxocara canis foi realizada a oftalmoscopia binocular indireta nos dias 3, 10, 17, 24, 31 e 38 após a infecção.Todos os animais apresentavam larvas nos tecidos e 80 por cento apresentavam lesões oculares, dos quais 92 por cento tinham lesões hemorrágicas focais na coróide e na retina. Lesões exudativas da retina, lesões do vítreo, vasculite e descolamento da retina foram menos freqüentes. Larva móvel ou traços de larva em quatro (13,3 por cento) animais. O estudo histológico confirmou as observações da oftalmoscopia, mostrando que as lesões eram focais e esparsas. Em um animal havia uma larva na retina, sem reação inflamatória em torno dela. Os resultados demonstraram que os gerbils apresentam freqüentes lesões oculares após infecção com o Toxocara canis mesmo quando infectados com pequeno número de ovos larvados. As lesões observadas eram focais, principalmente focos de hemorragia com sinais de reabsorção ou focos de inflamação nos diferentes segmentos do olho, diferentes das lesões granulomatosas descritas na larva migrans ocular humana.