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).

Toxocarosis y colecistitis aguda alitiásica: ¿consecuencia o coincidencia? / Toxocarosis and acalculous acute cholecystitis: consequence or coincidence?

La toxocarosis humana es una parasitosis larvaria crónica catalogada dentro de las cinco enfermedades subestimadas más importantes por los CDC. Las larvas pueden diseminarse por vía sistémica y migrar a distintos tejidos (larva migrans visceral) incluyendo el hígado y vesícula biliar. La colecistitis aguda acalculosa (CAA) es una enfermedad rara en niños. El diagnóstico se basa en parámetros clínicos y criterios imagenológicos. Se ha asociado a sepsis, shock, trauma, quemaduras, enfermedades sistémicas graves, anomalías congénitas e infecciones, como también en niños sanos. Presentamos el caso de una toxocarosis infantil con síntomas clínicos y criterios imagenológicos compatibles con una CAA tratado médicamente, y discutir la relación entre ambos cuadros en base a la evidencia publicada.

Human toxocarosis is a chronic larval parasitosis listed as one of the five most important neglected diseases by the CDC. The larvae can spread systemically and migrate to different tissues including liver and gallbladder. Acalculous acute cholecystitis (AAC) is a rare disease in children. The diagnosis is based on clinical parameters and imaging criteria. It has been reported in relation to sepsis, shock, trauma, burns, severe systemic diseases, congenital anomalies, infections and also in healthy children. We report a pediatric case of toxocarosis, with clinical symptoms and imaging criteria compatible with AAC treated medically, and discuss the relationship between toxocarosis and AAC based on published evidence.

Foodborne Eosinophilia due to Visceral Larva Migrans: A Disease Abandoned

No abstract available.

Causes of hepatic granuloma: a 12-year single center experience from Southern Iran

Hepatic granuloma is reported in 2 - 15% of liver biopsy specimens. It is relatively easy for the pathologist to diagnose, but sometimes arriving at a specific etiology is quite difficult. Until now, there are few published studies about the etiology of hepatic granuloma in Iran. In this study, we attempt to determine the causes of hepatic granuloma from one of the largest referral centers in this country. In a retrospective study over 12 years, a hepatopathologist reviewed all liver biopsies with granuloma. The medical records, including clinical findings, autoantibodies, viral markers, imaging studies, drug histories, and all other specialized tests, such as molecular studies, were reviewed to reach a definite diagnosis. During 12 years, there were 72 cases diagnosed with liver granuloma. The most common cause of hepatic granuloma was infectious, with Mycobacterium tuberculosis [52.8%]. The second most common cause was visceral leishmaniasis in 8.3% of biopsies. Other less common causes were fungal infections, visceral larva migrans, primary biliary cirrhosis, and hepatitis C, each in 4.2% of cases. Autoimmune hepatitis was diagnosed in 2.8% of patients. Lymphoma, drug induced, disseminated BCGitis, CMV infection, foreign body reaction and sarcoidosis, were each found in 1.4% of the liver biopsies. After all investigations, there were 12.5% idiopathic hepatic granulomas. According to this study, the most common cause of hepatic granuloma in Iran is tuberculosis. This finding is completely different from western countries and very similar to the results of countries such as Saudi Arabia

Human toxocariasis: contribution by Brazilian researchers / Toxocaríase humana: contribuição dos pesquisadores brasileiros

In the present paper the main aspects of the natural history of human infection by Toxocara larvae that occasionally result in the occurrence of visceral and/or ocular larva migrans syndrome were reviewed. The contribution by Brazilian researchers was emphasized, especially the staff of the Tropical Medicine Institute of São Paulo (IMT).

São abordados os principais aspectos da história natural da infecção humana por larvas de Toxocara que pode resultar na ocorrência da síndrome de larva migrans visceral e/ou ocular. Deu-se destaque, principalmente, à contribuição de pesquisadores brasileiros e, em especial, aos pertencentes ao quadro do Instituto de Medicina Tropical de São Paulo.

Frequência de ovos de Toxocara spp. em três parques públicos da cidade de Porto Alegre, Rio Grande do Sul, Brasil / Frequency of Toxocara spp in three public parks of Porto Alegre city-Brazil

Com o objetivo de realizar um monitoramento mensal para verificar a presença e a frequência de ovos de Toxacara spp, foram coletadas, entre fevereiro de 2002 e janeiro de 2003, 216 amostras de areia em 18 caixas, de praças de recreação localizadas em três parques públicos da cidade de Porto Alegre, Rio Grande do Sul, Brasil. As amostras foram processadas em laboratório pela técnica de Faust modificada, sendo que os resultados mostraram ema frequência de ovos de Toxocara spp em 77,7 por cento das caixas examinadas. Esses dados indicam a necessidade da implantação de medidas sanitárias e educativas visando à prevenção do risco de contaminação da população, especialmente a infantil, por parasitos causadores da larva migrans visceral.

