Toxocariasis Research Articles

Особливості перебігу токсокарозу в дітей

Актуальність. Недостатня поінформованість лікарів, в першу чергу педіатрів, про особливості клінічної картини та можливості лабораторної діагностики токсокарозу призводить до пізньої діагностики. Найчастіше токсокароз реєструється під різними діагнозами: алергоз, хронічна пневмонія, дерматит тощо. Мета: вивчити частоту та особливості клінічного перебігу токсокарозу в дітей. Матеріали та методи. Впродовж 2010–2017 рр. обстежено 180 дітей віком від 2 до 16 років із діагнозом «токсокароз». Групу порівняння становили 50 дітей із серонегативною відповіддю в імуноферментному аналізі на токсокароз. Проводилось комплексне обстеження з використанням тест-системи RIDASCREEN® Toxocara IgG, R-Biopharm (Німеччина). Статистичну обробку отриманих результатів проводили з використанням критерію Стьюдента за допомогою комп’ютерної програми Microsoft Statistica, Statson, версія 6.0. Результати. У структурі паразитозів за останні 7 років переважає ентеробіоз (98 %), рідше виявляються аскаридоз (1,5 %) і токсокароз (0,4 %), на частку інших гельмінтозів припадає 0,1 %. У 125 (69,4 %) дітей, хворих на токсокароз, відзначені геофагія та/або наявність собаки. Перевірка на гендерну залежність хворих на токсокароз виявила переважання хлопчиків — 80 (64 %). Найчастіше токсокари виявлялися у віковій групі від 5 до 7 років. Основними клінічними проявами токсокарозу в дітей були диспептичний, астеноневротичний, шкірно-алергічний і респіраторний синдроми. У всіх пацієнтів із токсокарозом визначалися антитіла, гіпохромна анемія, лейкоцитоз, ­еозинофілія. Майже в половини хворих на токсокароз дітей спостерігали зміни з боку гепатобіліарної системи (підвищення лужної фосфатази, диспротеїнемія, гіперферментемія) з високими титрами антитіл до токсокар, гепатомегалією, неоднорідністю ехоструктури печінкової тканини, трифазним типом кровотоку при дуплексному дослідженні та функціональними порушеннями біліарного тракту. Висновки. Встановлено відносно високу частоту токсокарної інвазії серед дітей, ключові фактори ризику інфікування (геофагія та/або контакт із собакою), поліморфізм клінічної маніфестації хвороби.

Вісцеральний токсокароз у підлітка: досвід лікування із застосуванням препарату Альдазол (клінічний випадок)

У статті подане власне клінічне спостереження випадка вісцерального токсокарозу у дівчинки 13 років, наведені результати ефективного лікування захворювання із застосуванням препарату Альдазол.

Эффективность препаратов ДИРОНЕТ® спот-он и ДИРОНЕТ® суспензия при токсокарозе собак

Эффективность препаратов ДИРОНЕТ® спот-он и ДИРОНЕТ® суспензия при токсокарозе собак

