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Kashyap A, Joshi P, Raj G, Narayan S, Upadhyay P, Hussain N. Hepatic visceral larva migrans: A radiological case report. Radiol Case Rep 2024; 19:2467-2471. [PMID: 38585398 PMCID: PMC10998046 DOI: 10.1016/j.radcr.2024.02.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Visceral larva migrans (VLM) occurs due to migration of the second stage of larvae of nematodes through human viscera. It is an underdiagnosed entity which commonly affects the liver as eosinophilic abscesses and appears as coalescing, conglomerated cavities on imaging. This case report details the sonographic and CT features of an 8 year old female patient with right upper quadrant pain and peripheral eosinophilia on laboratory reports, diagnosed as a case of VLM on biopsy. Imaging of VLM shows overlap with neoplastic lesions and other infective pathologies hence this case aims to highlight the clinical, laboratory, and radiological features to help narrow the differential diagnosis.
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Affiliation(s)
- Aniket Kashyap
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Pranjali Joshi
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Gaurav Raj
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Shamrendra Narayan
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Piyush Upadhyay
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
| | - Nuzhat Hussain
- Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, 226010, Uttar Pradesh, India
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Poulsen CS, Yoshida A, Wellbrant TT, Leifsson PS, Skallerup P, Thamsborg SM, Nejsum P. Migratory pattern of zoonotic Toxocara cati and T. canis in experimentally infected pigs. Eur J Clin Microbiol Infect Dis 2024; 43:587-596. [PMID: 38261158 PMCID: PMC10917876 DOI: 10.1007/s10096-024-04753-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Over a billion people are infected with Toxocara canis or T. cati, the roundworms of dogs and cats. Historically, T. canis has been considered the main species responsible for human toxocarosis, but as serodiagnosis cannot discriminate between the two species, this remains unresolved. We used pigs as a relevant large animal model for human infection to assess the migratory pattern of T. cati and T. canis. METHODS Pigs were inoculated with T. cati or T. canis eggs or PBS (negative controls) and necropsied 14 or 31 days later. Different organs and tissues were examined for parasites and pathological changes. RESULTS Overall, the two parasite species had a similar migration pattern reaching multiple organs and tissues, including the mesenteric lymph nodes, liver, lungs, and diaphragm. We recovered larvae of both species in the brain, suggesting that T. cati also can cause neurological toxocarosis in humans. Both species induced systemic eosinophilia and histopathological changes in the lungs, livers, and mesenteric lymph nodes. CONCLUSION This study emphasises the importance of T. cati as a zoonotic agent and the need to develop diagnostic methods that can differentiate between sources of infection in humans.
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Affiliation(s)
- Casper Sahl Poulsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ayako Yoshida
- Department of Veterinary Sciences, University of Miyazaki, Miyazaki, Japan
| | | | - Pall Skuli Leifsson
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Stig Milan Thamsborg
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Nejsum
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Aarhus, Denmark.
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
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Üblagger D, Auer H, Bezakova M, Kirchlechner V. Toxocarosis in a patient with autism spectrum disorder presenting with severe hypereosinophilia and acute respiratory distress: a case report. Parasitol Res 2024; 123:99. [PMID: 38228848 PMCID: PMC10791809 DOI: 10.1007/s00436-024-08119-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/07/2024] [Indexed: 01/18/2024]
Abstract
A boy with known autism spectrum disorder was transferred to our department due to a rapidly worsening respiratory situation. The patient's history revealed previous treatment with albendazole against a Toxocara infection 2 weeks prior in Poland. Blood analysis showed such severe eosinophilia and markedly elevated levels of IgE that, initially, a hematologic malignancy was suspected. However, diagnostic workup including autoimmune diagnostic, molecular genetic testing, fluorescence in situ hybridization (FISH), bone marrow aspiration, and parasitological testing led to the diagnosis of an insufficiently treated Toxocara infection. Treatment with albendazole and prednisone (six cycles for 4 weeks each) was administered. This treatment regime led to prompt improvement of symptoms and normalization of laboratory findings.
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Affiliation(s)
- Daniel Üblagger
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Herbert Auer
- Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
| | - Milina Bezakova
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Veronika Kirchlechner
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria.
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Henke K, Perunovic Cicovic T, Ziaka M. Case report: Probable toxocariasis in a Swiss adult patient with hypereosinophilic syndrome and multiorgan involvement. SAGE Open Med Case Rep 2023; 11:2050313X231198321. [PMID: 37667742 PMCID: PMC10475260 DOI: 10.1177/2050313x231198321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/12/2023] [Indexed: 09/06/2023] Open
Abstract
Hypereosinophilic syndromes are a heterogeneous group of rare diseases characterized by eosinophil-related organ damage and peripheral blood hypereosinophilia. Hypereosinophilic syndromes may occur secondary to a variety of clinical entities, for example, drug hypersensitivity reactions, parasitic infections, autoimmune disorders, and malignancies. Toxocariasis is a parasitic infection caused by the larval stage of the Toxocara species. It is usually a childhood disease and invades organs such as the liver but can affect any organ. Hypereosinophilic syndrome and multiorgan involvement are very rare manifestations of Toxocara infection, especially in adults. However, the disease may be underdiagnosed because of different factors, including a lack of laboratory infrastructure in some countries, a lack of uniform case definitions, and limited surveillance infrastructure, with its estimation constituting a challenge. We, therefore, present a probable case of hypereosinophilic syndrome with multiorgan involvement secondary to infection with Toxocara canis in a 79-year-old Swiss female patient with a medical history of ischemic cerebrovascular insult and a curatively resected non-small-cell bronchial carcinoma, successfully treated with albendazole and steroids.
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Affiliation(s)
- Katrin Henke
- Department of Internal Medicine, Hospital of Thun, Thun, Switzerland
| | | | - Mairi Ziaka
- Department of Internal Medicine, Hospital of Thun, Thun, Switzerland
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Magnaval JF, Fillaux J, Berry A. A Retrospective Study of the Efficacy of Albendazole and Diethylcarbamazine for the Treatment of Human Toxocariasis. Pathogens 2022; 11:pathogens11070813. [PMID: 35890057 PMCID: PMC9317386 DOI: 10.3390/pathogens11070813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/03/2022] [Accepted: 07/18/2022] [Indexed: 11/16/2022] Open
Abstract
In the Department of Parasitology and Mycology of Toulouse University Hospitals, patients presenting with common/covert toxocariasis were treated either with albendazole (39 cases) or with diethylcarbamazine (32 cases). Albendazole (ABZ) was given at 10 mg/kg b/w daily for 14 days, and diethylcarbamazine (DEC) was given at 4 mg/kg b/w daily for 21 days. In both groups, follow-up consultations occurred approximately 48 days after the end of the anthelmintic therapy. ABZ and DEC displayed a similar efficacy on the kinetics of the clinical picture (−64.5% of reduction vs. −72.7%, respectively) and on the levels of blood eosinophilia, serum eosinophil cationic protein and serum total IgE. However, the effect of the medication on the laboratory parameters was moderate. The rate of adverse reactions was similar in both groups (38% for ABZ vs. 31% for DEC), but DEC-treated patients complained of more intense and long-lasting side effects. The DEC group had more major adverse reactions, resulting in the termination of the anthelmintic treatment. The results from this retrospective study bring further arguments for considering ABZ, given at 10 mg/kg daily for 2 weeks, as the drug of choice in the treatment of human toxocariasis.
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Affiliation(s)
- Jean-François Magnaval
- Service de Parasitologie Médicale, Faculté de Médecine, Université de Toulouse III, 37 allées Jules-Guesde, 31000 Toulouse, France
- Correspondence:
| | - Judith Fillaux
- Service de Parasitologie-Mycologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 330 avenue de Grande-Bretagne, 31059 Toulouse, France; (J.F.); (A.B.)
| | - Antoine Berry
- Service de Parasitologie-Mycologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 330 avenue de Grande-Bretagne, 31059 Toulouse, France; (J.F.); (A.B.)
