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[Toxocariasis in children]
Insights
Toxocariasis in children often presents with high eosinophilia. While thiabendazole treatment reduces eosinophil counts, levels often rise again, indicating the need for considering toxocariasis in diagnosing high eosinophil cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Immunology
- Parasitology
Context:
- Presents a series of ten pediatric cases of toxocariasis.
- Patients exhibited high eosinophilia with non-specific health disturbances.
- Geophagia was noted in three of the children.
Purpose:
- To describe the clinical presentation and diagnostic findings of toxocariasis in children.
- To evaluate the efficacy of thiabendazole treatment for toxocariasis.
- To emphasize the importance of considering toxocariasis in the differential diagnosis of pediatric hypereosinophilia.
Summary:
- Ten children (6 girls, 4 boys; aged 21 months to 9 years) with toxocariasis were identified via enzyme-linked immunosorbent assay (ELISA) due to significant eosinophilia (median 6007/mm³).
- Treatment with thiabendazole (30-50 mg/kg BID for 5 days) resulted in an initial decrease in eosinophil counts (median 837/mm³).
- However, eosinophilia recurred within 2-8 weeks, albeit at lower levels, highlighting potential challenges in sustained treatment response.
Impact:
- Suggests toxocariasis should be a key consideration in the differential diagnosis of pediatric high peripheral eosinophilia.
- Highlights that while patients are often in good general health, severe cases may require aggressive treatment.
- Provides insights into the treatment response and potential relapse patterns of toxocariasis in children.
Abstract:
Ten children with toxocariasis are presented. All were admitted because of high eosinophilia accompanied by minor and non-specific disturbances of the general health condition. There were 6 girls and 4 boys in this series; the age ranged from 21 months to 9 years. Three of the children practised geophagia. Toxocariasis was confirmed by the enzyme-linked immunosorbent assay (ELISA). The absolute number of eosinophils in the peripheral blood was 592-29784 per mm3, median 6007 per mm3. Treatment consisted of thiabendazole, 30-50 mg/kg b. i. d. for 5 days. Immediately following the treatment there was an impressive fall in the absolute eosinophil count (142-10660 per mm3, median 837/mm3). However, 2-8 weeks thereafter the eosinophilia rose to high levels again, although somewhat lower than the pretreatment ones. Toxocariasis should be included in the differential diagnosis of high peripheral eosinophilia. The patients are commonly in a good general condition, although an occasional massive invasion may necessitate prompt and vigorous treatment.