Enhancing the effectiveness of deworming dogs with toxocarosis

Enhancing the effectiveness of deworming dogs with toxocarosis

Clinical characteristics of pediatric ocular toxocariasis

Objective To describe the clinical manifestations of pediatric ocular toxocariasis. Methods The clinical data of 163 pediatric patients (163 eyes) with ocular toxocariasis from March 2012 to March 2018 at Beijing Tongren Hospital were retrospectively analyzed, with at least a follow-up of 5 months.The mean age of the patients was (7.03±2.54) years old, and 71.8% of the patients were male.The provenances, clinical features, color doppler image (CDI) and ultrasound biomicroscope (UBM) manifestations and treatment of the patients were retrospectively analyzed. Results The patients were mainly from north area of China, 72.4% of the patients came from rural area, and 59.5% had a history of close contact with cats or dogs; 84.8% of the patients had an initial best corrected visual acuity (BCVA) of less than 0.1, 48.5% of the patients had peripheral granuloma formation, most cases presented with manifestations of chronic inflammation, such as lamellar vitreous opacity, tractional retinal detachment and band-shaped degenerations of the cornea.CDI examination demonstrated tractional retinal detachment in 84.4% of the patients and UBM detected that 52.7% of the patients had peripheral vitreoretinal pathologies ranged more than 6 clock-hours.Eighty-four percent of the patients undergone vitrectomy for severe vitreous opacity and/ or tractional detachment. Conclusions Most of the patients are school-age children, with a history of close contact of cats or dogs, and have poor visual acuity and severe clinical manifestations, such as vitreous opacity and/ or tractional detachment which needed vitrectomy.CDI and UBM are helpful in confirming the scope and severity of introcuar pathologies. Key words: Uveitis; Ocular toxoariasis; Children

Imaging of toxocariasis

Parasitäre Erkrankungen werden in Europa relativ selten diagnostiziert und behandelt. Somit sind auch klinische Besonderheiten und bildgebende Merkmale weniger bekannt. In den heutigen Zeiten von Migration und weltweiter Flüchtlingsströme ist die Kenntnis parasitärer Infektionen zunehmend von Bedeutung. Anhand von klinischen Beschreibungen der Echinokokkose, Schistosomiasis, Fasciolosis und Ascariasis wurden entsprechende Berichte in der Zeitschrift für Gastroenterologie publiziert. In der hier präsentierten Veröffentlichung werden klinische Besonderheiten und Bildgebungsmerkmale der Toxocariasis diskutiert.

Екологічні аспекти існування осередків токсокарозу на території міста Києва

Токсокарозна інвазія залишається актуальною проблемою сучасної екології, оскільки її поширення є не лише причиною розвитку токсокарозу як паразитарної хвороби тварин та людей, а й контамінацією збудником Toxocara canis об’єктів довкілля, зокрема урбанізованих територій. Використання сучасних методів прогнозування дозволяє моделювати ситуацію щодо кількості випадків захворюваності на токсокароз у майбутньому, враховуючи історичну довідку і статистичну обробку отриманих результатів. Токсокароз є антропозоонозом зі складним поліморфозом клінічних проявів, що ускладнює його діагностування й лікування. Результати проведених нами досліджень вказують на реальне і прогнозоване збільшення кількості випадків токсокарозу у людей, основною причиною якої є низька санітарно-гігієнічна культура населення та його обізнаність щодо питання біологічного забруднення. Враховуючи зростання чисельності населення в умовах міст, а із тим і кількості домашніх хижих необхідне проведення комплексного екологічного моніторингу довкілля, оскільки об’єкти навколишнього природного середовища є визначальним середовищем у циклі розвитку токсокар. Довкілля виступає середовищем ІІ порядку і за сприятливих абіотичних факторів яйця нематод досягають інвазійної стадії разом з тим мігруючи до людського або тваринного організму.

Prevalence of Toxocara eggs in the soil of public parks of Khorramshahr city, southwest Iran

Human toxocarosis is a chronic zoonotic disease, which creates various syndromes in humans such as visceral larva migrans, ocular larva migrans, and neurological toxocarosis. This disease is commonly contracted through ingestion of eggs from the Toxocara species. The eggs are transmitted to humans through contact with soil that contaminated with feces of infected animals by Toxocara species worm. This study, investigated the soil from various parks and public areas of Khorramshahr city southwest of Iran for Toxocara egg contamination. One-hundred and fifty soil samples were collected from 21 parks and green public areas from April to July 2018 and examined by the modified floatation method using saturated sucrose solution. The Toxocara eggs were isolated in 27 (18%) out of 150 samples collected. Based on Chi-square test, none of the factors: location of sampling (in city and the suburb), the presence of dogs and cats and the size of the sampling location; was not significant difference by soil contamination by Toxocara eggs. The presence of Toxocara eggs in Khorramshahr parks soil and green public areas is one of the main risk factors for catch the toxocarosis. This is important to develop preventive measures in the city and suburb areas to reduce the Environmental contaminations and thus reduce the incidence of disease in humans.