- UMR Infinity, Institut Toulousain des Maladies Infectieuses et Inflammatoires, Inserm-CNRS-Université de Toulouse III, 31024 Toulouse, France
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Magnaval JF, Bouhsira E, Fillaux J. Therapy and Prevention for Human Toxocariasis. Microorganisms 2022; 10:microorganisms10020241. [PMID: 35208697 PMCID: PMC8875715 DOI: 10.3390/microorganisms10020241] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 01/08/2023] Open
Abstract
For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.
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Affiliation(s)
- Jean-François Magnaval
- Service de Parasitologie Médicale, Faculté de Médecine, Université de Toulouse, 37 Allées Jules-Guesde, 31000 Toulouse, France
- Correspondence:
| | - Emilie Bouhsira
- Service de Parasitologie, Ecole Nationale Vétérinaire, 23 Chemin des Capelles, 31076 Toulouse, France;
| | - Judith Fillaux
- Service de Parasitologie-Mycologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, 330 Avenue de Grande-Bretagne, 31059 Toulouse, France;
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Ardekani A, Roshanshad A, Hosseini SA, Magnaval JF, Abdollahi A, Rostami A. Toxocariasis-associated urinary system diseases: a systematic review of reported cases. Trans R Soc Trop Med Hyg 2021; 116:668-672. [PMID: 34791477 DOI: 10.1093/trstmh/trab177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Toxocariasis is a neglected tropical disease caused by Toxocara canis and Toxocara cati. Toxocara species can involve many organs, such as the brain, heart and lungs, however, the urinary system involvement of toxocariasis is largely unknown. METHODS We performed a systematic review to identify cases infected with urinary tract toxocariasis. RESULTS We identified seven cases that were eligible to be reviewed. Among the included citations, four studies reported bladder involvement and three reported kidney involvement. Fever, urinary, and abdominal presentations were amongst the most important clinical symptoms. Eosinophilic cystitis and nephrotic syndrome were the most common diagnoses.. The treatment regimen included a combination of anthelmintic drugs and steroids. CONCLUSIONS In cases of urinary tract presentations accompanied by eosinophilia or histopathologic findings suggestive of parasitic infection, toxocariasis should be included in the list of differential diagnoses, especially in endemic areas.
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Affiliation(s)
- Ali Ardekani
- School of Medicine, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Amirhossein Roshanshad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Seyed Ali Hosseini
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Jean-François Magnaval
- Department of Medical Parasitology, Faculty of Medicine, University of Toulouse, Toulouse 31000, France
| | - Ali Abdollahi
- Department of Surgery, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran 1949635881, Iran
| | - Ali Rostami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 4717647745, Iran
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8
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Phuc LDV, Hai TX, Loi CB, Quang HH, Vinh LD, Le TA. The kinetic profile of clinical and laboratory findings and treatment outcome of patients with toxocariasis. Trop Med Int Health 2021; 26:1419-1426. [PMID: 34370367 DOI: 10.1111/tmi.13665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Human toxocariasis is a widespread zoonosis for which a chemotherapy decision and therapy effectiveness are difficult to determine. We aimed to investigate the kinetic profile of clinical and laboratory findings and treatment outcome of patients with toxocariasis in Vietnam. METHODS The prospective study was conducted between October 2017 and June 2019. The diagnosis of toxocariasis was established based on clinical, laboratory (eosinophilia, raised IgE concentration) and serological (positive Toxocara IgG ELISA) evaluation as well as the exclusion of another helminthic co-infection. The patients were followed up after seven days, then one, three and six months after chemotherapy by thiabendazole. RESULTS The study involved 80 patients with a mean age of 41.6 ± 15.2 years of whom 58.8% were female. At three and six months after chemotherapy, most patients demonstrated resolution of clinical signs and symptoms, eosinophil count and IgE concentration but not in the proportion of IgG seropositivity. Skin lesions and eosinophilia resolved earlier than the other symptoms (one month after treatment). About four-fifths of the patients were "cured" after three and six months of follow-up; 33.8% showed side effects to thiabendazole therapy but no severe events were reported. The most common adverse reaction was neurologic symptoms followed by gastrointestinal or skin manifestations which lasted as long as 4 days. CONCLUSIONS In toxocariasis patients, cutaneous manifestations and eosinophilia resolve more rapidly than other clinical and laboratory findings while IgG titre has a very slow kinetic after therapy. Thiabendazole seems to be a potential alternative for the treatment of human toxocariasis.
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Affiliation(s)
| | - Tang Xuan Hai
- Department of Otorhinolaryngology, Nghe An Obstetrics and Pediatrics Hospital, Vinh, Nghe An, Vietnam
| | - Cao Ba Loi
- Scientific and Training Management Department, National Institute of Malaria, Parasitology and Entomology of Vietnam, Ha Noi, Vietnam
| | - Huynh Hong Quang
- Institute of Malariology, Parasitology and Entomology, Binh Dinh, Vietnam
| | - Le Duc Vinh
- Medical Parasitology Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran-Anh Le
- Department of Parasitology, Vietnam Military Medical University, Ha Noi, Vietnam
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Docu Axelerad A, Stroe AZ, Gogu AE, Pusztai A, Jianu DC, Daniel D, Docu Axelerad D. Clinical spectrum of symptoms in cerebral Toxocariasis (Review). Exp Ther Med 2021; 21:521. [PMID: 33815594 PMCID: PMC8014984 DOI: 10.3892/etm.2021.9953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/09/2021] [Indexed: 11/06/2022] Open
Abstract
Human helminth zoonosis is one of the most encountered helminthiases worldwide. Representative diseases include Toxocara canis and Toxocara cati, which are common nematodes prevalent in dogs and cats. The infiltration of these roundworms in the human body through contaminated food or nematode eggs could lead to central nervous system injury as the roundworms can cross the blood-brain barrier leading to neurotoxocariasis. Among the neurological and neuropsychological disturbances produced by Toxocara infection, in humans, the most representative are meningitis, encephalitis, myelitis and cerebral vasculitis, but asymptomatic central nervous system infection is probably the most prevalent. The present review examines the clinical symptomatology of neurotoxocariasis in case reports in the literature in the last 7 decades (1950-2020). The available evidence was retrieved from PubMed and Medline electronic databases. The present review reports the most prevalent clinical symptomatology in the cases of detected and diagnosed Toxocara infection with neuroinvasion. Thus, the present review aims to raise the awareness of neurological cases of Toxocara infection with the potential to at least establish differential diagnosis of neurotoxocariasis.
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Affiliation(s)
- Any Docu Axelerad
- Department of Neurology, Faculty of General Medicine, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania
| | - Alina Zorina Stroe
- Department of Neurology, Faculty of General Medicine, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania
| | - Anca Elena Gogu
- Department of Neurology, Faculty of General Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Agneta Pusztai
- Department of Anatomy, Faculty of General Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Dragos Catalin Jianu
- Department of Neurology, Faculty of General Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Duta Daniel
- Department of Sports, Faculty of Physical Education and Sports, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania
| | - Daniel Docu Axelerad
- Department of Sports, Faculty of Physical Education and Sports, ‘Ovidius’ University of Constanta, 900470 Constanta, Romania
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Omer FM, Awadalla NJ, Alsaleem SA, Alsaleem MA, Moosa RA, Alqahtani MA, Asiri AA, Alahmari EM, Alqahtani AN, Mahfouz AA. Toxocara Awareness Among Medical Practitioners in Saudi Arabia. ECOHEALTH 2021; 18:107-112. [PMID: 34014415 DOI: 10.1007/s10393-021-01529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 06/12/2023]
Abstract
Human toxocariasis is a zoonotic infection with global and regional impacts. Worldwide it is underestimated and clinically overlooked. Medical practitioners are generally unaware of the extent of the resulting disease spectrum. The objective of the study was to assess knowledge and disease awareness among medical practitioners in Aseer, south-western Saudi Arabia. A questionnaire addressing knowledge about the parasite, its visceral larva migrans and the disease spectrum generated was used to interview participants. The study included 285 participants. In answer to the question what is toxocara, only 27%, answered correctly that it is a nematode, paediatricians being the majority. With regard to years of experience among participants, 56.8% of those who answered correctly had less than 5-year experience, as opposed to 35.4% for those with more than 10-year experience. The cumulative awareness about the disease manifestations and spectrum, i.e. those who knew, was less than 30% across specialties and years of experiences. Lack of awareness regarding Toxocara infection and the disease spectrum it can generate is evident. The consequence for such lack of knowledge within our practising medical community is simply unacceptable as it might translate into misdiagnosis and consequently misguided treatment.
