КЛИНИЧЕСКИЙ СЛУЧАЙ ТОКСОКАРОЗА ВЗРОСЛОГО С ОТЁКОМ ГОРТАНИ И АНГИООТЕКАМИ

Abstract

Introduction. Toxocariasis is a parasitic disease caused by the migration of the larvae of canids roundworm (T. canis). It is characterized by a long-term relapsing course and multiple organ lesions of an immunological nature. The core pathogenetic factor is sensitizing the body by Toxocara exo- and endoantigens formed after the larvae are destructed, which leads to the development of immediate and delayed allergic reactions. The aim of study was to review the scientific literature on toxocariasis, and to present a clinical case report of cutaneous form of toxocariasis in a 36-year-old man complicated by angioedema. Material and Methods. Review of foreign publications on this helminthiasis in the PubMed databases. Clinical case of patient E., 36 years old, with the development of a complicated cutaneous form of toxocariasis of the angioedema type. Results and Discussion. During the instrumental and laboratory studies, antibodies to Toxocara canis were detected (titer in dynamics 1:6400 and 1:400) in the patient. Noteworthy was a severe allergic reaction, which manifested itself as itching maculopapular confluent rash resembling angioedema. A peculiarity of the course of the disease was the manifestation of rash and swelling of the larynx with each meal, which required calling emergency medical help. Laboratory testing of the patient’s blood did not show eosinophilia or any other deviations of the core blood parameters in the general blood test from the reference values. Conclusions. Toxocariasis often imitates the clinical manifestations of various diseases, such as ARVI, eye damage, neurological disorders (eosinophilic meningoencephalitis), enlargement of peripheral lymph nodes, liver and spleen, and allergic reactions in form of urticaria and angioedema, which causes difficulties diagnosing it correctly. Lack of physicians’ alertness regarding allergic reactions in adults accompanied by skin manifestations may lead to an incorrect etiological diagnosis. Thus, we remind clinicians that this helminthiasis may occur in adults in cutaneous form with the development of angioedema.