Toxocariasis con afectación hepática / Toxocariasis with liver involvement

We are reporting 16 cases of toxocariasis found in a two year period. Mean age was 2 years and 9 months. Sex distribution was 1:1. Thirteen (81 per cent) children presented pica, 8 (50 per cent) had pets at home, 10 (62.5 per cent presented anemia and long standing fever, and all eosinophilic leukocytosis. Fundoscopy was normal in all. Toxocara antibodies (Through ELISA) were increased in all of them. High resolution ultrasonography revealed hypoechoic areas in the liver in 50 per cent of the cases. Therapeutic response was good, the clinical signs and symptoms disappearing at the end of treatment. The eosinophilic leukocytosis, ELISA serum positivity for toxocara and ultrasound findings persisted approximately for a year. Toxocariasis is a common parasitosis in our setting. It must be regarded as the first diagnosis when confronted with eosinophilic leukocytosis and abnormal liver findings by ultrasound.

Larva migrante visceral (toxocariasis humana) causa de hipereosinofilia y granulomas viscerales en el adulto / Visceral larva migrans (human toxocariasis) cause of hypereosinophilia and visceral granulomas in the adults

A 24-year -old woman 2-3 months after a normal parturation presented geophagy. Due to hypermenorrhea she consulted a gynecologist and in a hemogram a 57 percent (6, 893 x mm3) hypereosinophilia was detected. A chest TAC showed bilateral pulmonary nodules. The following tests resulted positive: ELISA IgG for toxocariasis 1: 1000, isohemagglutinins anti A 1:2048 and anti B 1:512. The patient was treated with albendazole and prednisone during 10 days. One month after treatment eosinophilia decreased to 2.590 x mm3 and ELISA IgG for toxocariasis descended to 1:128. Different aspect of human toxocariasis are commented. When hypereosinophia is observed in adult patients, toxocariasis must be checked

Larva migrans visceral: forma mista de apresentaçäo em adulto: aspectos clínicos e laboratoriais / Visceral larva migrans: a mixed form of presentation in adult patient: clinical and laboratorial features

We relate a case of an 18-year-old man, resident of Xapuri (state of Acre, Brazil), with a history of repeated episodes of meningoencephalitis (three in one year), each one was examined by a local doctor. In our service (Emílio Ribas Institute of Infectology) we observed a patient with polyjoint aches, radiological and bronchoscopic pulmonary alterations (without clinical features), meningeal and brain stem manifestations--with normal brain computed tomography and cerebrospinal fluid. Blood eosinophils and serological Toxocara canis test (ELISA) were greatly increased. With the hypothesis of Toxocariasis (visceral larva migrans) we administered thiabendazole that brought complete clinical and laboratory remission. Inspite of a new episode of headache with meningeal manifestation approximately one month later (treated with dexamethasone resulting in a full remission after three days) we have not found other manifestations in approximately three and a half years of ambulatory care.

Pneumopatia crônica - larva migrans visceral / Chronic lung diseases - visceral larva migrans

Das síndromes eosinofílicas, a Larva Migrans Visceral näo deve ser täo infrequente em nosso meio. Com este trabalho, queremos enfatizar a importância do diagnóstico de Larva Migrans Visceral, uma vez que se trata de uma patologia de bom prognóstico, e de tratamento que se mostra eficaz. Com isto há possibilidade de esclarecimento dos sintomas crônicos do paciente, muitas vezes tratatados inadequadamente e sem sucesso, como pneumonia e/ou crise de asma

Larva migrans visceral (Toxocariase): relato de um caso com intensa hipergamaglobulinemia / Visceral larva migrans (Toxocariases): report of one case with intense hypergammaglobulinemia

Os autores relatam um caso de paciente com 1 ano e 7 meses, natural e procedente de Säo Paulo, com quadro clínico-laboratorial e anátomopatológico de Larva Migrans Visceral, apresentando intensa hipergamaglobulenemia (até 8,54 g%). Os autores apresentam ainda quadro comparativo clínico-laboratorial entre o presente caso e casos de autores nacionais e um autor chileno