Risk factors and prevalence of toxocariasis in pregnant women and diabetic patients compared to healthy adults in Ilam province, western Iran.

Toxocara is one of the common intestinal nematodes in dogs and cats and is the agent of tissue migratory larvae in humans. Customarily, the prevalence of human toxocariasis hovers around 15.8 % in Iran. Furthermore, other research outcomes demonstrated a tendency for an outbreak of toxocariasis in Iran. Therefore, we carried out a cross-sectional study and assessed the seroprevalence of toxocariasis humans in Ilam Province, western of Iran. A total of 539 serum samples were collected between September 2017 and March 2018 from patients referred to the Health Centers of Ilam province, Iran. Serum samples were investigated for the presence of Toxocara using IgG antibodies, ELISA (Enzyme-Linked Immunosorbent Assay) kit. Risk factors such as contact with cats and dogs, living in rural areas were investigated among the study population. Out of 539 total samples collected, 97 cases (17.99 %) were positive for anti-toxocara IgG antibodies. These antibodies were recovered from serum samples of otherwise healthy adults (15.54 %, 49/296), pregnant women (21.16 %, 40/189) and diabetic patients (14.81 %, 8/54). This study showed significant relationship between toxocariasis and contact with animal pets in all studied groups (P value ≤ 0.05) and a significant relationship between toxocariasis and living in rural areas among pregnant women (P value ≤ 0.05).

Wells syndrome triggered by toxocariasis

Wells syndrome triggered by toxocariasis

Toxocariasis in Two Ecosystems in Argentina

Toxocariasis in Two Ecosystems in Argentina

Trend of toxocariasis in Iran: a review on human and animal dimensions.

One of the neglected soil and/or food-borne diseases with international public health importance is toxocariasis. Human cases are being increasingly reported from Asian, African, Oceania, European and the American countries. Hence, human toxocariasis (HT) is now considered as a major zoonosis with global and regional importance. In Iran, human and animal toxocariasis is an endemic disease with clinical and epidemiologic health problem aspects. Doubtless, understanding the epidemiology and the trend of this important parasitic disease and its affecting factors will provide the establishment of effective prevention and control programs. To better understand the trend of toxocariasis researches in Iran, this study was performed to analyze different aspects of this zoonotic disease including history, life cycle, species, human animals and environmental studies, diagnostic aspects and treatments to find out the gaps, including different aspects of clinical sings in human patients, new and specific recombinant antigens based on the native antigens, new diagnostic tools, especially rapid diagnostic tests, paratenic hosts status and new treatment procedures which is necessary to be investigated in the future studies on this important zoonotic disease.

Severe Toxocariasis in Children-Diagnostic Difficulties.

ABSTRACT: We present the case of an 18-month-old girl, from rural area, admitted to our clinic for fever and cough. The anamnestic data and the clinical and radiological examinations initially suggested the diagnosis of acute interstitial pneumonia. During hospitalization, she repeatedly presented exacerbations with acute respiratory failure, but without fever. Paraclinic examinations revealed anemia, leukocytosis, inflammatory tests with highly increased values, low values of serum iron and serum calcium, hyperproteinemia with hypergammaglobulinemia, the values of IgE and IgG being highly increased. Repeated pulmonary x-rays-peribronchovascular interstitial thickening, at the level of peri-and right infrahilar area. Medullary puncture-increased percentage of eosinophils in several stages of maturity, approximately 20%, normal values for the other medullary series, without atypical cells; the fingertip hemogram showed anemia, leukocytosis, eosinophilia. The diagnosis turned to a possible toxocariasis-atc anti toxocara canis=55.6 NTU. In the third week of hospitalization, the patient presented short crises of nonfebrile seizures. Normal CT and EEG brain. The child was discharged after 5 weeks, the diagnosis being severe toxocariasis with pulmonary and neurological manifestations; she was recommended an antiparasitary treatment and remained in our clinic's records.

