Larva migrans visceral. Presentación de un caso / Visceral larva migrans. Report of a case

RESUMEN La larva migrans visceral es una enfermedad que se produce al ingerir huevos infectantes de nematodos parásitos de gatos y perros (Toxocaracanis y Toxocaracati); los cuales eclosionan en el intestino del hombre y las larvas se distribuyen en todo el organismo, principalmente hígado, pulmón, corazón y cerebro. Las larvas en su migración dejan trazos de hemorragias, necrosis y células inflamatorias; algunas son destruidas por la respuesta inmune del huésped y otras forman granulomas eosinofílicos. Los síntomas dependen del tejido u órgano afectado, de la intensidad de la infección y del grado de la respuesta inmunológica inducida. Se presenta un caso del sexo masculino de 72 años que ingresa en el Servicio de Medicina del Hospital Militar Docente “Dr. Mario Muñoz Monroy”, de Matanzas, por cuadro de fiebre, diarreas, tos seca, astenia, anorexia y pérdida de peso al que se le diagnosticó larva migrans visceral. Por lo atípico de la edad del paciente y la complejidad del diagnóstico decidimos presentar este caso (AU).

ABSTRACT Visceral larva migrans is a disease produced after the ingestion of infectant eggs of cat´s and dog´s nematode parasites (Toxocara canis and Toxocara cati). These parasites harch in the men´s intestines and the larvas are distributed around the organism, mainly in the following organs: liver, lungs, hearth and brain. In their migration, the larvas leave traces of hemorrhage, necrosis and inflammatory cells; several of them are destroyed by the host´s immune answer and others form eosinophilic granulomas. The symptoms depend on the affected tissue or organ, on the infection intensity and on the level of induced immunologic answer. The case of a male patient, aged 72 years-old is presented. He entered the Medicine Service of the Teaching Military Hospital “Dr. Mario Muñoz Monroy”, of Matanzas with fever, diarrhea, dry cought, asthenia, anorexia and weight loss.Visceral larva migrans was diagnosed. The presentation of the case was decided because of the atypical patient´s age and the complexity of the diagnosis (AU).

Primer reporte de Toxocara cati en el caracol doméstico Rumina decollata / First report of Toxocara cati in the domestic land snail Rumina decollata

Se estudió el rol prospectivo de Rumina decollata como potencial hospedador paraténico de Toxocara cati para los gatos domésticos. Se recolectaron caracoles R. decollata y heces de gatos de un hospital de la Ciudad Autónoma de Buenos Aires. Se procesaron las heces y los caracoles fueron digeridos para identificar estadios de T. cati por análisis morfológico y molecular. El 23,5% (4/17) de las muestras de heces resultaron positivas a huevos larvados de T. cati. El 20% (5/25) de los pooles de caracoles fue positivo a larvas de tercer estadío (L3) de Toxocara spp. por PCR. El promedio de larvas totales recuperadas por gramo de caracol en todos los pooles positivos fue de 5.1, con un máximo de 33 L3/pool. Se trata del primer reporte de R. decollata como hospedador paraténico de T. cati, puesto que ha sido demostrada la infección en caracoles y gatos en un ambiente común

The prospective role of the land snail Rumina decollata as a potential paratenic host of Toxocara cati for domestic cats was studied. R. decollata specimens and cats' feces were collected from the open spaces of a Buenos Aires city hospital. Cats' feces were analyzed and snails were digested to identify T. cati stages, by morphological and molecular analyses. T. cati larval eggs were recovered from 23.5% (4/17) of the sampled feces. Twenty percent of snail pools (5/25) were confirmed to be positive for Toxocara spp. third larval stage (L3) by PCR. The mean value of total larvae recovered per gram of snail in all positive pools was 5.1, with a maximum 33 L3/pool. This is the first report of T. cati infective larvae in R. decollata domestic snail as a paratenic host, since the relationship between infection in snails and in cats' feces could be demonstrated in a common environment

Toxocara cati (Nematoda: Ascarididae) in Didelphis albiventris (Marsupialia: Didelphidae) from Brazil: a case of pseudoparasitism / Toxocara cati (Nematoda: Ascarididae) em Didelphis albiventris (Marsupialia: Didelphidae) do Brasil: um caso de pseudoparasitismo

Eggs of Toxocara cati were found in the feces of Didelphis albiventris from a peridomestic urban environment in Brazil. Negative fecal tests following short-term captivity of the opossums, as well as the absence of ascaridids during necropsy, suggest the occurrence of pseudoparasitism. Implications of the findings for the epidemiology of toxocariasis are discussed.

