VISCERAL MIGRATING LARVA. CLINICAL CASES. UKRAINIAN BURDEN

Abstract

Introduction. The work highlights the problematic issues of diagnosis and treatment of toxocariasis infection in people in Ukraine, which become even more acute and urgent due to the migration of the population and animals, and the destruction of the country's infrastructure as a result of the war unleashed by Russia.
 The aim of the study. Improvement of aspects of clinical, laboratory and instrumental diagnostics, as well as treatment of VML in humans
 Materials and methods. A literature research of the state of the problem of primary and differential diagnosis of the migrating larva in Ukraine and the world has been conducted. 2 clinical cases of diagnosis and treatment of migrating larva in are described.
 Results. The article describes two clinical cases of visceral migrating larva. The differences of these cases, in addition to the migrating formations in the lungs, were the asymptomatic course, the absence of eosinophilia, and the simultaneous determination of blood class G antibodies by ELISA to Toxocar and human roundworm (A. lumbricoide), which persisted even after treatment. Patients at the stage of diagnosis were examined in an oncology hospital, were consulted by thoracic surgeons and oncologists to exclude lung cancer. Both women were immunocompetent, one patient had a history of cervical cancer. From the epidemiological anamnesis, both women kept cats, and one of them, during chemotherapy for the treatment of a tumor, had a propensity for carnivorous raw-eating. Before prescribing systemic antiparasitic chemotherapy, the patients were examined by an ophthalmologist to exclude parasitic chorioretinitis. The patients were prescribed a 20-day course of albendazal 800 mg/day in two doses. Support therapy consisted of a 5-day course of prednisolone at a dose of 30 mg/day orally in two doses, which started one day before the appointment of albendazole. A control CT scan of the lungs after therapy did not reveal any formations, fibrosis, or calcifications.
 Discussion. This case proves that tocoscarosis in humans is a multidisciplinary medical and social problem. Conclusions were made on the need to restore the national registration of the disease, adopt national consensuses on treatment and diagnosis, and implement into clinical practice modern methods of verification of specific antibodies to nematodes based on immunoblotting.
 Conclusions. The registration of cases of VML and T. in the system of control and prevention of infectious diseases in Ukraine should be resumed. It is expedient to introduce specific studies on nematodes in clinical laboratory practice.