Clinical outcome of minimally invasive vitrectomy for ocular toxocariasis patients

Objective To observe the clinical outcome of minimally invasive vitrectomy for ocular toxocariasis (OT). Methods The clinical data of 37 eyes in 37 patients with OT who underwent 23-gauge vitrectomy were retrospectively reviewed. There were 27 male patients and 10 female patients. The age was from 9 months to 22 years, with the mean age of (7.90±4.47) years. Patients who can cooperate underwent non-contact tonometer examination, slit lamp examination, fundus photography, ultrasound examination, optical coherence tomography and ultrasound biomicroscopic examination. The visual acuity was from no light perception to 0.6. According to the clinical type of OT, 18 eyes had posterior granuloma, 13 eyes had peripheral granuloma, 4 eyes had endophthalmitis and 2 eyes had atypical presentation. Seventeen eyes had vitrectomy for tractional retinal detachment (TRD), 13 eyes for epiretinal membrane (ERM), 6 eyes for TRD combined with ERM and 1 eye for endophthalmitis. Twenty-five eyes had lens-sparing vitrectomy, 12 eyes had lensectomy with vitrectomy; five eyes had limbus incision and 32 eyes had pars plana incision. Five eyes (13.51%) had reoperation. Followed up from 6 months to 39 months, with the mean of (13.90±10.25) months. Results Vision improved in 25 of 35 eyes (71.43%), was unchanged in 9 eyes (25.71%), and was declined in 1 eye (2.86%). Retina was reattached in 22 of 23 eyes that had TRD before surgery (95.65%); the rest one eye had redetachment (4.35%). Three eyes had cataract after surgery, which accounted for 12% in lens-sparing eyes. Among them, 2 eyes had lensectomy therefore. ERM was removed and had no recurrence in 18 of 19 eyes (94.74%). Conclusion Minimally invasive vitrectomy for OT patients can improve their vision and achieve retinal reattachment. Key words: Toxocariasis/complications; Vitreoretinal surgery

Determinación de Anticuerpos IGG Antitoxocara Canis en Estudiantes de Medicina

Abstract Toxocariasis in an infection caused by the larval stage of a nematode parasite, the Toxocara (T. canis more often and T. cati ,rarely), and it is acquired by ingestion of contaminated dirt or food by embryonated eggs of the parasite coming from animal feces. The aim was to determine whether the presence of a dog and frequent contact with it imply a greater risk for infection in healthy populations without evidence of clinical symptoms of the disease. Method: Using ELISA method, the levels of antibodies against Toxocara canis were determined in two populations: a group of dog owners (183 students in the third year of medical school, between 21 and 23 years old, from different areas of the country who voluntarily submitted for the study, with a dog as a pet) and a control group (30 would-be policemen, aged 20-25, who do not own a pet dog). Results: Out of the 183 samples analyzed from the first population (medical students), 25 were positive, showing a prevalence of 13.67%. In the population with no dogs, the prevalence was 3.33%. Conclusions: Although the percentage of positivity in both populations was low, a higher prevalence of Toxocara canis antibodies can be seen in the medical students, suggesting that contact with the animal favors parasitic infection. Therefore, it is extremely important to educate the population as regards care and veterinary control of pets, and to maximize hygiene measures to prevent the spread of this and other parasites.

