[The ocular form of larval toxocariasis in the Czech Republic]. / Ocní forma larvální toxokarózy v Ceské republice.

The damage of the eye is one of the clinical syndromes of the Toxocara infection, caused by the migration activity of the Toxocara canis and Toxocara cati larvae. Ocular larva migrans (OLM) lesions mostly occur unilaterally and frequently are diagnosed as retinoblastoma. The typical symptoms of OLM are presented in our publication. The first signs of the ocular infection most often include diminished vision, leukocoria, red eye and strabismus. Inflammatory intraocular reaction, caused as a response to the antigens, released from dead or dying larvae is often diagnosed. The living larvae are observed very rarely. The reason and a way of the ocular invasion are still not sufficiently cleared. The supposition that the ocular syndrome is caused by migration of single larvae, when the immunological response is light, was not reliably verified. Sometimes if the infection size was heavy, the eye can be invaded with systemic complications as well. The most common laboratory findings include an elevation of the immunoglobulins in the serum of the patient and the presence of Toxocara specific antibodies response in the vitreous and/or aqueous humor. An analysis of the humor in cases of presumptive OLM was made only in 8 patients because not all oculists are ready to take this material, mainly in children. Highly sensitive assay--ELISA reaction with specific excretory-secretory antigen (TES) was used. For discrimination between chronic and recent infection the method of measuring IgG avidity was applied.

[Diagnosis of the early phase of larval toxocariasis using IgG avidity]. / Diagnóza casné fáze larvální toxokarózy s pouzitím avidity IgG.

The term avidity used to express the strength of the bond between a serum specimen and a multivalent antigen. It is known that the avidity increases with time after antibody challenge and measurement of the avidity has been used diagnostically. Recently an assay measuring the IgG avidity of various virus infections and of toxoplasmosis was used to distinguish between acute and chronic infection. Our study was focused on the method to distinguish acute and chronic Toxocara infection, zoonosis caused by the larvae of dog and cat ascarids Toxocara canis and Toxocara cati known all over the world for the possibility of provoking the infestation of man, accompanied by visceral or ocular clinical manifestations. The infection is generally diagnosed by demonstration of specific immunoglobulins to Toxocara excretory-secretory antigens (TES) in sera of infected patients. Highly sensitive assays with specific antigens are necessary for detection of antibodies. The test that has been proved clinically useful is the ELISA reaction with TES antigens. This method detects the antibodies for months or even years after infection and this is the reason why the discrimination between chronic and recent infection is very difficult. For disrupting the hydrogen bond urea has been used. The index of avidity was calculated as the ratio of IgG values in sera treated with urea and the value of IgG in non-treated sera, multiplied by 100. An index up to 40 is considered as low avidity, that means freshly acquired infection (36 to 40 borderline) and more than 40 is high avidity. In the group of 1,376 patients only 5.09% low avidities were found. It means that predominantly patients in the chronic stage of infection attend examination.

Seroprevalence of Toxocara canis infection in Czech Republic.

An enzyme-linked immunosorbent assay (ELISA) with Toxocara canis excretion--secretion (TES) antigen was used for determination the seroprevalence of Toxocara canis infection in healthy population of several districts in Czech Republic. It was found that the seropositivity ranged from 5.8% to 36.0% in various districts. Valuation by sex, age, profession of the examined persons and different type of their habitation (urban or rural) was used. It is obvious that the percentage of seropositivity rise in dependence on the age of examined persons. This fact may be attributed to the longlasting serological positivity detected in ELISA reaction. Almost in all districts the positivity was higher in inhabitants with a rural type of habitation in comparison with urban residents. The geographical conditions in various districts play an important role in seropositivity of the population too.

[Alveolar hydatidosis (alveococcosis) in the Czech Republic and its immunodiagnosis]. / Alveolární hydatidóza (alveokokóza) v Ceské republice a moznosti její imunodiagnostiky.

The frequent contemporary infections with the tapeworm Echinococcus multilocularis in foxes in some districts of the Czech Republic make it necessary to consider the probability of infection of man by the larval stage of this tapeworm in this country. So far there was in the Czech Republic a single case of alveolar hydatidosis (in 1977) in man with a lethal outcome. Foxes Vulpes vulpes increased in the Czech Republic considerably in numbers in recent years, and their infestations with E. multilocularis, in particular in the South Bohemian and North Bohemian regions is alarming. However so far it is not known whether the findings in foxes have a rising trend as compared with previous years as nobody was concerned with this particular problem in the past. The authors discuss also the epidemiology of alveococcosis and describe briefly its symptomatology.

Immunological studies on human larval toxocarosis.

The aim of the study was to characterize the antiparasite humoral response in patients with the syndrome of visceral larval toxocarosis. Specific IgG, specific IgE and total IgE immunoglobulins against Toxocara canis excretory/secretory antigens (TES) were detected by using ELISA technique. Antibody response was studied in complete sera as well as in immunoglobulin fractions (IgG and IgE), isolation of which was performed on Protein A Sepharose. It was observed that removal of IgG from the serum samples resulted mostly in increasing levels of anti-Toxocara IgE antibodies what agrees with the theory of the blocking effect of IgG in the immune response. The results demonstrated a little correlation between slgG and slgE in the sera of symptomatic patients, examined in ELISA reaction.

[Cysticercosis in the Czech Republic]. / Cysticerkóza v Ceské republice.