Ovos de Toxocara cati foram encontrados nas fezes de Didelphis albiventris oriundos de um ambiente peridomiciliar urbano no Brasil. A negatividade dos exames de fezes após um curto período de cativeiro dos gambás e a ausência de nematódeos ascaridídeos durante a necropsia sugerem a ocorrência de pseudoparasitismo. As implicações dos achados para a epidemiologia da toxocarose são discutidas.

EXPERIMENTAL INFECTION WITH Toxocara cati IN PIGS: MIGRATORY PATTERN AND PATHOLOGICAL RESPONSE IN EARLY PHASE / Infección experimental en cerdos con Toxocara cati: patrón migratorio y respuesta patológica en etapa temprana

Experimental inoculations of approximately 100,000 infective Toxocara cati larval eggs were done in twelve pigs. The T. cati eggs used for inoculation were collected from cat's feces. Another group of three pigs served as an uninfected control. Groups of infected pigs were euthanized at seven, 14, 21, and 28 days post-inoculation (dpi). Tissue samples were taken for digestion and histopathology changes in early phase. The number of larvae recovered from the lungs peaked at seven and 14 dpi and were also present at 21, and 28 dpi. Larvae of T. cati were present in the lymph nodes of the small and large intestine at seven, 14, and 28 dpi and at seven, 14, 21, and 28 dpi respectively. In other studied tissues, no larvae or less than one larva per gram was detected. The pathological response observed in the liver and lungs at seven and 14 dpi, showed white spots on the liver surface and areas of consolidation were observed in the lungs. The lungs showed an inflammatory reaction with larvae in center at 28 dpi. In the liver we observed periportal and perilobular hepatitis. The lymph nodes of the intestines displayed eosinophil lymphadenitis with reactive centers containing parasitic forms in some of them. The granulomatous reaction was not observed in any tissues. The role of the other examined tissues had less significance. The relevance of this parasite as an etiological agent that leads to disease in paratenic hosts is evident.

Se realizó la infección experimental de doce cerdos con aproximadamente 100.000 huevos infectivos de Toxocara cati. Los huevos de T. cati utilizados en la inoculación fueron recolectados de heces felinas. Otro grupo de tres cerdos no infectados se utilizó como control. Grupos de cerdos infectados se eutanaciaron a los 7,14,21 y 28 días posinoculación (pi). Se tomaron muestras de tejidos para digestión y evaluación de cambios histopatológicos en la etapa temprana de la infección. El número de larvas recuperadas de los pulmones se incrementó en los días 7 y 14 pi, recuperándose también los días 21 y 28 pi. Se encontraron larvas de T. cati en los linfonódulos del intestino delgado y grueso los días 7,14 y 28 pi y los días 7,14,21 y 28 pi respectivamente. En los restantes tejidos estudiados o no se recuperaron larvas o los valores fueron menores a una larva por gramo de tejido. La respuesta patológica observada en el hígado y los pulmones a los 7 y 14 días posinoculación, mostró en la superficie del hígado manchas blancas y en los pulmones áreas de consolidación. Los pulmones presentaron una reacción inflamatoria con presencia de larva en el centro en el día 28 pi. En el hígado se observó una hepatitis periportal y perilobular. Los linfonódulos del intestino presentaron una linfoadenitis eosinofílica con un centro reactivo conteniendo formas parasitarias en algunos de ello. En ninguno de los tejidos se observó la típica reacción granulomatosa. El rol de los restantes tejidos examinados fue de menor significancia. Queda evidenciada la importancia de éste parasito como un agente etiológico que desarrolla la enfermedad en hospederos paraténicos.

Toxocara cati larvae in the eye of a child：a case report

Toxocariasis is a consequence of human infection by Toxocara larvae. There are symptomatic (visceral, ocular) and asymptomatic course of toxocariasis. The ocular form is very rare. We present a 6-year-old patient who developed an ocular form of toxocariasis caused by Toxocaracati. He demonstrated lesions in the peripheral retina of the right eye. White granuloma was present in the superior peripheral retina. A positive immunological assay for toxocariasis essentially completed the outcomes. On the basis of clinical manifestations and conducted examinations, a diagnosis of ocular form of toxocariasis was established. Albendazole and corticosteroids were applied in treatment. Current results clearly highlight the usefulness of excretory-secretory antigens derived from larvae of Toxocara cati for the fine diagnosis ocular larva migrans caused by Toxocara larvae.

