Toxocara encephalitis presenting with autonomous nervous system involvement.

Human toxocariasis has been reported to cause a broad spectrum of neurological syndromes, including encephalitis, meningitis and meningo-radiculitis. Nevertheless, cerebral infection by Toxocara may go undiagnosed due to its rarity, elusive symptoms and lack of availability of appropriate testing. We report the case of a 54-year-old man who presented with abdominal pain and paralytic ileus approximately 3 weeks after having eaten raw snails (a folk remedy for peptic ulcer). Three weeks later, marked eosinophilia ensued, associated with mental clouding, nystagmus, diplopia, peripheral limbs ataxia, urinary retention, slackened deep tendon reflexes, arthralgias and myalgias. Cerebrospinal fluid (CSF) examination demonstrated an eosinophilic meningitis, and Toxocara canis cerebral infection was diagnosed by positive serology and by the detection of T. canis DNA in the CSF. The patient made a full recovery following treatment with albendazole and corticosteroids. Physicians should be aware of this rare presentation of toxocariasis, whose diagnosis is, today, facilitated by molecular biology techniques. A history of ingestion of raw snails may alert the clinician to consider the possibility of such an uncommon condition.

Toxocara canis: potential activity of natural products against second-stage larvae in vitro and in vivo.

The anthelmintic activity of extracts from Chenopodiumambrosioides, Pycnanthusangolensis and Nutridesintox was in vitro and in vivo investigated, against Toxocaracanis larvae. The in vitro assays results showed that the aqueous extract of Nutridesintox was the most effective, followed by C. ambrosioides extracts, hexane, dichloromethane and the infusion. P. angolensis extracts showed a lower anthelmintic activity compared to the other natural products. For the in vivo assays, Nutridesintox, the hexane extract and the infusion of C. ambrosioides were administered orally to T. canis-infected mice, in single doses, during three consecutive days. The efficacy was evaluated on the 17th day post-infection, not only by counting T. canis larvae in the tissues but also by ELISA detection of IgM and IgG antibodies and histological analysis of liver and lungs. The different treatments did not reduce the larvae burden and had no influence on the antibodies dynamic. Interestingly, a reduction on the inflammatory infiltrates was observed in the liver and lung sections of the group treated with the hexane extract of C. ambrosioides. In conclusion, the hexane extract of C. ambrosioides is of further research interest, as it showed an anthelmintic activity in vitro and a reduction on the inflammatory reaction produced by the infection of T. canis larvae in vivo.

Cognitive dysfunction, urinary retention, and a lesion in the thalamus--beware of possible toxocariasis of the central nervous system.

Toxocariasis of the central nervous system is usually characterized by an eosinophilic meningitis, encephalitis or myelitis. We here report a patient with an at least 7 years history of unexplained neurologic signs and symptoms. MRI showed a cystic lesion in the left thalamus, compatible with a parasitic infection. Blood and CSF analyses were positive for Toxocara canis IgG Western-blot, but were otherwise unremarkable. The case report raises the question whether there are chronic or late variants of this disease.

Selenium supplementation enhances the protective response to Toxocara canis larvae in mice.

The effect of oral and intraperitoneal supply of sodium selenite on the immune response to, and the course of T. canis larvae infection in mice were determined. The number of worms in the host tissue was reduced but the migratory route of larvae was not affected. Selenite (Se) supplementation influences Se retention in the liver, enhanced IL-5 and eosinophil responses and evoked IL-6 production in mice infected with T. canis. The enhanced protection in mice given Se intraperitoneally was associated with high levels of parasite-specific IgE, and enhanced concentration of Th1-related cytokines such IL-12p70, TNF-α and IFN-γ. In mice given Se orally, the predominant cytokines produced were IL-10, MCP-1 and IL-6 and these mice had lower protection. In conclusion, Se supplementation increases production of specific cytokines in mice infected with T. canis and increases protection against infection.

Modulation of eosinophil generation and migration by Mangifera indica L. extract (Vimang).

The effects of Vimang, an aqueous extract of the stem bark of Mangifera indica L. (Anacardiaceae), on cell migration in an experimental model of asthma was investigated. In vivo treatment of Toxocara canis-infected BALB/c mice for 18 days with 50 mg/kg Vimang reduced eosinophil migration into the bronchoalveolar space and peritoneal cavity. Also, eosinophil generation in bone marrow and blood eosinophilia were inhibited in infected mice treated with Vimang. This reduction was associated with inhibition of IL-5 production in serum and eotaxin in lung homogenates. In all these cases the effects of Vimang were more selective than those observed with dexamethasone. Moreover, Vimang treatment is not toxic for the animals, as demonstrated by the normal body weight increase during infection. These data confirm the potent anti-inflammatory effect of Vimang and support its potential use as an alternative therapeutic drug to the treatment of eosinophilic disorders including those caused by nematodes and allergic diseases.

A novel C-type lectin secreted by a tissue-dwelling parasitic nematode.

Many parasitic nematodes live for surprisingly long periods in the tissues of their hosts, implying sophisticated mechanisms for evading the host immune system. The nematode Toxocara canis survives for years in mammalian tissues, and when cultivated in vitro, secretes antigens such as TES-32. From the peptide sequence, we cloned TES-32 cDNA, which encodes a 219 amino-acid protein that has a domain characteristic of host calcium-dependent (C-type) lectins, a family of proteins associated with immune defence. Homology modelling predicted that TES-32 bears remarkable structural similarity to mammalian immune-system lectins. Native TES-32 acted as a functional lectin in affinity chromatography. Unusually, it bound both mannose- and galactose-type monosaccharides, a pattern precluded in mammalian lectins by a constraining loop adjacent to the carbohydrate-binding site. In TES-32, this loop appeared to be less obtrusive, permitting a broader range of ligand binding. The similarity of TES-32 to host immune cell receptors suggests a hitherto unsuspected strategy for parasite immune evasion.

Effect of glucan immunomodulator on the immune response and larval burdens in mice with experimental toxocarosis.

Glucan immunomodulator, combined with immunoglobulin and zinc (GI), was tested in mice infected with Toxocara canis for its effects on the immune response and parasite recovery. Infection with 2 500 T. canis eggs per mouse induced a short-term depression of the proliferative response of T cells to phytohemaglutinin from Day 35 to a Day 49 post infection (p.i.). GI given in two doses at the start of the experiment markedly stimulated and restored cell proliferation at Days 21-63 p.i. Infection resulted in significant increase in specific circulating antibody level at Days 21 and 35 p.i. A striking reduction in the number of T. canis larvae, after GI administration was observed in the muscles of the GI-treated mice, compared with the untreated animals.