Application of specific IgG detection in intraocular fluid for the laboratory diagnosis of ocular toxocariasis

Objective To evaluate the clinical value of detecting specific IgG against Toxocara canis in intraocular fluid for the diagnosis of ocular toxocariasis(OT). Methods Fifty patients diagnosed as having OT(OT group), 152 otolaryngology patients (serum control group) and 70 other oculopathy patients (intraocular fluid control group) were enrolled in the study. Intraocular fluids(28 aqueous humor and 22 vitreous humor) and serum samples of OT group were analyzed for specific IgG against Toxocara canis by enzymelinked immunosorbent assay, so were the intraocular fluids(46 aqueous humor and 24 vitreous humor) and 152 serum samples of two control group. Specific IgG level was compared between paired serum and intraocular fluids of OT group. Results 68.00% serum samples of OT group were positive for specific IgG against Toxocara canis and the U value was 20.42±17.01. The positive rate was 88.00% and U value 25.72±23.04 in intraocular fluids. In serum control group, it was 2.63% and 2.37±2.71 respectively. The intraocular fluids were negative and U value 0.69±0.34 in intraocular fluid control group. The difference of specific IgG level was proved significant between OT group and control group in both serum and intraocular fluid (Z=8.962, 8.120; P=0.000, 0.000). Twenty-eight patients (56.00%) were positive for specific IgG in both serum and intraocular fluid. Six patients (12.00%) were positive only in serum, and 16 patients (32.00%) only in intraocular fluid. The positive rate was significantly higher in intraocular fluid than in serum (χ2=4.720, P=0.028). Moreover, 64.00% intraocular fluid showed higher specific IgG level than pared serum. Conclusion The complementary detection of intraocular specific IgG have referential value in diagnosing ocular toxocariasis. Key words: Toxocariasis/diagnosis; Larva migrans; Toxascariasis; Immunoglobulin G/diagnostic use

The role of Toxocara larva migransin hypereosinophilia with unknown origin in patients referred to laboratories

The role of Toxocara larva migransin hypereosinophilia with unknown origin in patients referred to laboratories Mahdi Mosayebi, Reza Hajihossein, Mojtaba Didehdar, Zahra Eslamirad, Mostafa Ejtehadifar, Zeinab Hamzelo Abstract Background: Toxocariasis is a parasitic infection in dogs and cats, and human gets infected with larva migrants when embryonated eggs are accidentally ingested. Migration of toxocara larvae to tissues causes inflammatory responses (visceral, ocular and cerebral) and eosinophilia increase in blood. This study was aimed to investigate the human toxocariasis, one of the possible causes of hypereosinophilia with an unknown origin. Methods: This case-control study was performed on 100 hypereosinophilic patients (cases) and 100 people with normal eosinophil count (controls) that referred to hematology department of laboratories of Arak University of Medical Sciences in 2012. Epidemiological data were collected by a questionnaire and diagnosis was performed using excreted-secreted antigens of Toxocara (TES Ag - ELISA). Results: Positive test for toxocariasis in hypereosinophilic patients was 16% and in patients with normal eosinophil count was zero (P=0.001). There was no statistically significant difference between groups in terms of gender, age, residential place, occupation and education level (P>0.05). However, there was a significantly higher history of contact with dogs and consumption of unclean fruits and vegetables in the infected patients (p<0.05). The mean of eosinophilia in patients with toxocariasis showed a significant difference compared with that of eosinophilia in patients not infected with toxocariasis (p=0.001). Conclusion: The results confirmed the role of toxocariasis in hypereosinophilic patients with unknown origin, and eosinophilia can be considered to analyze and treat toxocariasis. Keywords Toxocariasis, visceral larva migrans, hypereosinophilia

Clinical and Serological Findings in Patients with Toxocariasis in the Pohang Region: The Features of Toxocariasis in Pohang