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Affiliation(s)
- Fakhreldin M Omer
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nabil J Awadalla
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
- Department of Community Medicine, Mansoura University, Mansoura, Egypt
| | - Safar Abadi Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Mohammed Abadi Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Riyad A Moosa
- Department of Microbiology and Clinical Parasitology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Mohamed A Alqahtani
- Medical Student, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Abdulmageed A Asiri
- Medical Student, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Ebtesam M Alahmari
- Medical Student, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Amal N Alqahtani
- Medical Student, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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Dewair A, Bessat M. Molecular and microscopic detection of natural and experimental infections of Toxocara vitulorum in bovine milk. PLoS One 2020; 15:e0233453. [PMID: 32433671 PMCID: PMC7239449 DOI: 10.1371/journal.pone.0233453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/05/2020] [Indexed: 02/02/2023] Open
Abstract
Toxocara vitulorum is an Ascarid nematode infecting the small intestine of buffalo and cattle particularly neonate calves, with the postnatal route through milk is the main infection source. However, little is known about shedding rates and the optimum detection methods of T. vitulorum larvae in the milk of the infected bovine hosts. In this study, we aimed to evaluate the use of two methods, microscopy and PCR, and their detection limits both under the experimental and natural infection situations. In doing this, T. vitulorum eggs extracted from naturally occurring adult female worms were successfully subjected to experimental embryonation, and larvae were implemented in experimental infection of milk in ascending infection doses of 0, 1, 5, 10, 20, 50 larvae/2-ml milk samples. With the except of negative control, microscopy-based examination detected larvae in all samples, albeit with means, ranges, and the total number of larvae were detected in exponential rates relative to larvae densities in milk samples. PCR technique corresponded well to microscopy in detecting genomic DNA of T. vitulorum larvae in all milk samples down to a single larva/sample. On the other hand, and by applying the same methodology approach on 50 naturally-occurring bovine colostrum/milk samples, 13 (26%) and 20 (40%) samples were tested positive for T. vitulorum infection by microscopy and the PCR-based detection, respectively. Of these, 11 out of 26 buffalo samples (42.30%) and 2 out of 24 cow samples (8.33%) were tested positive by microscopy, while 16 (61.54%) and 3 (12.50%) of buffalo and cow samples were tested positive by PCR, respectively. By applying the Agreement Coefficient, substantial agreement (0.77) between molecular and microscopy detection was detected from all tested samples. In conclusion, larvae of T. vitulorum were unequivocally detected by microscopy and molecular methods in milk samples both under the experimental and natural field situations. Nevertheless, slightly higher rates by PCR than microscopy were obtained when detecting naturally-infected milk samples. To the best of our knowledge, this is the first in situ detection of larvae of T. vitulorum in the milk of the naturally infected animals.
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Affiliation(s)
- Amira Dewair
- Department of Parasitology, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Bessat
- Department of Parasitology, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt
- * E-mail:
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12
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Magnaval JF, Fillaux J, Cassaing S, Valentin A, Iriart X, Berry A. Human toxocariasis and atopy. ACTA ACUST UNITED AC 2020; 27:32. [PMID: 32400389 PMCID: PMC7219086 DOI: 10.1051/parasite/2020029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/23/2020] [Indexed: 11/14/2022]
Abstract
To assess the possible influence of atopy on the clinical picture of human toxocariasis, a retrospective study was carried out using file records for patients who attended the Outpatient Clinic of Parasitology in Toulouse University Hospitals. A total of 106 file records for patients who had been diagnosed with common/covert toxocariasis were extracted from the database. Forty-nine patients (20 females and 29 males) were considered atopic since they exhibited a long (≥ 1 year) history of various allergic issues along with a titer ≥ 0.7 kIU/L for specific IgE against at least two out of nine mixes of common inhalant allergens. Fifty-seven patients (42 females and 15 males) were designated nonatopic on the basis of a negative result (<0.35 kIU/L) of the test for specific IgE. Demographic (age and sex), clinical (20 signs or symptoms) and laboratory (blood eosinophil count, eosinophil cationic protein, serum total IgE, and specific anti-Toxocara IgE) variables were investigated by bivariate analysis followed by multivariate regression analysis using "atopy" as the outcome variable. On the basis of our results, the clinical or laboratory picture of toxocaral disease was not affected by the presence of an atopic status.
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Affiliation(s)
- Jean-François Magnaval
- Service de Parasitologie Médicale, Faculté de Médecine, Université de Toulouse, 31000 Toulouse, France
| | - Judith Fillaux
- Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, TSA 40031-31059 Toulouse cedex 9, France - PharmaDev, Faculté de Pharmacie, Université de Toulouse, IRD, UPS, 31062 Toulouse cedex 9, France
| | - Sophie Cassaing
- Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, TSA 40031-31059 Toulouse cedex 9, France - PharmaDev, Faculté de Pharmacie, Université de Toulouse, IRD, UPS, 31062 Toulouse cedex 9, France
| | - Alexis Valentin
- Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, TSA 40031-31059 Toulouse cedex 9, France - PharmaDev, Faculté de Pharmacie, Université de Toulouse, IRD, UPS, 31062 Toulouse cedex 9, France
| | - Xavier Iriart
- Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, TSA 40031-31059 Toulouse cedex 9, France - Centre de Physiopathologie Toulouse-Purpan (CPTP), Université de Toulouse, INSERM, CNRS, UPS, TSA 40031-31059 Toulouse cedex 9, France
| | - Antoine Berry
- Service de Parasitologie et Mycologie, Université de Toulouse, Centre Hospitalier Universitaire de Toulouse, TSA 40031-31059 Toulouse cedex 9, France - Centre de Physiopathologie Toulouse-Purpan (CPTP), Université de Toulouse, INSERM, CNRS, UPS, TSA 40031-31059 Toulouse cedex 9, France
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Adeel AA. Seroepidemiology of human toxocariasis in North Africa. ADVANCES IN PARASITOLOGY 2020; 109:501-534. [PMID: 32381215 DOI: 10.1016/bs.apar.2020.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.
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Toxocariasis: a silent threat with a progressive public health impact. Infect Dis Poverty 2018; 7:59. [PMID: 29895324 PMCID: PMC5998503 DOI: 10.1186/s40249-018-0437-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/09/2018] [Indexed: 11/10/2022] Open
Abstract
Background Toxocariasis 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 text Over 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. Conclusions Although 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 material The online version of this article (10.1186/s40249-018-0437-0) contains supplementary material, which is available to authorized users.
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Abstract
In determining the etiology of eosinophilia, it is necessary to consider the type of patient, including previous travel and exposure history, comorbidities, and symptoms. In this review, we discuss the approach to the patient with eosinophilia from an infectious diseases perspective based on symptom complexes.
