Síndrome de larva migrans visceral y absceso hepático: Reporte de un caso / Visceral larva migrans syndrome and hepatic abscess: A case report

La infección por T oxocara canis o catis es una zoonosis diseminada en el ser humano. La toxocariasis puede coexistir con otras parasitosis endémicas. El hombre actúa como huésped no natural y adquiere la infección a través de la ingesta de huevos del geohelminto. Estos pueden localizarse en la tierra, los patios y los juegos de los niños, y son eliminados, principalmente, por perros o gatos. Existen distintos espectros en la presentación clínica; algunos de ellos son toxocariasis ocular, larva migrans visceral, toxocariasis encubierta y neurotoxocariasis. Se presenta el caso de un paciente de 2 años y 3 meses de edad, con antecedente de síntomas respiratorios, fiebre prolongada y hepatomegalia, con resultados de laboratorio que informa hipereosinofilia, hipergammaglobulinemia y serología positiva para toxocariasis (ensayo por inmunoabsorción ligado a enzimas). Se plantea el diagnóstico de síndrome de larva migrans visceral.

Toxocariasis canis or catis is a zoonotic infection disseminated in humans. Human beings can act as non-natural hosts in which the parasite can survive for long periods of time and they become infected by the ingestion of geohelminth eggs. These can be located on the ground, playgrounds and children's games, and are mostly eliminated by dogs or cats. There are different spectra in the clinical presentation of this infection, which can vary from an asymptomatic host to the production of serious organic lesions; some of them are ocular toxocariasis, visceral larva migrans, covert toxocariasis and neurotoxocariasis. In this case report a patient who presents with a history of respiratory problems, prolonged fever, and hepatomegaly. Laboratory analyses show hypereosinophilia, hypergammaglobulinemia and serodiagnosis is positive for toxocariasis. Preliminary diagnosis: Visceral Larva Migrans Syndrome.

[Visceral larva migrans syndrome and hepatic abscess: A case report]. / Síndrome de larva migrans visceral y absceso hepático: Reporte de un caso.

Toxocariasis canis or catis is a zoonotic infection disseminated in humans. Human beings can act as non-natural hosts in which the parasite can survive for long periods of time and they become infected by the ingestion of geohelminth eggs. These can be located on the ground, playgrounds and children's games, and are mostly eliminated by dogs or cats. There are different spectra in the clinical presentation of this infection, which can vary from an asymptomatic host to the production of serious organic lesions; some of them are ocular toxocariasis, visceral larva migrans, covert toxocariasis and neurotoxocariasis. In this case report a patient who presents with a history of respiratory problems, prolonged fever, and hepatomegaly. Laboratory analyses show hypereosinophilia, hypergammaglobulinemia and serodiagnosis is positive for toxocariasis. Preliminary diagnosis: Visceral Larva Migrans Syndrome.

La infección por T oxocara canis o catis es una zoonosis diseminada en el ser humano. La toxocariasis puede coexistir con otras parasitosis endémicas. El hombre actúa como huésped no natural y adquiere la infección a través de la ingesta de huevos del geohelminto. Estos pueden localizarse en la tierra, los patios y los juegos de los niños, y son eliminados, principalmente, por perros o gatos. Existen distintos espectros en la presentación clínica; algunos de ellos son toxocariasis ocular, larva migrans visceral, toxocariasis encubierta y neurotoxocariasis. Se presenta el caso de un paciente de 2 años y 3 meses de edad, con antecedente de síntomas respiratorios, fiebre prolongada y hepatomegalia, con resultados de laboratorio que informa hipereosinofilia, hipergammaglobulinemia y serología positiva para toxocariasis (ensayo por inmunoabsorción ligado a enzimas). Se plantea el diagnóstico de síndrome de larva migrans visceral.

