Pulmonary toxocariasis: a case report and literature review

Ranasuriya, Ganga; Mian, Asim; Boujaoude, Ziad; Tsigrelis, Constantine

doi:10.1007/s15010-014-0587-3

Cited by 26 publications

(9 citation statements)

References 16 publications

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“…On BAL and sputum examination, eosinophilia and Charcot-Leyden crystals may be seen. The exceedingly high level of pulmonary eosinophilia in this case (86%) is rarely reported in the literature, and fits with the florid immune response to larval migration through the lung [3] , [6] , [7] . It is possible to visualize larvae in the bronchial washings, but this finding is rare, and the absence of larvae by no means excludes the diagnosis [2] .…”

Section: Discussionsupporting

confidence: 85%

Löffler syndrome on a Louisiana pig farm

Gipson

Avery

Shah

et al. 2016

Respiratory Medicine Case Reports

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Löffler syndrome, a fulminant eosinophilic pneumonitis associated with the larval migratory phase of human parasites, is rarely reported in the United States. A previously healthy 8-year-old male was hospitalized with tachypnea, cough, hypoxemia, and fever of one week's duration. History revealed exposure to pigs on his family's farm in southernmost Louisiana, where the patient was responsible for cleaning the farm's pigpens. His fingernails were soiled and extremely short, with the edge of the nail bed exposed secondary to onychophagia. Laboratory evaluation demonstrated peripheral eosinophilia (39%), pulmonary eosinophilia (86%), high total IgE, diffuse reticulonodular lung opacities, and mixed obstructive and restrictive pulmonary function pattern. Systemic corticosteroids were initiated for his acute respiratory insufficiency and produced rapid clinical improvement. Serum Ascaris-specific IgE was markedly elevated and he was treated with albendazole. An extensive evaluation for other infectious and allergic etiologies was negative. A site visit to the family farm and laboratory investigation was coordinated with the Louisiana Animal Disease Diagnostic Laboratory at LSU. Ascaris suum eggs were detected in fresh pig feces and in the soil immediately surrounding the pens. Ascariasis should be considered even in the absence of travel history, especially in swine raising areas that are endemic for Ascaris in pigs, such as the southeastern United States. Onychophagia is a highly probable mechanism of zoonotic fecal-oral transmission in this case, and such habits could lead to continual reinfection. Systemic corticosteroids were effective in treating the patient's acute respiratory compromise due to Löffler syndrome.

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Section: Discussionsupporting

confidence: 85%

Löffler syndrome on a Louisiana pig farm

Gipson

Avery

Shah

et al. 2016

Respiratory Medicine Case Reports

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“…Symptomatic disease manifestations depend on the infection intensity, the duration of migration, the organs involved, and immune-and age-mediated host responses (20). Currently, both pediatric and adult patients with toxocariasis report a wide variety of inflammation-related conditions, such as asthma, pneumonia, lymphadenopathy, endomyocarditis, granulomatous hepatitis, generalized endophthalmitis, meningoencephalitis, and cutaneous manifestations (33,(62)(63)(64)(65)(66)(67)(68)(69). Notably, the focus of much research has been on the role of T. canis in neuropathological disorders, particularly epilepsy (70)(71)(72)(73).…”

Section: Types Of Human Toxocariasis and Immunopathogenesismentioning

confidence: 99%

Cerebral Toxocariasis: Silent Progression to Neurodegenerative Disorders?

et al. 2015

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SUMMARY Toxocara canis and T. cati are highly prevalent nematode infections of the intestines of dogs and cats. In paratenic hosts, larvae do not mature in the intestine but instead migrate through the somatic tissues and organs of the body. The presence of these migrating larvae can contribute to pathology. Toxocara larvae can invade the brains of humans, and while case descriptions of cerebral toxocariasis are historically rare, improved diagnosis and greater awareness have contributed to increased detection. Despite this, cerebral or neurological toxocariasis (NT) remains a poorly understood phenomenon. Furthermore, our understanding of cognitive deficits due to toxocariasis in human populations remains particularly deficient. Recent data describe an enhanced expression of biomarkers associated with brain injury, such as GFAP, AβPP, transforming growth factor β1 (TGF-β1), NF-L, S100B, tTG, and p-tau, in mice receiving even low doses of Toxocara ova. Finally, this review outlines a hypothesis to explore the relationship between the presence of T. canis larvae in the brain and the progression of Alzheimer's disease (AD) due to enhanced AD-associated neurodegenerative biomarker expression.

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“…In cases with cardiac involvement, regimens involving 800 mg/day for two weeks, 50 mg/(kg·day) for 28 days, 600 mg/day for 14 days, or 1000 mg/day for four weeks have been used [ 58 ]. Corticosteroids have been used in cases of pulmonary toxocariasis and toxocariasis-associated cardiac diseases [ 95 , 96 ].…”

Section: Treatmentmentioning

confidence: 99%

Toxocariasis: a silent threat with a progressive public health impact

et al. 2018

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BackgroundToxocariasis is a neglected parasitic zoonosis that afflicts millions of the pediatric and adolescent populations worldwide, especially in impoverished communities. This disease is caused by infection with the larvae of Toxocara canis and T. cati, the most ubiquitous intestinal nematode parasite in dogs and cats, respectively. In this article, recent advances in the epidemiology, clinical presentation, diagnosis and pharmacotherapies that have been used in the treatment of toxocariasis are reviewed.Main textOver the past two decades, we have come far in our understanding of the biology and epidemiology of toxocariasis. However, lack of laboratory infrastructure in some countries, lack of uniform case definitions and limited surveillance infrastructure are some of the challenges that hindered the estimation of global disease burden. Toxocariasis encompasses four clinical forms: visceral, ocular, covert and neural. Incorrect or misdiagnosis of any of these disabling conditions can result in severe health consequences and considerable medical care spending. Fortunately, multiple diagnostic modalities are available, which if effectively used together with the administration of appropriate pharmacologic therapies, can minimize any unnecessary patient morbidity.ConclusionsAlthough progress has been made in the management of toxocariasis patients, there remains much work to be done. Implementation of new technologies and better understanding of the pathogenesis of toxocariasis can identify new diagnostic biomarkers, which may help in increasing diagnostic accuracy. Also, further clinical research breakthroughs are needed to develop better ways to effectively control and prevent this serious disease.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0437-0) contains supplementary material, which is available to authorized users.

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Pulmonary toxocariasis: a case report and literature review

Cited by 26 publications

References 16 publications

Löffler syndrome on a Louisiana pig farm

Löffler syndrome on a Louisiana pig farm

Cerebral Toxocariasis: Silent Progression to Neurodegenerative Disorders?

Toxocariasis: a silent threat with a progressive public health impact

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