Related Experiment Videos
[Loffler's fibroblastic endocarditis. A report of a case complicating toxocarosis]
F Prunier1, S Delépine, J Victor
1Service de cardiologie, centre hospitalier universitaire, 4, rue Larrey, 49033 Angers.
Abstract:
The authors report a case of Löffler's fibroblastic endocarditis complicating a toxocarosis infection. Parasitic infestation with toxocara canis is usually asymptomatic, but this was a very rare observation of cerebral involvement associated with symptomatic Löffler's endocarditis. This is an unusual form of restrictive cardiac disease constantly accompanied by prolonged hypereosinophilia. In addition to the classical signs of cardiac failure, an acute febrile illness imitating a connective tissue disease may be observed. Echocardiography helps diagnosis by showing endomyocardial fibrosis and adherent thrombosis at one or both ventricular apices. The management of cardiac failure should include, whenever possible, radical treatment of the hypereosinophilia. At an advanced stage, surgical endocardial decortication is the only means of improving symptoms and the prognosis of these patients.
Insights
This rare case highlights Löffler's endocarditis in a toxocarosis infection, presenting with cardiac failure and hypereosinophilia. Early diagnosis via echocardiography and treating the parasitic cause are crucial for managing this restrictive cardiac disease.
Area of Science:
- Cardiology
- Infectious Diseases
- Parasitology
Background:
- Löffler's endocarditis is a rare form of restrictive cardiomyopathy.
- Toxocariasis, a parasitic infection, is typically asymptomatic but can have severe manifestations.
- Hypereosinophilia is a common finding in Löffler's endocarditis.
Observation:
- A rare case of Löffler's endocarditis complicating a toxocariasis infection is presented.
- The patient exhibited cerebral involvement and symptomatic cardiac disease.
- Clinical presentation mimicked a connective tissue disease with acute febrile illness.
Findings:
- Echocardiography revealed endomyocardial fibrosis and ventricular apical thrombosis.
- Prolonged hypereosinophilia was a consistent laboratory finding.
- The case underscores the potential for severe cardiac complications from Toxocara canis.
Implications:
- Early diagnosis of Löffler's endocarditis is critical, aided by echocardiography.
- Management requires addressing the underlying hypereosinophilia and parasitic infection.
- Surgical intervention (endocardial decortication) may be necessary for advanced disease.