Seroprevalencia contra toxocara canis en niños de 1 a 6 años con y sin síntomas respiratorios de barquisimeto, venezuela / Seroprevalence against Toxocara canis in children of 1-6 years without respiratory symptoms barquisimeto, Venezuela

Sabiendo la existencia de casos de Síndrome de Larva Migrans Visceral en Venezuela, es necesario conocer la seroprevalencia contra uno de sus agentes causales: Toxocara canis. Determinar la presencia de anticuerpos séricos IgG anti- Toxocara canis y su relación con síntomas respiratorios y factores de riesgo para Síndrome de Larva Migrans Visceral en niños de 1 a 6 años, que acudieron a dos ambulatorios urbanos de Barquisimeto-Venezuela. Se evaluaron 215 niños y niñas de 1 a 6 años de edad con y sin síntomas respiratorios. Previa información y solicitud del consentimiento informado de sus representantes, se les entrevistó y tomó muestra de sangre para determinar anticuerpos IgG séricos anti-Toxocara canis por ELISA, con el estuche DRG®. Se calcularon porcentajes y proporciones y se usaron Prevalencia Relativa (PR) y Chi Cuadrado con intervalo de confianza de 95%. Se detectaron anticuerpos en 34,4%. El mayor porcentaje de seroreactivos estuvo representado por los niños con síntomas respiratorios (83,8%), los del grupo de edad de 3 a 4 años (55,4%), el sexo masculino (54,1%), quienes refirieroncontacto con tierra y/o geofagia (95,9%) y contacto con cachorros caninos menores de 3 meses de edad (90,5%), quienes consumían agua de calidad inadecuada (85,1%) y quienes disponían inadecuadamente las excretas caninas (60,8%). La elevada seroprevalencia crea la necesidad de nuevos estudios para evaluar con precisión las características epidemiológicas de la infección por T. canis en Lara y Venezuela a fin de establecer planes adecuados de control

In view of the presence of Visceral Larva Migrans Syndrome in Venezuela, it is necessary to know the seroprevalence against one of its causal agents: Toxocara canis. A transversal study was performed to determine the presence of serum IgG anti-Toxocara canis antibodies and their relation with respiratory symptoms and risk factors for Visceral Larva Migrans Syndrome in patients from 1 to 6 years, who assisted to two urban outpatient clinics of Barquisimeto-Venezuela. 215 children 1 to 6 years old with and without respiratory symptoms were evaluated. Previous information on the investigation and request of the consent in writing of their care givers, an interview was withheld and a blood sample was drawn to determine serum IgG anti-Toxocara canis antibodies by the ELISA method, with DRG® commercial kit. Percentage and proportions were calculated and Relative Prevalence (RP) and x Squared used, with an interval of statistical confidence of 95%. Antibodies were detected in 34.4% of the children. The greater percentage of seroreactives was represented by children with respiratory symptoms (83.8%), those inthe age group of 3 to 4 years (55.4%), boys (54.1%), those who referred soil contact and/or geophagy (95.9%) and contact with puppies under three months of age (90.5%), that consumed water of inadequate quality (85.1%) and that had inadequate disposal of canine excretes (60.8%). The high seroprevalence creates the necessity of new studies to evaluate accurately the epidemiologic characteristics of the infection by T. canis in Lara and Venezuela in order to establish suitable control plans

[Analysis of children with a presumptive diagnosis of toxocariasis in Santa Fe, Argentina]. / Estudio en niños con diagnóstico presuntivo de toxocariasis en Santa Fe, Argentina.

Human toxocariasis is a parasitic disease found worldwide. The most important etiological agent is Toxocara canis, a dog parasite. Humans are infected by the ingestion of their eggs; the eggs hatch in the small intestine and the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children's Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59) and non-infected (41). The statistical analysis showed a non significant association between infection and sex (p = 0.279). Infected subjects tended to be older than the non infected (p = 0.009). Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis (p = 0.950). The association of these two parameters was significantly higher among infected patients (R = 0.918). Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05). Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53). According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as priority health activities in this region.

