Toxocara canis larvae in the brain of a British child

Abstract

The clinical and autopsy findings of a two and a half year-old infant with Toxocara sp. infection of the brain and granulomatous lesions in the liver are reported. The cause of death was non-accidental injury. The relationship between Toxocara infection and behavioural disorders is discussed.

Toxocariasis of the central nervous system: with report of two cases

“…Neural involvement by Toxocara larvae is highly probable in both cases if one takes into account: a) cerebrospinal fluid pleocytosis with marked eosinophilia; b) positive serology, with IgM anti-Toxocara, in both serum and cerebrospinal fluid, and negative serology for Schistosoma mansoni and Cysticercus cellulosae (parasites that reach the nervous system most frequently in Brazil ); c) sterile cerebrospinal fluid and negative serology for other common infections in the central nervous system such as toxoplasmosis, syphilis and cytomegalovirus; and d) improvement of signs and symptoms after treatment 47 6.0/M Granuloma with larvae (cerebellum)* 3-Moore 1962 27 2.0/M Granuloma with larvae (cerebellum and medulla) 4-Schoenfield et al 1964 39 5.0/M Multiple granuloma and larvae in CNS* 5-Beautyman et al 1966 4 6.0/F Granuloma with larvae (thalamus) 6-Schochet et al 1967 40 2.0/M Multiple granulomas with larvae in CNS* 7-Mikhael et al 1974 26 1.5/M Multiple granulomas with larvae in CNS* 8-Hill et al 1985 15 2.5/F Larvae (cerebrum, cerebellum and pons) 9-Nelson J et al 1990 30 3 with albendazole and thiabendazole. Furthermore, Toxocara infection is frequent in children that are treated at the Children's Hospital Nossa Senhora da Glória in Vitória 28 .…”

“…Autopsy studies of isolated cases have revealed Toxocara larvae in leptomeninges 7 , gray and white matter of cerebrum and cerebellum 15 26 27 40, thalamus 4 and spinal cord 7 . Most of these cases did not present clinical neurological signs.…”

Highlights of human toxocariasis

“…However, a review of the English literature from 1950 to the present, found less than twenty reports of neurological toxocariasis in humans, as determined by the finding of Toxocara larvae in cerebral spinal fluid (CSF), in brain tissue, in the meninges, and/or by immunodiagnosis on CSF (Wang et al, 1983;Hill et al, 1985;Russegger and Schmutzhard, 1989;Ruttinger and Hadidi, 1991;Kumar and Kimm, 1994;Komiyama et al, 1995;Duprez et al, 1996). As with VLM, the clinical signs of neurological toxocariasis are nonspecific (Magnaval et al, 1997), leading to possible under diagnosis of this condition.…”

A Rare Cause of Hypereosinophilia: A Case Report

“…The larvae enter the bloodstream and spread to the lung, brain, heart, eyes, and other organs and tissues, especially liver (6,16,17). Liver involvement is quite common through the portal venous circulation.…”

“…Colonoscopy findings of the patient were compatible with eosinophilic colitis and hemorrhagic colitis. Laboratory values were as follows: hemoglobin: 14.5 g/dL (11)(12)(13)(14)(15)(16)(17)(18), eosinophils: 1800/ mm 3 (0-420), CRP: 20.6 mg/L (0-5), leucocytes: 12800 thousand/ mm 3 (4.000-11.000), and IgE: 17.3 IU/mL (0-100). Fasciola serology of the patient was positive.…”