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[Toxocariasis: clinical and laboratory features in 54 patients]
1Laboratorio de Parasitología. Hospital de Niños Ricardo Gutiérrez. Buenos Aires. Argentina. jaltcheh@intramed.nte.ar
Insights
Most children infected with toxocariasis are asymptomatic. Treatment led to clinical improvement and reduced eosinophil counts, though further studies are needed for asymptomatic cases.
Area of Science:
- Pediatric infectious diseases
- Parasitology
- Ophthalmology
Context:
- Toxocariasis is a parasitic infection caused by roundworms.
- Clinical manifestations in children vary widely.
- Early diagnosis and treatment are crucial for preventing complications.
Purpose:
- To characterize the clinical and laboratory findings in pediatric toxocariasis.
- To compare findings across asymptomatic, visceral larva migrans, and ocular larva migrans groups.
- To assess treatment outcomes in children with toxocariasis.
Summary:
- Fifty-four children with confirmed toxocariasis were studied.
- Asymptomatic cases (44.4%) were most common, followed by visceral larva migrans and ocular larva migrans.
- Lower eosinophil counts were noted in ocular toxocariasis; treatment improved symptoms and reduced eosinophilia.
Impact:
- Highlights the prevalence of asymptomatic toxocariasis in children.
- Demonstrates treatment efficacy in improving clinical signs and laboratory markers.
- Underscores the need for further research on treatment effectiveness, particularly in asymptomatic infections.
Objective:
To describe the clinical and laboratory findings in children with toxocariasis.
Methods:
Fifty-four children with reactive serology to Toxocara determined by ELISA were prospectively identified between January 1998 and September 2000. The patients were divided into three groups: asymptomatic children (n 24), those with visceral larva migrans (n 16) and those with ocular larva migrans (n 14). Age, serology titers, and eosinophil count at diagnosis were compared among the groups. The patients received treatment with albendazole 10-15 mg/kg/day for 15 days or thiabendazole 25 mg/kg/day in two series of 7 days.
Results:
The clinical features were as follows: 24 children (44.4 %) were asymptomatic, pneumonitis was found in 9 (16.7 %), hepatomegaly in 6 (11.1 %), acute posterior uveitis in 5 (9.3 %), strabismus in 5 (9.3 %), leukocoria in 4 (7.4 %), fever in 3 (5.6 %). There was 1 case of keratitis, 1 of cataracts, 1 of myocarditis and 1 case of pneumonia with pleural effusion. Some patients showed more than one clinical feature. Four children experienced loss of vision in the affected eye. No differences in age or serology titers were found among the groups. Eosinophil count was lower in the group with ocular larva migrans than in the other groups (p < 0.001). Children with active disease showed clinical improvement and a 70.4 % decrease in eosinophilic count one year after treatment. Serological titers showed an unpredictable pattern during the follow-up.
Conclusions:
Most of the infected children were asymptomatic. In the post-treatment follow-up, clinical improvement and a decrease in eosinophilic count were observed. Further studies are needed to evaluate the efficacy of treatment, especially in asymptomatic children.