Estudio en niños con diagnóstico presuntivo de toxocariasis en Santa Fe, Argentina / Analysis of children with a presumptive diagnosis of toxocariasis in Santa Fe, Argentina

La toxocariasis humana es una parasitosis de amplia distribución en el mundo, cuyo agente etiológico más importante es el Toxocara canis, parásito del perro. El hombre adquiere esta zoonosis mediante la ingesta de huevos infectivos; en el intestino delgado desarticulan sus envolturas y las larvas se liberan atravesando la mucosa, ubicándose en diversos tejidos. Los niños son la población de mayor riesgo. El diagnostico clínico es dificultoso. El test de ELISA usando antígenos de excreción-secreción de la larva, es la técnica de elección. Se estudiaron por esta técnica inmunoserológica 100 niños con diagnóstico presuntivo de toxocariasis y se revisaron posteriormente sus historias clínicas de Hospital. La técnica de diagnóstico fue estandarizada y validada en el laboratorio. Su aplicación permitió identificar dos poblaciones de niños: infectados (59) y no infectados (41). La eosinofilia fue más frecuente en la población infectada (100% vs. 85.2%, p = 0.017); no así la leucocitosis (p = 0.950). La fuerza de asociación de ambos parámetros fue mayor en la población positiva (R = 0.918). La dificultad respiratoria se presentó más frecuentemente en pacientes con ELISA positiva, considerados como infectados (p = 0.05). La edad promedio de los positivos fue significativamente mayor que la de los negativos (p = 0.009). Se halló eosinofilia en el 100% de los infectados y en el 85.2% de los no infectados. La tenencia de canes en los domicilios no fue significativamente mayor entre los casos positivos que entre los negativos (p = 0.53). Sería necesario investigar esta enfermedad en niños consultantes con sospecha clínica, y promover las medidas de prevención, diagnóstico temprano y su correcto tratamiento.

Human toxocariasis is a parasitic disease found worldwide. The most important etiological agent is Toxocara canis, a dog parasite. Humans are infected by the ingestion of their eggs; the eggs hatch in the small intestine and the larvae migrate through the capillaries, taking up residence in different tissues. Clinical manifestations are associated with mechanical and/or reaction damage caused by these parasites larvae. Clinical diagnosis is difficult. The method applied in this work is the demonstration of antibodies against the helminth in the blood of children, target host population of this parasitic disease. An ELISA test was performed using T. canis larval excretory-secretory products as antigen. A total of 100 children presumptively diagnosed of toxocariasis that had been derived from different services of the Regional Children’s Hospital for complementary studies, were included in the analysis. The test detected two different populations: infected (59) and non-infected (41). The statistical analysis showed a non significant association between infection and sex (p = 0.279). Infected subjects tended to be older than the non infected (p = 0.009). Eosinophilia was detected in 100% of seropositive children and in 85.2% of the seronegative. There was no significant association between infection and leucocytosis ( = 0.950). The association of these two parameters was significantly higher among infected patients (R = 0.918). Respiratory symptoms and signs were more frequently detected in the positive population (p = 0.05). Dogs tenancy was as frequent among infected as in the non infected homes (p = 0.53). According to these results, prevention, early diagnosis and opportune treatment for toxocariasis should be considered as prioritary health activities in this region.

Epidemiological aspects of Visceral Larva Migrans in children living at São Remo Community, São Paulo (SP), Brazil.

In preparation for a study of risk factors for Visceral Larva Migrans of children living in São Remo Community, São Paulo (SP), Brazil, fecal samples were collected from 41 dogs younger than one year of age, 338 serum samples from children ages 1-15 years and 37 soil samples, during March-June 2001. Fecal and soil samples were examined for the presence of Toxocara spp. eggs and serum samples were evaluated by ELISA for antibodies to Toxocara canis. Of the fecal, serum and soil samples tested, 39.0%, 26.9% and 29.7%, respectively, were positive, suggesting the possibility of the presence of Visceral Larva Migrans in children.

[Toxocariasis with liver involvement]. / Toxocariasis con afectación Hepática.