Toxocara cati larvae in the eye of a child: a case report

Toxocariasis is a consequence of human infection by Toxocara larvae. There are symptomatic (visceral, ocular) and asymptomatic course of toxocariasis. The ocular form is very rare. We present a 6-year-old patient who developed an ocular form of toxocariasis caused by Toxocara cati. He demonstrated lesions in the peripheral retina of the right eye. White granuloma was present in the superior peripheral retina. A positive immunological assay for toxocariasis essentially completed the outcomes. On the basis of clinical manifestations and conducted examinations, a diagnosis of ocular form of toxocariasis was established. Albendazole and corticosteroids were applied in treatment. Current results clearly highlight the usefulness of excretory-secretory antigens derived from larvae of Toxocara cati for the fine diagnosis ocular larva migrans caused by Toxocara larvae.

A Seroepidemiological Survey of Toxocariasis among Eosinophilia Patients in Chungcheongnam-do

There have been several reports on the relationship between toxocariasis and eosinophilia, but all have been limited to the areas of Seoul or Gangwon-do. In the present study, we investigated the seroprevalence of toxocariasis among eosinophilia patients in Chungcheongnam-do, the central district of Korea. Among the 101 patients tested, 51 (50.5%) were identified as positive by Toxocara ELISA, and 46 (45.5%) were confidently diagnosed with toxocariasis because of absence of any other cause of eosinophilia. Whereas 22 of 42 seropositive patients (52.3%) had a recent history of consuming raw livers, especially the cow liver, only 1 of 25 seronegative patients (4%) had done so (P<0.01). From these results, we could confirm that toxocariasis is related to eosinophilia, and infer that ingestion of raw cow liver plays a vital role in the transmission of toxocariasis in Chungcheongnam-do.

The prevalence of feline parasites in Suwon, Korea / 대한수의학회지

Feline parasites were investigated in the area of Suwon in Korea from September to October, 2003. Wild cat had spread to zoonotic parasites, these parasites could cause infection with a person. People have a lot of interest in parasite infection of wild cat. This article reviews rate of infection of a parasites and kind of a parasite of wild cats. We will report the critical characteristic features of parasites to a better understanding of the disease. The incidence rates of Toxocara cati, Trichuris felis, Ancylostoma braziliense and Capillaria sp were 37.0, 4.3, 1.1 and 1.1% in nematodes. Those of Taenia taeniaformis and Opisthorchis sp were 2.2 and 1.1% in cestode and trematode. Those of Isospora felis, Toxoplasma gondii, and Sarcocystis sp were 8.7, 9.8, and 2.2% in protozoa. Almost of these were zoonotic parasites without Isospora felis.

Experimental Toxocara cati Infection in Gerbils and Rats

Mongolian gerbils and Wistar rats were inoculated orally with 240 and 2,500 Toxocara cati embryonated eggs, respectively, to evaluate the larval recovery in different tissues and organs, such as the liver, lungs, heart, kidney, and skeletal muscles after 5, 30, 49, 70, and 92 days post-infection (PI). Larval recovery rates were 1.7-30.0% in Mongolian gerbils on days 5-92 PI and 0.2-3.8% in rats on the same days. These results indicate that Mongolian gerbils and Wistar rats are suitable experimental paratenic hosts for the study of neurological toxocariasis as well as visceral toxocariasis.

Longevity of Toxocara cati Larvae and Pathology in Tissues of Experimentally Infected Chickens

This study was conducted to determine the distribution patterns and duration of stay of Toxocara cati larvae in organs of chickens and to investigate chronic phase and potential zoonotic risk of toxocariasis in chickens. Chickens were orally infected with 1,000 embryonated T. cati eggs and necropsied 240 days post-infection. Organs of the chickens were examined at gross and microscopic levels; tissues were digested to recover larvae. Peribronchiolitis with infiltration of lymphocytes, and hyperplasia of bronchiolar associated lymphatic tissues (BALT) and goblet cells, were evident in the lungs of infected chickens. There were mild hemorrhages and infiltration of lymphocytes and a few eosinophils in the meninges. Larvae were recovered from 30% of the exposed chickens. Larvae recovery indicated that T. cati larvae stay alive for at least 240 days in the chicken brain. Therefore, chickens may potentially act as a paratenic host in nature and transfer T. cati larvae to other hosts.

Larval recovery of Toxocara cati in experimentally infected Rattus norvegicus and analysis of the rat as potential reservoir for this ascarid

Toxocara cati is a common feline parasite transmitted by the ingestion of embryonated eggs, by the transmammary route or by predation of paratenic hosts harbouring third-stage larvae in their bodies. In the present study, the larval distribution of T. cati in tissues and organs of Rattus norvegicus experimentally infected with 300 embryonated eggs was analysed. Third-stage larvae were recovered from livers, lungs, kidneys, eyes, brains and carcasses of infected rats, following tissue digestion with HCl 0.5 percent for 24 h at 37°C. Some differences from the known larval distribution of Toxocara canisin the same rodent species were found.

