Neurotoxocaríase infantil com acometimento cerebral, cerebelar, e periférico simultâneo: relato de caso e revisão da literatura

Abstract

Objective: To alert pediatricians to the neurologic consequences of toxocariasis and to describe the first pediatric case of neurotoxocariasis with concomitant cerebral, cerebellar and peripheral nervous system involvement. Description:We report a case of neurotoxocariasis in a previously healthy 5-year-old boy with unusual symptoms and multi-site involvement of both the central and peripheral nervous system. Differential diagnoses are discussed and the relevant literature is reviewed. Since the early 1950s, fewer than fifty cases have been described, mostly in adult patients. Comments:Although human toxocariasis is one of the most common zoonotic helminth infections, neurotoxocariasis is a rare condition, especially in pediatric patients. Although toxocariasis usually presents as a self-limiting disease with no central nervous system involvement, when it does occur, it can be devastating. Neurotoxocariasis should be added to the differential diagnosis of pediatric patients with unusual neurologic symptoms accompanied by high levels of eosinophils in the cerebrospinal fluid. Early diagnosis and treatment can prevent long-term neurologic sequelae.J Pediatr (Rio J). 2010;86(6):531-534: Pediatrics, nervous system, toxocariasis.

Human Toxocariasis: 2010 to 2020 Contributions from Brazilian Researchers

“…Albendazole treatment (10 mg/kg/day for 10 days) provided complete resolution of her condition. Another uncommon complication of toxocariasis in a child was reported by Salvador et al, 61 who described the concomitant involvement of the cerebrum, cerebellum, and the peripheral nervous system of a 5-year-old boy from Porto Alegre (Rio Grande do Sul State).…”

Clinical and Magnetic Resonance Imaging Findings of Neurotoxocariasis

“…Encephalic localization has been reported in 34 patients [18 men (54.5%); mean age 33.5 ± 21.3 years]; 2 patients were classified as meningitis ( 38 , 52 ), 1 as encephalitis ( 37 ), 4 as meningoencephalitis ( 46 , 53 , 54 , 58 ), 3 as encephalomyelitis ( 29 , 49 , 51 ), 1 as meningoencephalomyelitis( 55 ), 2 as cerebral abscess ( 41 , 50 ), and 1 as obstructive hydrocephalus ( 61 ). Thirteen were generically defined as cerebral toxocariasis ( 21 , 39 , 40 , 42 – 45 , 47 , 48 , 56 , 57 , 59 , 60 ) and seven were classified as vasculitis ( 62 – 68 ).…”

“…Out of the 19 patients assessed by CSF ELISA, 15 tested positive of whom three were also confirmed by positive WB; in two additional patients, the presence of anti- Toxocara antibodies was detected only by WB. In 10 patients, of whom 4 were vasculitis ( 62 , 63 , 67 , 68 ), in which the diagnosis of neurotoxocariosis was based only on the presence of a positive serum ELISA seropositivity [CSF ELISA was negative in 5 ( 39 , 47 , 48 , 59 , 63 ) and not performed in the other 5 ( 53 , 56 , 62 , 67 , 68 )], not confirmed by biopsy or WB (Table 1 ; Table S1 in Supplementary Material).…”

Sensitivity and specificity of recombinant proteins in Toxocara spp. for serodiagnosis in humans: Differences in adult and child populations

“…Children are substantially more exposed to one of the most important risk factor for the disease: the geophagy habit. In addition, children are at risk for early infection and progression to ocular toxocariasis or/and neurotoxocariasis, potentially conferring permanent damage to vision and/or the brain, respectively, implicating toxocariasis as a major non-diagnosed health problem [4,12,13]. In addition, prior research has noted that the immune system of children responds differently than the immune system of adults to parasite infection, with lower expression levels of toll-like receptors and interleucin-5, both of which are important signaling pathways in the mature response against parasites [14–16].…”