We are reporting 16 cases of toxocariasis found in a two year period. Mean age was 2 years and 9 months. Sex distribution was 1:1. Thirteen (81%) children presented pica, 8 (50%) had pets at home, 10 (62.5%) presented anemia and long standing fever, and all eosinophilic leukocytosis. Fundoscopy was normal in all. Toxocara antibodies (Through ELISA) were increased in all of them. High resolution ultrasonography revealed hypoechoic areas in the liver in 50% of the cases. Therapeutic response was good, the clinical signs and symptoms disappearing at the end of treatment. The eosinophilic leukocytosis, ELISA serum positivity for toxocara and ultrasound findings persisted approximately for a year. Toxocariasis is a common parasitosis in our setting. It must be regarded as the first diagnosis when confronted with eosinophilic leukocytosis and abnormal liver findings by ultrasound.

Visceral larva migrans and tropical pyomyositis: a case report

Os autores relatam o caso de um jovem com piomiosite tropical grave, eosinofilia e hiperimunoglobulinemia E. O paciente relatou historia de contato com um cao e o teste de ELISA para Toxocara canis revelou-se positivo. O Staphylococcus aureus foi a unica bacteria isolada da secrecao purulenta obtida dos abscessos musculares. Sugere-se que a piomiosite tropical possa ser iniciada pela presenca das larvas desse ou de outros parasitos com tropismo para os musculos. As alteracoes imunologicas e estruturais nos musculos acometidos pelas larvas e a presenca de bacteriemia podem favorecer a instalacao da bacteria e o desenvolvimento da piomiosite

Síndrome de larva migrante visceral: toxocariasis: enfermedad transmitida por perros / Visceral larva migrans syndrome: toxocariasis: dog transmitted sickness

Se realiza una Síntesis Bibliográfica sobre el síndrome de larva migrante visceral provocado por toxocara cani. Dado que es una patología que se está diagnosticando y tratando hace pocos años en nuestro país y hay poca información del punto de vista epidemiológico, se considera de importancia transmitir este conocimiento a la comunidad, dado que la prevención primaria es muy importante

La toxocariasis humana en Venezuela, especialmente en el valle de Caracas / The human toxocariasis in Venezuela, specially in the valley of Caracas

Los autores presentan un trabajo sobre la Larva Migratoria viceral en Venezuela, especialmente en el valle de Caracas, sede de la capital de la Republica. Se trata de una helmintiasis accidental del hombre producida por el ascaridio del perro Toxocara canis, menos frecuente por el del gato Toxocara cati. Se describe el área de estudio, la metodología de la investigación, los patrones empleados para la sospecha clínica y la reacción de inmunoensayo enzimático (Elisa) con antígeno obtenido de larvas del tercer estadio de Toxocara canis. la población estimada del área metropolitana es de 3.575.989 habitantes y 286.079 perros (8% de la población humana) de los cuales 14.304 son perros callejeros (sin dueños). Existe una importante población marginal agrupada en barrios que vive en precarias condiciones socio-económicas y sanitarias. es muy frecuente la Toxocariasis canina en el Valle de Caracas y una muestra de suelos de cada tres examinadas se encontraron contaminadas con los huevos del ascaridio. La dinámica de transmisión es similar a la del Ascaris lumbricoides y se encuentra íntimamente asociada a la relación ecológica suelo contaminado-perro-hombre. El ciclo evolutivo del Toxocara canis en el hombre difiere del correspondiente al Ascaris lumbricoides en que las larvas en tercer estadio realizan un recorrido por todos los órganos, especial hígado, pulmón, ojo y cerebro, sin llegar a la luz intestinal, ni alcanzar el desarrollo de vermes adultos y por lo tanto no hay los huevos del parásito en las heces por lo cual el diagnóstico de la helmintiasis en el hombre se lleva a efecto por procedimientos..

[Visceral larva migrans in childhood: report of 2 cases]. / Larva migrans visceral na infância: relato de dois casos.

Reports of Visceral larva migrans (VLM) are not frequent in Brazil, but the prevalence of this disease may be more common due to poor environmental conditions to which most of the children are exposed. The most common infectious agent is Toxocara canis, a parasite of the intestinal tract of dogs. Children get infected eating contaminated material with feces of dogs. The ova are swallowed and reach the intestinal lumen of the children. Systemic migration occurs by lymphatic or portal circulation to several organs, most frequently, to the liver and lungs, causing hepatosplenomegaly and/or bronchospasm.