[Chronic intestinal ischemia after migration of larvae in ascaridiasis (author's transl)]

A case report is given of a 25 year old turkish patient, who had ascaridiasis and multiple stenoses of the small intestine. This syndrome was caused by extensive obliterating phlebitis of the small mesenterial veins and sclerosing lymphadenitis of the mesenterial lymph nodes. Granuloma containing epitheloid cells and giant cells could be found in the venous walls and in the lymph nodes, some of the granuloma being grouped around atrophic ascarides larvae; this demonstrates, that the intestinal stenoses represent an unusual complication of larvae migration in this worm disease. Perforation of the intestinal wall in one these stenotic areas possibly was caused by ascarides worms actively.

[Toxocara canis (larva migrans visceralis) from an ophthalmological point of view (author's transl)]

Visceral Larva Migrans (Toxocara canis) is usually a relatively benign disease which is caused by infective second-stage larvae of the common cosmopolitan ascarid of dogs, characterized chiefly by sustained eosinophilia, pulmonary symptoms and hepatomegaly. Its severity varies with the number of larvae in the tissue and the immune or allergic state of the infected individual. The most important aspect of the neurotropic larvae perhaps is its potential as a facilitating agent, for instance, for Virus or Toxoplasma gondii invasion of the central nervous system by destroying the blood-brain barrier. Ocular invasion characteristically occurs after primary infestation, seldom bilaterally. Larvae may present three different ocular lesions: a granulomatosis at the posterior pole (solitary granuloma), a chronic endophthalmitis or peripheral retinal lesions with proliferation. Prognosis regarding visual acuity depends on early diagnosis and larval localization. The author reports on successful therapy with a combination of antibiotics, sulfonamides, prednisolone and vermifuge. The microprecipitation test on living larvae is considered to be superior all serological tests at present but a negative result (at first) does not exclude T. canis invasion (compare case report). LMV syndrome should be ruled out if the patient suffers from cerebral spasms whose cause is unclear.

Ophthalmic manifestations of visceral larva migrans

Two patients had ocular manifestations of infestation with visceral larva migrans. In neither case did the eye involvement improve despite thiabendazole, local and systemic steroids, and cryotherapy. The lack of ocular response to treatment may be assumed to be because of organisms were already dead. Thiabendazole therapy is probably worth trying for early ophthalmic involvement with visceral larva migrans if the organism is still alive. In most cases the diagnosis of visceral larva migrans can be made with the help of the ELISA serum antigen determination so that enucleation of the eye will not be necessary for diagnostic purposes.

Toxocara canis

Toxocara canis, commonly known as the dog ascrid, is a frequent parasite of the domestic dog. If the eggs of an adult worm are accidentally ingested by a human host, usually a child, a larval form of the worm develops that can survive for a limited period in various human tissues. The retina is one of these tissues and upon the death of this organism a granulomatous reaction occurs and a fibrotic mass is formed in the retina. This unusual ophthalmoscopic appearance is demonstrated by the presentation of three fundus photographs of patients with suspected Toxocara lesions. A knowledge of this parasite and its life cycle will aid in its recognition, treatment, and possible prevention.

Visceral larva migrans. A review and reassessment indicating two forms of clinical expression: visceral and ocular

Visceral larva migrans is a disease in which the larvae of animal parasites invade human tissues but do not complete their life cycles. The most frequent cause of this illness in children is the dog roundworm, Toxocara canis. A review of the literature, as well as our clinical experience, indicates that there are two forms of clinical expression: one, visceral, and the other, ocular. In general the clinical and laboratory abnormalities (hepatomegaly, recurrent pneumonia, eosinophilia, and hyperglobulinemia) usually associated with visceral disease are absent in children with ocular abnormalities. Conversely, there is a general lack of eye complications in patients with systemic disease. Reasons for these variations in clinical expression are unknown, but immune responses of the host and the antigenic composition of the parasite may be contributing factors.

Human toxocariasis (visceral larva migrans) causing an abscess of the rectus sheath in an infant

A patient is described with an abscess of the rectus sheath associated with the clinical features and operative findings of toxocariasis (visceral larva migrans).

Few cases of this condition are ever submitted to laparotomy, and the complication of rectus sheath abscess has not previously been reported. A brief review of the literature is given in order to outline the salient features of the condition.