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Affiliation(s)
- Elise M O'Connell
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA.
| | - Thomas B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 4 Center Drive, Building 4, Room B105, Bethesda, MD 20892, USA
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Laroia ST, Rastogi A, Bihari C, Bhadoria AS, Sarin SK. Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center. Trop Parasitol 2016; 6:56-68. [PMID: 26998435 PMCID: PMC4778184 DOI: 10.4103/2229-5070.175100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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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Affiliation(s)
| | - Archana Rastogi
- Department of Hepato Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Chhagan Bihari
- Department of Hepato Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ajeet Singh Bhadoria
- Department of Community Medicine and Public Health, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Toxocariasis-associated cardiac diseases--A systematic review of the literature. Acta Trop 2016; 154:107-20. [PMID: 26571071 DOI: 10.1016/j.actatropica.2015.11.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 11/23/2022]
Abstract
Toxocariasis, caused by Toxocara canis or Toxocara catis, is a worldwide occurring parasitic disease, reaching high prevalences especially in tropical and subtropical countries. The clinical presentation can range from asymptomatic seropositivity to life threatenting disease, depending on the organ system involved. Cardiac involvement, one of the possible manifestations of human Toxocara spp. infection, is rarely reported in case reports. As far as we know, no systematic reviews of clinical presentations have been published till now and no clear recommendations regarding the treatment of Toxocara spp. infection involving the heart exist. In a systematic review of the literature, 24 published cases of Toxocara spp. infection involving the heart were identified. The cardiac entities described included myocarditis, pericarditis, and Loeffler's endocarditis. The clinical presentation ranged from asymptomatic or mild disease to life threatening myocarditis/pericarditis with heart failure or cardiac tamponade, leading to death. In most cases, the diagnosis was based on a combination of clinical, laboratory and radiological findings. Only in three of the nine cases in which histological analysis was performed (either pre- or post-mortem), granulomas or remnants of the parasite were detected. In the other six cases, findings were non-specific; the damage of the heart was equally caused by direct invasion of the larvae and by immunological reactions, either caused by the systemic hypereosinophilia or by the presence of the larvae in the tissue. The treatment regimen described mostly consisted of anthelmintic drugs in combination with corticosteroids. Even though dosage and duration of treatment varied widely, ranging from days to months, most patients were treated successfully. Cardiac involvement in Toxocara spp. infection is a rare but potentially life-threatening complication of a very common disease. The therapeutic regimens vary widely especially with regard to the duration of therapy, however, the combination of an anthelmintic drug and a corticosteroid appears to be a valuable option. For the daily clinical work, tissue manifestation by parasites should be considered in cases of unspecific organ manifestations, (i.e. heart, lungs, liver), accompanied by fever and eosinophilia with or without allergic skin rashes.
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Abstract
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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Toxocariasis diagnosed in international travelers at the Institute of Tropical Medicine, Antwerp, Belgium, from 2000 to 2013. PLoS Negl Trop Dis 2015; 9:e0003559. [PMID: 25746418 PMCID: PMC4351981 DOI: 10.1371/journal.pntd.0003559] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/22/2015] [Indexed: 11/19/2022] Open
Abstract
Although infection with Toxocara canis or T. catis (commonly referred as toxocariasis) appears to be highly prevalent in (sub)tropical countries, information on its frequency and presentation in returning travelers and migrants is scarce. In this study, we reviewed all cases of asymptomatic and symptomatic toxocariasis diagnosed during post-travel consultations at the reference travel clinic of the Institute of Tropical Medicine, Antwerp, Belgium. Toxocariasis was considered as highly probable if serum Toxocara-antibodies were detected in combination with symptoms of visceral larva migrans if present, elevated eosinophil count in blood or other relevant fluid and reasonable exclusion of alternative diagnosis, or definitive in case of documented seroconversion. From 2000 to 2013, 190 travelers showed Toxocara-antibodies, of a total of 3436 for whom the test was requested (5.5%). Toxocariasis was diagnosed in 28 cases (23 symptomatic and 5 asymptomatic) including 21 highly probable and 7 definitive. All but one patients were adults. Africa and Asia were the place of acquisition for 10 and 9 cases, respectively. Twelve patients (43%) were short-term travelers (< 1 month). Symptoms, when present, developed during travel or within 8 weeks maximum after return, and included abdominal complaints (11/23 symptomatic patients, 48%), respiratory symptoms and skin abnormalities (10 each, 43%) and fever (9, 39%), often in combination. Two patients were diagnosed with transverse myelitis. At presentation, the median blood eosinophil count was 1720/μL [range: 510-14160] in the 21 symptomatic cases without neurological complication and 2080/μL [range: 1100-2970] in the 5 asymptomatic individuals. All patients recovered either spontaneously or with an anti-helminthic treatment (mostly a 5-day course of albendazole), except both neurological cases who kept sequelae despite repeated treatments and prolonged corticotherapy. Toxocariasis has to be considered in travelers returning from a (sub)tropical stay with varying clinical manifestations or eosinophilia. Prognosis appears favorable with adequate treatment except in case of neurological involvement.
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La Sala LF, Leiboff A, Burgos JM, Costamagna SR. Spatial distribution of canine zoonotic enteroparasites in Bahía Blanca, Argentina. Rev Argent Microbiol 2015; 47:17-24. [DOI: 10.1016/j.ram.2014.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 12/19/2014] [Accepted: 12/29/2014] [Indexed: 12/31/2022] Open
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Deshayes S, Galateau-Sallé F, de La Blanchardière A. [Hepatic abnormality]. Rev Med Interne 2014; 36:363-4. [PMID: 25063545 DOI: 10.1016/j.revmed.2014.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 06/16/2014] [Indexed: 11/19/2022]
Affiliation(s)
- S Deshayes
- Service de médecine interne, CHU Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - F Galateau-Sallé
- Service d'anatomopathologie, CHU Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France
| | - A de La Blanchardière
- Service de maladies infectieuses, CHU Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
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Cheepsattayakorn A, Cheepsattayakorn R. Parasitic pneumonia and lung involvement. BIOMED RESEARCH INTERNATIONAL 2014; 2014:874021. [PMID: 24995332 PMCID: PMC4068046 DOI: 10.1155/2014/874021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/15/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022]
Abstract
Parasitic infestations demonstrated a decline in the past decade as a result of better hygiene practices and improved socioeconomic conditions. Nevertheless, global immigration, increased numbers of the immunocompromised people, international traveling, global warming, and rapid urbanization of the cities have increased the susceptibility of the world population to parasitic diseases. A number of new human parasites, such as Plasmodium knowlesi, in addition to many potential parasites, have urged the interest of scientific community. A broad spectrum of protozoal parasites frequently affects the respiratory system, particularly the lungs. The diagnosis of parasitic diseases of airway is challenging due to their wide varieties of clinical and roentgenographic presentations. So detailed interrogations of travel history to endemic areas are critical for clinicians or pulmonologists to manage this entity. The migrating adult worms can cause mechanical airway obstruction, while the larvae can cause airway inflammation. This paper provides a comprehensive review of both protozoal and helminthic infestations that affect the airway system, particularly the lungs, including clinical and roentgenographic presentations, diagnostic tests, and therapeutic approaches.
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Affiliation(s)
- Attapon Cheepsattayakorn
- 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand
- 10th Office of Disease Prevention and Control, Department of Disease Control, Ministry of Public Health, Chiang Mai 50100, Thailand
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Lim SJ, Lee SE, Kim SH, Hong SH, You YS, Kwon OW, Kim HS. Prevalence ofToxoplasma gondiiandToxocara canisamong Patients with Uveitis. Ocul Immunol Inflamm 2014; 22:360-6. [DOI: 10.3109/09273948.2013.841491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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Immunodiagnosis of Human Toxocariasis and Prospects for Improved Diagnostics. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-013-0001-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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McGuinness SL, Leder K. Global Burden of Toxocariasis: A Common Neglected Infection of Poverty. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-013-0012-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Lim SJ, Lee SE, Kim SH, Hong SH, You YS, Kwon OW, Kim HS. Prevalence of Toxoplasma gondii and Toxocara canis among Patients with Uveitis. Ocul Immunol Inflamm 2013; 23:111-7. [PMID: 24131311 DOI: 10.3109/09273948.2013.839798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the prevalence of Toxoplasma gondii and Toxocara canis in patients with uveitis. METHODS Patients with uveitis were examined. Serum antibodies to T. gondii and T. canis were tested by using the enzyme-linked immunosorbent assay. Polymerase chain reaction (PCR) was done using blood and aqueous humor (AH). RESULTS Ninety-eight patients were enrolled. Mean age was 43.5 ± 13.2 years. Six patients were seropositive for T. gondii with the following pattern: anterior uveitis, 1; posterior uveitis with retinitis, 2; pan uveitis, 2. One patient had a positive PCR result for T. gondii in AH, who showed panuveitis. Twenty-three patients were positive to serum IgG for T. canis with the following clinical manifestation: granuloma, 6; pigmented scar, 3; vitritis, 6--but none were PCR positive. CONCLUSIONS T. gondii and T. canis are still important causes of uveitis. Ocular toxocariasis is not an uncommon cause of uveitis, even in adults.