목적: 톡소카라증은 개회충 또는 고양이회충의 충란을 섭취함으로써 발생하는 질환이며 원충에 대한 여러 가지 알레르기 반응을 통한 다양한 증상을 일으킨다. 저자들은 포항 지역의 톡소카라증의 임상적, 혈청학적 특징을 연구하여 호산구증가증 환자에서 톡소카라증을 더 의심할 수 있게 하는 소견을 알아보고자 본 연구를 시행하였다. 방법: 2008년 8월부터 2011년 5월까지 말초 호산구증가증으로 본 병원에 방문한 145명의 환자들을 대상으로 하였다. Toxocara ELISA 양성군 90명 및 음성군 55명으로 환자군을 분류하였고 나이, 성별, 알레르기 천식, 비염, 폐 또는 간의 호산구 침착 같은 임상양상뿐만 아니라 Immuno-CAP 방법을 사용하여 혈청 총 IgE, 집먼지진드기에 대한 특이 IgE와 같은 혈청학적 양상을 비교 분석하였다. 결과: 전체 대상 환자 145명 중 Toxocara ELISA 양성 90예 (62.1%) 음성 55예 (37.9%)였다. Toxocara ELISA 양성군에서 평균연령은 54.8±14.5세, 음성군에서 49.2± 20.5세로 두 군 간에 연령의 유의한 차이는 없었다(p=0.081). Toxocara ELISA 양성군에서 남성의 비율은 76.7%, 음성군에서 47.3%로 양성군에서 유의하게 높았다(p<0.01). 혈청 총 호산구수(cells/μL)는 Toxocara ELISA 양성군 2,325±361, 음성군 1,407±249로 양성군이 유의하게 많았고 (p=0.038), 총 IgE(IU/mL)는 Toxocara ELISA 양성군 2,089±196, 음성군 984±199로 양성군이 유의하게 높았다(p<0.01). Df 양성률은 Toxocara ELISA 양성군 82.3%, 음성군 44.2%로 양성군이 유의하게 높았으며(p<0.01) Dp 양성률은 Toxocara ELISA 양성군 53.2%, 음성군 42.3%로 두 군 간에 유의한 차이는 없었다(p=0.224). 폐(p<0.01)와 간(p<0.01)의 호산구 침착 및 익히지 않은 소의 간 또는 고기를 섭취한 비율(p<0.01)은 Toxocara ELISA 양성군에서 높았다. 그러나 폐와 간 침범 사이의 상관관계는 없었다(p=0.272). 알레르기 천식(p<0.01)과 비염(p<0.01) 환자의 비율은 Toxocara ELISA 음성군에서 높았다. 아토피는 Toxocara ELISA 양성군에서 유의하게 많았다(p<0.01). 그리고 Toxocara ELISA의 흡광도와 총 IgE (r=0.502, p<0.01), Toxocara ELISA의 흡광도와 총 호산구 수(r=0.256, p=0.015)간에 양의 상관관계가 있었다. 그리고 Df에 대한 특이 IgE가 Dp보다 의미있게 높은 점은(p<0.01) 포항 지역의 톡소카라 증에서 개회충 항원과 Df항원 간의 유사성이 Dp 보다 클 것이라는 것을 시사하고 있다. 결론: 포항 지역의 톡소카라증은 알레르기 천식 또는 비염이 없는 경우가 더 많고 집먼지진드기 중 Df항원에 대한 특이 IgE가 Dp보다 의미있게 높다는 특징을 보이고 있다. 이러한 특징들은 향후 호산구증가증 환자에서 톡소카라증을 진단함에 있어서 유용한 임상적, 혈청학적 소견이 될 수 있을 것으로 생각된다.

A Case of Toxocariasis with Visceral Larva Migrans Combined with Ocular Larva Migrans

Correspondence to Mi-Jung Oh, M.D., Ph.D. Department of Internal Medicine, Bundang Jesaeng General Hospital, 20 Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam 463-774, Korea Tel: +82-31-779-0575, Fax: +82-31-779-0897, E-mail: mjoh@dmc.or.kr Copyrightc 2012 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 내장 유충 이행증과 안구 유충 이행증이 동시에 발현된 개회충증 1예

Lessons from eight cases of adult pulmonary toxocariasis: Abridged republication

Lessons from eight cases of adult pulmonary toxocariasis: Abridged republication