Aspectos clínico-epidemiológicos de la toxocariasis: una enfermedad desatendida en Venezuela y América Latina / Clinical and epidemiological aspects of toxocariasis: A disease neglected in Venezuela and Latin America

La toxocariasis es una enfermedad zoonótica de gran importancia en términos de la morbilidad que puede producir en el ser humano y por lo difícil que puede resultar su control para la salud pública. Recientes hallazgos en cuanto a su asociación con otras patologías, el avance en técnicas diagnósticas y nuevos descubrimientos terapéuticos generan la inquietud de revisar un tópico de actualidad que puede ser considerado olvidado y desatendido por la escasez de estudios nacionales y latinos. En el presente artículo se hace una revisión de diferentes aspectos relacionados a la biología del parásito Toxocara canis y su relevancia clínico-epidemiológica en el ser humano, con énfasis en Venezuela y América Latina

Toxocariasis is a zoonotic disease of great importance in terms of its morbidity that it produces inthe human beings, as well the difficulty that results itscontrol for the public health. Recent findings in regardto its association with other pathologies, the advance indiagnostic techniques and new therapeutic discoverieshave generated the interest in reviewing a topic ofcurrent attention that would be considered neglecteddue to scarcity of national and Latin American studies.In the current article a review of different aspectsrelated to the biology of the parasite Toxocara canisand its clinical and epidemiological relevance in thehuman beings, with emphasis on Venezuela and Latin America is presented

Estudio preliminar sobre los distintos estadios de Toxocara cati en gatos / Preliminary study on the different stages of Toxocara cati in cats

Las larvas de T. cati tienen la capacidad de realizar migraciones por los tejidos del gato, permaneciendo infectivas. El objetivo del presente estudio fue determinar la presencia de distintos estadios de T. cati en gatos naturalmente infectados. Se efectuó la necropsia de 12 gatos hallados muertos en la vía pública. Se tomaron muestras de materia fecal para análisis coproparasitológico y muestras de músculo, la totalidad de los pulmones, rí±ones, hígado y cerebro. Se utilizó la técnica de digestión artificial rßpida para detectar la presencia de larvas de Toxocara cati en los tejidos. El análisis coproparasitológico fue positivo a T. cati en un 25 por ciento, a Toxascaris leonina en un 16, 66 por ciento y en un 8,33 por ciento a ambas especies. El 50 por ciento de los animales presentó parásitos adultos de T. cati, de los cuales el 20 por ciento presentó parasitosis mixta con T. leonina. La existencia de parásitos adultos y su relación con la edad del animal fue estadísticamente significativa. No resultó estadísticamente significativa con respecto al sexo. En el análisis de las muestras de órganos y tejidos no se detectaron larvas de T. cati. Las diferencias obtenidas en los resultados con la técnica coproparasitológica y con la necropsia podrían deberse a la presencia de estadios inmaduros o a la eliminación intermitente de huevos por materia fecal. La ausencia de larvas en los tejidos plantea diversos interrogantes que podrían condicionar el comportamiento migratorio de las mismas en el gato. Es necesario incrementar la cantidad de felinos estudiados y realizar estudios bajo condiciones controladas de infección para obtener un mayor conocimiento sobre el comportamiento de las larvas de T. cati durante la fase migratoria en el gato.

Toxocara cati larvae are able to migrate through the tissues of the cat, remaining infective. The objective of this study was to determine the presence of different stages ofT. cati in naturally infected cats. Twelve cats found dead in the street were necropsied and samples of faeces were collected for coproparasitological analysis. Samples of muscle, the lungs, kidneys, liver, mammary gland and brain were removed. They were processed by the rapid artificial digestion technique to detect T. cati larvae. Coproparasitological analysis was positive for T. cati by 25 percent, to Toxascaris leonina at 16, 66 percent and 8.33 percent to both species. The 50 percent of animals presented adult parasites ofT. cati, of which 20 percent were positive to T. leonina. Statistically significant differences were found between the presence of adult parasites and cat's age. No statistically significant differences were observed in regard to sex. No larvae ofT. cati were recovered from tissues. The differences in the results obtained between the coproparasitological technique and the necropsy could be due to the presence of immature stages of the parasites or to intermittent elimination of eggs in faeces. The absence of larvae in tissues raises several questions related to the migratory behaviour of T. cati larvae. Increasing the number of felines studied will contribute to ensure the validity of the results and will provide a better understanding about the behavior ofT. cati larvae during the migratory phase in the cat.