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Affiliation(s)
- Su Jin Lim
- The Retina Center of Nune Eye Hospital , Seoul , Korea
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Zibaei M, Firoozeh F, Bahrami P, Sadjjadi SM. Investigation of anti-Toxocara antibodies in epileptic patients and comparison of two methods: ELISA and Western blotting. EPILEPSY RESEARCH AND TREATMENT 2013; 2013:156815. [PMID: 23710354 PMCID: PMC3654325 DOI: 10.1155/2013/156815] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 11/17/2022]
Abstract
The relationship between Toxocara infection and epilepsy was previously demonstrated by several case-control studies and case reports. These previous studies were often based on the enzyme-linked immunosorbent assay (ELISA) using Toxocara excretory-secretory antigens, which are not specific due to cross-reactivity with other parasitic infections such as ascariasis, trichuriasis, and anisakiasis. An immunoblot analysis is highly specific and can detect low levels of Toxocara antibodies. Therefore, this assay may be useful in the identification of toxocariasis in epileptic patients. We examined patients who had epilepsy and healthy subjects for seropositivity for Toxocara infection by ELISA and Western blotting. Out of 85 epileptic patients, 10 (11.8%) and 3 (3.5%) persons exhibited Toxocara immunoglobulin G (IgG) antibodies responses by ELISA and by both techniques, respectively. Moreover, in the healthy group (n = 85), 3 (3.5%) persons were positive by ELISA, but none was detected by Western blotting. This study indicates that Toxocara infection is a risk factor for epilepsy in Iran. These findings strongly suggest the need to perform Western blotting immunodiagnosis, as well as the ELISA using Toxocara excretory-secretory antigens, to improve diagnosis of human toxocariasis in patients with epilepsy.
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Affiliation(s)
- Mohammad Zibaei
- Department of Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, P.O. Box 381351698, Khorramabad, Iran
| | - Farzaneh Firoozeh
- Department of Microbiology and Immunology, School of Medicine, Kashan University of Medical Sciences, P.O. Box 8715988141, Kashan, Iran
| | - Parviz Bahrami
- Department of Neurology, School of Medicine, Lorestan University of Medical Sciences, P.O. Box 381351698, Khorramabad, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, P.O. Box 713451735, Shiraz, Iran
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Dabrowska J, Walski M, Dybicz M, Doligalska M. Comparative ultrastructural studies of the alterations to mouse lung parenchyma during Trichinella spiralis or Toxocara canis infection. Parasite Immunol 2013; 34:455-63. [PMID: 22803684 DOI: 10.1111/j.1365-3024.2012.01381.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Trichinella spiralis and Toxocara canis larvae migrated through the lung and induced many alterations in the lung parenchyma. Using electron microscopy, we identified and described the histopathological changes. These changes resulted from mechanical damage or from local inflammatory reactions provoked by larvae. The pattern of changes was described between 6 and 12 days post-infection (DPI) with T. spiralis larvae, and between 21 and 28 DPI with T. canis. The ultrastructural studies demonstrated that T. spiralis larvae migrating through the lungs evoked mainly destruction of type I epithelial cells, destruction of lamellar bodies of epithelial cells or extracellular alveolar lining layer. The severity of these changes was dependent on the number of infective larvae (400 or 800 T. spiralis larvae) and possibly the result of mechanical damage in the lung parenchyma. In contrast, infection with T. canis larvae initiated mainly eosinophilic perivasculitis and vasculitis as well as macrophage accumulation in the lung, which were additionally impacted by numerous crystalloid inclusions in macrophages. Trichinella spiralis larvae and T. canis larvae induced different pathological changes in the lungs of infected mice.
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Affiliation(s)
- J Dabrowska
- Department of General Biology and Parasitology, Biostructure Centre, Medical University of Warsaw, Warsaw, Poland.
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Abstract
Toxocariasis is a helminth zoonosis caused by infection with the larvae of Toxocara spp. ascarid worms. Only two species, Toxocara canis and Toxocara cati, are recognised as causative agents of human disease. The best choice for serodiagnosis of the generalised forms of toxocariasis, visceral larva migrans (VLM) or covert toxocariasis, relies upon the initial use of TES-ELISA, after which any positive result should subsequently be tested by Western blotting (WB). Covert toxocariasis is mostly a benign infection, so a large majority of infected subjects are asymptomatic or have very few symptoms and therefore go undiagnosed. In this form, this helminthosis is often self-limiting, leaving residual specific antibodies. A positive serodiagnosis caused by residual antibodies that do not have any diagnostic significance can be associated with any infectious or non-infectious disease. If separated from the ongoing clinical and laboratory context, such a positive result has no diagnostic value and should be only taken into account after the possible etiologies of any observed syndromes have been ruled out. Unlike the methods used for the immunodiagnosis of bacterial, viral or protozoal (toxoplasmosis) infections, it is not possible with toxocariasis to assess the age of the presence of specific IgG using the levels of specific IgM because IgM antibodies can be found throughout the course of helminthiasis. The detection of other classes of immunoglobulins, namely IgE and IgA, the subclasses, namely IgG4 or circulating Ag was proven to be unable to discriminate between active and self-cured generalised toxocaral infections. Currently, the diagnosis of an active covert toxocariasis relies upon indirect arguments, e.g., the presence of otherwise unexplained symptoms along with blood eosinophilia and/or elevated levels of eosinophil cationic protein (ECP). This situation is far from ideal and more research should be carried out to solve this difficult problem.
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Traversa D. Pet roundworms and hookworms: a continuing need for global worming. Parasit Vectors 2012; 5:91. [PMID: 22574783 PMCID: PMC3418564 DOI: 10.1186/1756-3305-5-91] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 04/22/2012] [Indexed: 11/10/2022] Open
Abstract
Ascarids and ancylostomatids are the most important parasites affecting dogs and cats worldwide, in terms of diffusion and risk for animal and human health. Different misconceptions have led the general public and pet owners to minimize the importance of these intestinal worms. A low grade of interest is also registered among veterinary professions, although there is a significant merit in keeping our guard up against these parasites. This article reviews current knowledge of ascarids and ancylostomatids, with a special focus on pathogenicity, epidemiology and control methods in veterinary and human medicine.
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Affiliation(s)
- Donato Traversa
- Department of Comparative Biomedical Sciences, University of Teramo, Teramo, Italy.
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Dattoli VCC, Freire SM, Mendonça LR, Santos PC, Meyer R, Alcantara-Neves NM. Toxocara canis infection is associated with eosinophilia and total IgE in blood donors from a large Brazilian centre. Trop Med Int Health 2011; 16:514-7. [DOI: 10.1111/j.1365-3156.2010.02719.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sharif M, Daryani A, Barzegar G, Nasrolahei M, Khalilian A. Seroprevalence of toxocariasis in schoolchildren in Northern Iran. Pak J Biol Sci 2010; 13:180-184. [PMID: 20437685 DOI: 10.3923/pjbs.2010.180.184] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This cross-sectional study was carried out on 1210 randomly selected schoolchildren, attending sixteen primary and secondary schools, during the period between November 2005 and June 2006. Parents who accepted to include their children were requested to be present at sampling time and to fill in a simple questionnaire with personal and epidemiological data. Three milliliter of venous blood were taken by vein puncture under sterile conditions from each subject for detection and titration of antibodies to T. canis and eosinophil counts. Total IgG anti-Toxocara antibodies was evaluated by T. canis IgG ELISA kit. According to the manufacture recommendations, an index positivity >11 U was considered positive. Of the 1210 serum specimens tested, an overall seroprevalence for Toxocara antibodies of 25% was obtained. There was no association between positive seroprevalence and age (p = 0.34). Boys and girls differed significantly with regard to Toxocra titre (p = 0.003). Eosinophilia in peripheral blood (> or = 5%) was detected in 24.5% (297/1210) of the population studied, 97/297 (32.8%) of whom were seropositive for toxocariasis. The findings of this study confirmed that infection with Toxocara is quite high and widespread in children in Northern Iran. Therefore, health promotion efforts must be directed at increasing the awareness of the population about the potential zoonotic hazards associated with the disease and how to minimize them.