The authors report 10 cases of cysticercosis registered by the National Reference Laboratory for tissue helminthiasis. Six Czech citizens and four foreigners contracted the disease. Four of 6 Czech citizens were contaminated abroad. Six patients suffered from nervous manifestations of cysticercosis, 2 from muscular or subcutaneous cysticercosis and 2 patients had an asymptomatic course of the infection. The prerequisite of successful treatment with new anthelmintics is early diagnostics.

[Isolation of Dirofilaria repens in vitreoretinal findings]. / Izolácia Dirofilaria repens pri vitreoretinálnom náleze.

The authors present the case of a 18-year-old patient who reported deteriorated vision and mobile dark shadows on the left eye. Examination revealed in the vitreous body an extremely mobile filiform, worm-like formation, white in colour, of the size of an arteriole, about 9 mm long. In the course of hospitalization the formation was isolated by surgery of the pars plana vitrectomy and subjected to detailed helminthological examination. The worm was identified as Dirofilaria repens (Reillet et Henry 1911) and described in detail. The presented finding is the first finding of this parasite in this country and at the same time the first finding of this parasite in Czechoslovakia.

[Simultaneous toxoplasmosis and larval toxocariasis infection in the Czechoslovak population]. / Soubezné nákazy a onemocnení cloveka toxoplazmózou a larvální toxokarózou v populaci CSSR.

The authors discuss the coexistence of infection with toxoplasmosis and larval toxocariasis in man. Both these zoonoses are the most widespread and most serious of all tissue parasitoses on the territory of the CSSR. Knowledge of the incidence and frequency of concurrent infections is important for the differential diagnosis and therapy. In the introduction the authors mention briefly the incidence of toxoplasmosis and toxocariasis in animal hosts on the territory of the CSSR, deals with the developmental stages of the two parasites, Toxoplasma gondii and Toxocara canis and Toxocara cati which are infectious also for man, and with the transmission of infection. In the world literature there are so far only two papers dealing with the parallel course of these two zoonoses and they present only one confirmed case of concurrent disease in man. In the diagnostic group investigated by the authors during examination of tissue helminthoses among almost 9000 examinations larval toxocarosis was diagnosed 798 times. These patients were examined repeatedly to investigate the dynamics of toxocaral antibodies and concurrently possible toxoplasmatic antibodies. In 45 instances concurrent toxoplasmosis was revealed. In the discussion the author deals with possibilities and interrelations of infection with the two parasitoses.

[Larval toxocariasis in a 40-year-old man with detection of larvae in a liver biopsy]. / Larvální toxokaróza u 40letého muze s prukazem larvy v biopsii jater.

A 40-year old cattle feeder has been suffering from indigestion, leukocytosis and conspicuous eosinophilia for about 4 years. A sample of liver tissue was taken during gastrectomy and multiple allergic granulomas rich in eosinophilia leukocytes were found. Toxocara canis was identified in serial sections outside the granulomas. Larval toxocariasis was confirmed by a high level of specific antibodies which failed to decrease even after administration of Mintezol antithelmintic. In this country, there was serological proof of 287 cases of larval toxocariasis till July 1982. This is the first finding of Toxocara larvae in liver biopsy published in Czechoslovak literature. Another finding of liver Toxocara larvae was made in a 86-year old woman included among 4 cases of allergic granulomatosis of the liver published before.

Contribution to the knowledge of the reliability of some serological tests in detecting spontaneous bovine cysticercosis.

A total of 110 bulls coming from a farm where cysticercosis repeatedly occurred were examined by means of indirect haemagglutination (IHA), microprecipitation in agar (MPA), and indirect immunofluorescence reaction (IFR). Cysticercosis (isolated cysts with live or dead cysticerci) was detected in 29 of them at post-mortem examination. Among the 29 infected animals, positive reactions were obtained in 37.9% with IHA, 51.7% with MPA and 10.3% with IFR. The remaining animals were negative. Of 82 animals giving negative reactions with IHA, 22% harboured cysticerci at post-mortem examination. Of 70 animals negative with MPA, 20% were infected with cysticerci and of 71 animals negative with IFR, 29.5% were positive at the slaughter. Consequently, none of the used serological methods is reliable for the detection of a very light spontaneous infection.

[Organ reaction and antibody response in experimental bovine cysticercosis]. / Orgánová reakce a protilátková odpoved pri experimentální cysticerkóze skotu.

Antibody response in the course of experimental invasion of calves with the eggs of tapeworm (Taenia saginata) was studied with the use of indirect haemagglutination reaction and microprecipitation in relation to tissue reaction. Indirect haemagglutination was positive for the first time the 21st day, microprecipitation between the 16th and 21st day, at the time of acute pathological changes induced by the developing larvae. In the period of the morphological rest of cysts, beginning about the 50th day p.i., the level of titres stabilized in the haemagglutination reaction which remained positive throughout the time of serological study (250 days p.i.). Precipitation was detectable in our set the 70th and 85th day after invasion at the latest.

Larva migrans lentis.

A unique case of a larva migrans lentis in a 33-year-old female is presented. The intraocular larval (obviously Toxocara) affection was characterized in the first phase by the development of a peripheral chorioretinal granuloma and in the second phase by the finding of larva migrans in the lens. The lively larva appeared several times in the pupillary area under the anterior and posterior lens capsule and survived an intensive treatment by Mintezol.