Visceral larva migrans presenting as multiple liver abscesses

Ramachandran, Jeyamani; Chandramohan, Anuradha; Gangadharan, Sajith Kattiparambil; Unnikrishnan, LS; Priyambada, Leena; Simon, Anna

doi:10.1177/0049475513507254

Cited by 7 publications

(7 citation statements)

References 7 publications

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“…VLM abscesses have been predominantly known to present as multiple focal lesions with migration within the liver on repeated imaging. [ 14 ] In addition, our experience suggests that coalesced appearance of multiple lesions may sometimes mimic a honeycomb and give a solitary pseudotumor-like appearance. This needs to be kept in mind when forming a differential diagnosis of such a presentation in the liver.…”

Section: Discussionmentioning

confidence: 97%

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Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center

et al. 2016

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Introduction:Hepatic visceral larva migrans (VLM) is an uncommon parasitic manifestation seen in the liver. It presents as coalescing, conglomerated, or solitary abscess cavities in the liver on imaging. We conducted a retrospective clinico-radiological analysis of 24 patients with biopsy proven VLM who were reviewed and followed up at our tertiary liver institute over a period of 4 years.Materials and Methods:The study was performed to correlate the radiological features and imaging response to therapy for hepatic VLM. The disease course, imaging findings, progressive, absolute eosinophil counts (AEC), hydatid serology, and the extent of radiological regression of the liver lesions, on follow-up were analyzed.Results:Imaging showed a diagnostic accuracy of 42%. Hydatid serology was positive in 46% patients before starting treatment. The median pretreatment AEC of 507 showed a significant posttreatment AEC decline to median value of 117. The Wilcoxon signed ranks test showed significant decline in the AEC (P < 0.001). Radiological regression was present in all lesions. However, patients showed residual abscesses on imaging, up to 2 years on follow-up.Conclusion:This study reveals that AEC has a significant predictive value in diagnosis and as a marker for disease regression. Complete radiological resolution of hepatic lesions does not correlate with total clinical remission. This finding warrants the need for further studies to look into the role of prolonged medical therapy or surgery as an alternate to current therapy module in cases of hepatic visceral larva abscesses.

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Section: Discussionmentioning

confidence: 97%

“…Imaging differential diagnosis includes other parasitic, pyogenic as well as amoebic abscesses, which may be difficult to distinguish without laboratory and pathological correlation. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center

et al. 2016

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“…Although there are case reports of VLM, liver abscess caused by this disease is not commonly described. 3 A tropical climate in addition to poor socioeconomic background, overcrowding, bad hygiene, consumption of contaminated raw vegetables and geophagia are important risk factors. 4 Furthermore, stray dogs, open defecation by dogs and improper faecal disposal are conducive factors for persistence of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Although there are case reports of VLM, liver abscess caused by this disease is not commonly described. 3…”

Section: Discussionmentioning

confidence: 99%

Liver abscesses caused by visceral larva migrans: Aimless wanderer separated from the host

et al. 2022

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Visceral larva migrans (VLM) is a systemic zoonotic parasitic disease caused by migration of the second stage larva through viscera of humans. Despite being a foremost public health problem in low- and middle-income countries (LMICs) such as India, larva migrans remains an untended zoonosis. Here, we report two cases of VLM who presented with fever and abdominal pain for a prolonged duration. On further investigation, marked peripheral eosinophilia with multiple confluent necrotizing eosinophilic granulomas were identified on histopathological examination of the liver.

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“…Differential diagnoses for similar ultrasonographic findings may include neoplasia, torsion, granulomatous disease, nodular hyperplasia, haematomas or visceral larva migrans 6. Visceral larva migrans can produce liver abscessation due to the migratory stages of larvae of certain nematode parasites ( Toxocara canis and T cati ), although this is rare 7…”

Section: Discussionmentioning

confidence: 99%

Multifocal abdominal abscessation in a three‐month‐old puppy due toEscherichia coli

Sarmiento¹,

Walker²,

Watson³

2019

Vet Record Case Reports

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A 12-week-old, crossbreed, male entire dog was evaluated for a three-week history of lethargy, nausea, anorexia, haemorrhagic diarrhoea and free abdominal fluid. Abdominal ultrasound revealed multiple cavitated hepatic masses, abdominal lymphadenopathy and marked abdominal effusion. Fine needle aspiration and culture of the hepatic lesions and lymph nodes identified hepatic abscessation and pyogranulomatous lymphadenitis, with a heavy growth of Escherichia coli. Intravenous fluid therapy and antimicrobial therapy were initiated. Persistent hypotension and hypoglycaemia during hospitalisation, despite intensive treatment, were suggestive of systemic inflammatory response syndrome, septic shock and multiple organ dysfunction syndrome. Due to patient morbidity and poor response to treatment, euthanasia was performed.

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Visceral larva migrans presenting as multiple liver abscesses

Cited by 7 publications

References 7 publications

Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center

Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center

Liver abscesses caused by visceral larva migrans: Aimless wanderer separated from the host

Multifocal abdominal abscessation in a three‐month‐old puppy due toEscherichia coli

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