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Affiliation(s)
- M Sharif
- Department of Parasitology and Mycology, Sari Medical School, Mazandaran University of Medical Sciences, Sari, Iran
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Bellanger AP, Humbert P, Gavignet B, Deschaseaux A, Barisien C, Roussel S, Millon L, Aubin F, Piarroux R. Comparative assessment of enzyme-linked immunosorbent assay and Western blot for the diagnosis of toxocariasis in patients with skin disorders. Br J Dermatol 2009; 162:80-2. [DOI: 10.1111/j.1365-2133.2009.09411.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee SU, Yu JR, Huh S. Ultrastructural localization of Toxocara canis larval antigen reacted with a seropositive human serum. THE KOREAN JOURNAL OF PARASITOLOGY 2009; 47:65-8. [PMID: 19290095 DOI: 10.3347/kjp.2009.47.1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Revised: 11/24/2008] [Accepted: 01/14/2009] [Indexed: 11/23/2022]
Abstract
Excretory-secretory products of Toxocara canis larvae have been considered as a major functional antigen in immune responses against toxocariasis. We studied ultrastructural localization of T. canis second-stage larval antigen using a seropositive human serum under immunogold electron microscopy. High-density gold particles were observed in the secretory cells, excretory duct, intestinal epithelium, and cuticle of the larval worm sections. The distribution of the positive reactions in the larval worms suggests that the nature of the antigen is excretory-secretory antigen including waste metabolites and secretory enzymes.
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Affiliation(s)
- Soo-Ung Lee
- Department of Environmental and Tropical Medicine, School of Medicine, KonKuk University, Chungju, Korea
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Smith H, Holland C, Taylor M, Magnaval JF, Schantz P, Maizels R. How common is human toxocariasis? Towards standardizing our knowledge. Trends Parasitol 2009; 25:182-8. [PMID: 19269251 DOI: 10.1016/j.pt.2009.01.006] [Citation(s) in RCA: 200] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 01/23/2009] [Accepted: 01/23/2009] [Indexed: 11/18/2022]
Abstract
Our understanding of the global impact and cost of human toxocariasis is poor because there is insufficient clinical awareness and no clear repository for the efficacy of clinical, laboratory and treatment interventions. Uniform clinical and laboratory investigative approaches maximize disease diagnosis. International collaboration is required to develop web-based, professional educational support, surveillance questionnaires and standardized serodiagnostic criteria. Determining clinical benefits and treatment outcomes using less crossreactive antigens will enhance clinical and treatment interventions. Increased liaison will identify realistic occurrence and prevalence data and cost benefits of intervention. Web-based centres of excellence and repositories of current knowledge, which augment current veterinary and public health educational sites, should be supported. Expected outcomes should be capable of addressing the clinical and financial burdens of this treatable disease.
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Affiliation(s)
- Huw Smith
- Scottish Parasite Diagnostic Laboratory, Stobhill Hospital, Glasgow G21 3UW, UK.
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Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol 2008; 59:1031-42. [DOI: 10.1016/j.jaad.2008.06.031] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Revised: 06/15/2008] [Accepted: 06/24/2008] [Indexed: 11/22/2022]
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Toxocariasis associated with chronic cough in childhood: a longitudinal study in Hungary. J Helminthol 2008; 82:357-63. [PMID: 18752712 DOI: 10.1017/s0022149x0804827x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Chronic cough lasting 8 weeks or more often seems to be an intractable problem in childhood. Toxocara infection is associated with an increased prevalence of airway symptoms and may be the possible aetiological agent of chronic cough. Of 425 children aged 2-17 years with chronic cough who were investigated for toxocariasis and the distribution of bronchial asthma (BA), cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB), 136 (32%) were seropositive for Toxocara canis antigens. Ninety-three of the 136 were adequately assessed, diagnosed and followed up during 1 year. BA was diagnosed in 40%, CVA in 27% and NAEB in 33% of the children. The eosinophil cell count, serum T. canis IgG levels and symptoms are predictors of the improvement or the decline of the condition. Presuming the aetiopathogenetic role of T. canis in the inflammatory process of chronic cough, we treated the children not only with inhaled corticosteroid (ICS), but also with a 1-week course of anthelminthics. We could significantly decrease the dose of ICS in 23 (62%) of the 37 with BA. The administration of anthelminthics and the avoidance of sensitizers were sufficient for those with NAEB; none needed ICS. ICS therapy could be stopped 2-3 months later in 17 (68%) of the 25 with CVA. We found that 8 of the 25 with CVA (32%) presented asthmatic symptoms at the end of the 1-year period. In Hungary, T. canis may be a potential sensitizer for chronic cough in seropositive children. Deworming therapy will then alleviate the airway symptoms without exacerbation in patients with BA, and have a positive effect on those with NAEB and the majority of those with CVA.
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Paludo ML, Falavigna DL, Elefant GR, Gomes ML, Baggio ML, Amadei LB, Falavigna-Guilherme AL. Frequency of toxocara infection in children attended by the health public service of Maringá, south Brazil. Rev Inst Med Trop Sao Paulo 2007; 49:343-8. [DOI: 10.1590/s0036-46652007000600002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Accepted: 04/12/2007] [Indexed: 11/21/2022] Open
Abstract
The lack of specific laboratorial diagnosis methods and precise symptoms makes the toxocariasis a neglected disease in Public Health Services. This study aims to determine the frequency of Toxocara spp. infection in children attended by the Health Public Service of Hospital Municipal de Maringá, South Brazil. To evaluate the association of epidemiological and clinical data, an observational and cross-section study was carried out. From 14,690 attended children/year aged from seven month to 12 years old, 450 serum samples were randomly collected from September/2004 to September/2005. A questionnaire was used to evaluate epidemiological, clinical and hematological data. An ELISA using Toxocara canis larval excretory-secretory products as antigen detected 130 (28.8%) positive sera, mainly between children from seven month to five years old (p = 0.0016). Significant correlation was observed between positive serology for Toxocara, and frequent playing in sandbox at school or daycare center (p = 0.011) and the presence of a cat at home (p = 0.056). From the families, 50% were dog owners which exposed soil backyards. Eosinophilia (p = 0.776), and signs and symptoms analyzed (fever p = 0.992, pneumonia p = 0.289, cold-like symptoms p = 0.277, cough p = 0.783, gastrointestinal problems p = 0.877, migraine p = 0.979, abdominal pain p = 0.965, joint pain p = 0.686 and skin rash p = 0.105) could not be related to the presence of anti-Toxocara antibodies. Therefore, two asthmatics children showed titles of 1:10,240 and accentuated eosinophilia (p = 0.0001). The authors emphasize the needs of prevention activities.
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Draycott RAH, Woodburn MIA, Ling DE, Sage RB. The effect of an indirect anthelmintic treatment on parasites and breeding success of free-living pheasantsPhasianus colchicus. J Helminthol 2007; 80:409-15. [PMID: 17125551 DOI: 10.1017/joh2006367] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIn Great Britain free-living common pheasantsPhasianus colchicusare often managed at high densities owing to their popularity as a quarry species. They are prone to infection by a range of parasite species includingHeterakis gallinarum,Capillariaspp. andSyngamus trachea. In 1995 the efficacy of an indirect anthelmintic technique for controlling parasitic worm burdens of pheasants was determined in a pilot study on a shooting estate in the south of England. Between 2000 and 2003 a large-scale field experiment was conducted on nine estates in eastern England to determine the effect of the technique on parasite burden and pheasant breeding success. In the absence of anthelmintic treatment worm burdens increased rapidly through March and April, whereas birds given anthelmintic-treated grain had lower worm burdens during the same period. The breeding success of pheasants was significantly higher on plots provided with anthelmintic treatment, although no long-term increases in population densities were observed. The burdens of the most common parasiteH. gallinarumwere significantly lower in pheasants from treatment plots six weeks after the anthelmintic treatment had ceased, but spring treatment did not influence parasite burden in the following winter.
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Affiliation(s)
- R A H Draycott
- The Game Conservancy Trust, Fordingbridge, Hampshire, UK.
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Magnaval JF, Faufingue JH, Morassin B, Fabre R. Eosinophil cationic protein, specific IgE and IgG4 in human toxocariasis. J Helminthol 2007; 80:417-23. [PMID: 17125552 DOI: 10.1017/joh2006369] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAmong 67 French patients presenting a toxocaral infection, various demographic, environmental, clinical and laboratory parameters (blood eosinophil count, eosinophil cationic protein (ECP), serum total IgE, specific IgE against common inhalant allergens, specific IgE and IgG4 againstToxocaraexcretory-secretory antigens) were investigated. Correlation studies and logistic regression analyses were conducted, testing elevated levels of ECP, specific anti-ToxocaraIgE or IgG4 as outcome variables An elevated ECP level was significantly associated with both cough and rhinitis, a high level of specific anti-ToxocaraIgE with itchy rashes and possible atopic status, and an increase of specific anti-ToxocaraIgG4 with rural residence.
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Affiliation(s)
- J-F Magnaval
- Department of Parasitology, CH Rangueil, University Hospitals, 31059 Toulouse 9, France.
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Cho S, Egami M, Ohnuki H, Saito Y, Chinone S, Shichinohe K, Suganuma M, Akao N. Migration behaviour and pathogenesis of five ascarid nematode species in the Mongolian gerbilMeriones unguiculatus. J Helminthol 2007; 81:43-7. [PMID: 17381866 DOI: 10.1017/s0022149x07212118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractTo understand the characteristic features of the Mongolian gerbil,Meriones unguiculatus,as an animal model of ascarid infections, the migration behaviour and pathogenesis of larvae were investigated in experimentally infected gerbils. Embryonated eggs from each ofToxocara canis,Baylisascaris procyonis, B. transfuga, Ascaris suum, andA. lumbricoideswere orally inoculated into gerbils and larvae were recovered from various organs at designated periods. InT. canis-infected gerbils, larvae were present in the liver 3 days after infection and in the skeletal muscle and brain via the heart and lungs at a similar rate. InB. procyonis- andB. transfuga-infected gerbils, larvae were present in the lungs within 24 h after infection, with some having reached the brain by that time. After 24 h, larvae ofB. procyonistended to accumulate in the brain, while those ofB. transfugaaccumulated in skeletal muscles. InA. suum- andA. lumbricoides-infected gerbils, larvae remained in the liver on day 5 post-infection and elicited pulmonary haemorrhagic lesions, which disappeared 7 days after initial infection. Thereafter, no larvae of any type were recovered. Ocular manifestations were frequently observed inT. canis- andB. procyonisinfected gerbils, but were rare inB. transfuga-infected gerbils. In the cases ofA. suumandA. lumbricoides, migration to the central nervous system and eyes was extremely rare, and larvae had disappeared by 2 weeks post-infection. Fatal neurological disturbances were observed inB. procyonis-infected gerbils, whereas irreversible non-fatal neurological symptoms were observed in the case ofB. transfuga.
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Affiliation(s)
- S Cho
- Department of Veterinary Parasitology, Azabu University, Fuchinobe 1-17-71, Sagamihara 229-8501, Japan
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Chang S, Lim JH, Choi D, Park CK, Kwon NH, Cho SY, Choi DC. Hepatic Visceral Larva Migrans ofToxocara canis: CT and Sonographic Findings. AJR Am J Roentgenol 2006; 187:W622-9. [PMID: 17114516 DOI: 10.2214/ajr.05.1416] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to describe the CT and sonographic findings of hepatic visceral larva migrans of Toxocara canis. MATERIALS AND METHODS Fifty-four patients (44 men, 10 women; age range, 30-80 years; mean age, 53 years) with serologically confirmed visceral larva migrans of Toxocara canis underwent evaluation of the liver with CT (n = 25), sonography (n = 48), or both. Two radiologists used consensus for retrospective evaluation of CT and sonographic findings. Correlation between the presence and severity of hepatic abnormalities on images and the degree of peripheral eosinophilia was assessed. RESULTS Seventeen (68%) of 25 patients who underwent CT had single or multiple ill-defined, oval or elongated, small, low-attenuating lesions in the liver. Eighteen (38%) of 48 patients who underwent sonography had single or multiple small, poorly defined, oval or elongated, hypoechoic scattered focal lesions in the liver. In the 19 patients who underwent both CT and sonography, the two techniques had no significant difference in rate of detection of hepatic lesions (p = 0.375, McNemar test). The lesion numbers on CT and sonography showed excellent linear correlation (r = 0.844, p = 0.001) by Pearson's correlation test. An independent samples t test showed that eosinophil count and percentage in the peripheral blood were significantly higher in patients with hepatic lesions on CT and sonography than in patients without lesions. CONCLUSION CT and sonographic findings of hepatic visceral larva migrans of T. canis are multiple, ill-defined, oval or elongated, small, nodular lesions scattered in the liver parenchyma. The presence of hepatic lesions on images was associated with higher peripheral eosinophil count and percentage.
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Affiliation(s)
- Samuel Chang
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, South Korea 135-230
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Teixeira CR, Chieffi PP, Lescano SAZ, de Melo Silva EO, Fux B, Cury MC. Frequency and risk factors for toxocariasis in children from a pediatric outpatient center in southeastern Brazil. Rev Inst Med Trop Sao Paulo 2006; 48:251-5. [PMID: 17086311 DOI: 10.1590/s0036-46652006000500003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Accepted: 05/17/2006] [Indexed: 11/22/2022] Open
Abstract
To estimate the frequency of anti-Toxocara sp. antibodies, and evaluate factors associated with this infection, sera from 242 male and female children, aged from one to fifteen years old, attended at the Hospital of the Federal University of Uberlândia, Minas Gerais State, Brazil, were analyzed by ELISA. Information on the patients was collected and registered using an investigative questionnaire, and details on possible clinical alterations were obtained from the medical charts of 187 patients. Of a total of 242 samples, 21 (8.7%) were positive for anti-Toxocara sp. antibodies. The presence of dogs and cats and the school variable (place of contact), appeared to be significantly associated (p < 0.05) with a positive serology. Respiratory symptoms and eosinophil counts greater than 20% also showed a positive statistical correlation with a positive serology for Toxocara sp.. Factors such as sex and age, and symptoms like headache, stomach ache, convulsive crises and anemia were not associated with toxocariasis.
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Affiliation(s)
- Cristiane Rodrigues Teixeira
- Laboratório de Parasitologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
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Sakai S, Shida Y, Takahashi N, Yabuuchi H, Soeda H, Okafuji T, Hatakenaka M, Honda H. Pulmonary Lesions Associated With Visceral Larva Migrans Due toAscaris suumorToxocara canis: Imaging of Six Cases. AJR Am J Roentgenol 2006; 186:1697-702. [PMID: 16714661 DOI: 10.2214/ajr.04.1507] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The objective of our study was to evaluate chest radiographic and CT findings of patients with pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis. CT investigation was focused on the location, size, contour, and internal features of the lesions; migration of lesions; mediastinal lymphadenopathy; and pleural effusion. CONCLUSION Pulmonary visceral larva migrans appears on CT as multifocal subpleural nodules with halo or ground-glass opacities and ill-defined margins.
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Affiliation(s)
- Shuji Sakai
- Department of Health Sciences, School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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Sommerfelt IE, Rosa A, Duchene A, Degregorio O, López C, Pisanú A, De Torres R. Toxocara canis in experimentally infected pigs: migratory pattern and tissue lesions. Vet Parasitol 2004; 125:323-34. [PMID: 15482888 DOI: 10.1016/j.vetpar.2004.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 07/14/2004] [Indexed: 10/26/2022]
Abstract
Fifteen Yorkshire female pigs were inoculated with 100,000 infective T. canis eggs. Three animals were used as uninfected controls. Groups of three infected pigs were euthanized by accepted methods on days 7, 14, 21, 28 and 126 p.i., respectively. Larvae were recovered from all animals included in each group slaughtered on days 7 and 14 p.i.; on day 21 p.i. from two pigs, on day 28 p.i. from one, and no larvae were found on day 126 p.i. Differences in the mean number of larvae per gram in lymph nodes, liver and lungs between slaughter days, were significant for livers on day 7 p.i. and for lungs on day 14 p.i. (P < 0.10). The decrease over time was significant in all the organs that previously had larvae. Larvae were not found in the other organs and tissues analysed. Macroscopical lesions were found in the liver, lungs and lymph nodes on days 7, 14, 21, and 28 p.i. The entire surface of the liver was covered with small white spots on day 7 p.i., on days 14 and 21 p.i. the spots were distinctly nodular and, in some places, individual lesions were confluent. Lesions had apparently started to heal on days 28 and 126 p.i. appearance was normal. Lymph nodes were enlarged and oedematous during the first 4 weeks and the lungs had small areas of consolidation visible all over the surface, but by day 126 p.i., no visible lesions could be seen. Microscopical lesions were observed in the liver on day 7 p.i., with a largely periportal hepatitis. Numerous eosinophils and lymphocytes were present. The typical granulomatous reaction was observed on days 14 and 21 p.i. with a central necrotic core and a narrow region of fibroblastic tissue. By day 28 p.i. lesions had almost disappeared and the number of eosinophils was fewer. There were fewer leukocytes and the fibrous tissue had disappeared from the liver on day 126 p.i. For the first 3 weeks, pictures of the lymph nodes and the lungs were characterised by the formation of a granuloma. In the center of the granuloma larvae were observed. The majority of the lesions had healed by day 126 p.i.
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Affiliation(s)
- I E Sommerfelt
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Av. Chorroarín 280, 1427 Buenos Aires, Argentina.
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Afifi Y, Aubin F, Puzenat E, Degouy A, Aubrion D, Hassam B, Humbert P. [Pruritus sine materia: a prospective study of 95 patients]. Rev Med Interne 2004; 25:490-3. [PMID: 15219366 DOI: 10.1016/j.revmed.2003.12.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2003] [Accepted: 12/05/2003] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the nature and the frequency of systemic diseases responsible for the pruritus sine materia. Value of this sign as a marker of malignancy. METHODS Prospective study undertaken over five years (1996-2001). INCLUSION CRITERIA generalized aspect of the pruritus and absence of specific primitive cutaneous lesions of an itching dermatosis. Parameters taken from the data of the anamnesis and the physical examination. Standard biologic and morphologic investigations were done. RESULTS Ninety-five patients included (54 men, 41 women) of 55.5 years average age +/-18.1. In 24 patients, traditional hospitalisation with one average duration of eight days stay +/-3.15 was necessary. In 38 cases (40%), a systemic cause was found. The main conditions were: toxocariasis (8 cases), hematologic diseases (7 cases), chronic renal failure (6 cases), hypothyroidism (5 cases) and iron deficiency (5 cases). A neoplasm was found in eight cases (8,42%): seven hematologic malignancy (3 myeloma, 2 Hodgkin's diseases, 2 myeloproliferative syndromes) and one solid cancer (pulmonary adenocarcinoma). CONCLUSION A systemic aetiology was observed in 38 cases (40%). The toxocariasis an underestimated disease comes at the first place. The pruritus sine materia can hide an hematologic malignancy.
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Affiliation(s)
- Y Afifi
- Service de dermatologie I, CHU Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon cedex, France
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Abstract
PURPOSE Toxocariasis is a widespread zoonotic parasitosis that is frequent in France. It is due to the presence of larvae of roundworms belonging to the genus Toxocara in the human body. Clinical signs are often non-specific. The disease can be asymptomatic or can lead to death. Toxocariasis can be thought of because of clinical signs or presence of hypereosinophilia, but the diagnosis is made by specific serology. Since there is no consensus to date regarding treatment, prevention is of paramount importance. CURRENT KNOWLEDGE AND KEYPOINTS Recent studies point out the frequency of this parasitic disease that is often asymptomatic. The serological diagnosis remains the main tool for the diagnosis of toxocariasis. FUTURE PROSPECTS AND PROJECTS Further studies on toxocariasis should focus on the prevalence of this disease in French population regarding the probability of infection: living in the countryside, food habits, hygiene and presence of dogs in the neighborhood. Tools of the biological diagnosis (mainly serological techniques) should be improved, but, especially, studies should focus on the evaluation of specific treatment in order to give unquestionable guidelines on this point.
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Affiliation(s)
- H Pelloux
- Parasitologie-mycologie, CHU A-Michallon, Grenoble, France.
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Aguiar-Santos AM, Andrade LD, Medeiros Z, Chieffi PP, Lescano SZ, Perez EP. Human toxocariasis: frequency of anti-Toxocara antibodies in children and adolescents from an outpatient clinic for lymphatic filariasis in Recife, Northeast Brazil. Rev Inst Med Trop Sao Paulo 2004; 46:81-5. [PMID: 15141276 DOI: 10.1590/s0036-46652004000200005] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In a transversal study on a sample of 386 children and adolescents from an outpatient clinic for filariasis in Recife, Northeast Brazil, the frequency of anti-Toxocara antibodies and its relation to age, gender, number of peripheral eosinophils, Wuchereria bancrofti microfilariae and intestinal helminths was determined. The total anti-Toxocara IgG antibody frequency was 39.4%, by ELISA technique. The difference in frequency between males (40.1%) and females (37.6%) was not statistically significant. The 6 to 10-year-old subset presented the highest frequency of anti-Toxocara antibodies (60%), and within this age group there was a statistically significant male bias. There was also a significant association between the number of eosinophils and the presence of anti-Toxocara antibodies. Intestinal parasite frequency was 52.1%, but no association was found between this data and the presence of anti-Toxocara antibodies. In the present sample, 42.2% of the patients were Wuchereria bancrofti carriers, however, again this was not associated with the presence of anti-Toxocara antibodies. In conclusion, anti-Toxocara antibodies were highly prevalent in this sample. The present data show that there is no cross correlation between anti-Toxocara IgG antibody and the presence of intestinal helminths and filariasis.
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Affiliation(s)
- Ana Maria Aguiar-Santos
- Centro de Pesquisas Aggeu Magalhães, FIOCRUZ, Campus da Universidade Federal de Pernambuco, Cidade Universitária, Recife, PE, 50670-420, Brasil.
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Abstract
Toxocariasis in man is traditionally thought to be contracted through the ingestion of eggs from contaminated soil. The disease may manifest itself in different syndromes such as ocular larval migrans, visceral larval migrans and covert toxocariasis. This paper assesses the evidence for the soil contamination hypothesis and proposes that direct contact with dogs may provide a better explanation of the epidemiology of the disease. Hair was collected from 60 dogs from various places in Ireland and the UK and examined for the presence of Toxocara canis eggs. T. canis eggs were found in the hair of 25 per cent of the dogs; in total, 71 eggs were recovered, of which 4.2 per cent were embryonated and 23.9 per cent were embryonating. The maximum densities of the embryonating and embryonated eggs were 180 and 20 eggs per gram of hair, respectively, much higher than the densities reported for soil samples. It is suggested that dogs infected with T. canis may infect people by direct contact.
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