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Üblagger D, Auer H, Bezakova M, Kirchlechner V. Toxocarosis in a patient with autism spectrum disorder presenting with severe hypereosinophilia and acute respiratory distress: a case report. Parasitol Res 2024; 123:99. [PMID: 38228848 PMCID: PMC10791809 DOI: 10.1007/s00436-024-08119-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/07/2024] [Indexed: 01/18/2024]
Abstract
A boy with known autism spectrum disorder was transferred to our department due to a rapidly worsening respiratory situation. The patient's history revealed previous treatment with albendazole against a Toxocara infection 2 weeks prior in Poland. Blood analysis showed such severe eosinophilia and markedly elevated levels of IgE that, initially, a hematologic malignancy was suspected. However, diagnostic workup including autoimmune diagnostic, molecular genetic testing, fluorescence in situ hybridization (FISH), bone marrow aspiration, and parasitological testing led to the diagnosis of an insufficiently treated Toxocara infection. Treatment with albendazole and prednisone (six cycles for 4 weeks each) was administered. This treatment regime led to prompt improvement of symptoms and normalization of laboratory findings.
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Affiliation(s)
- Daniel Üblagger
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Herbert Auer
- Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
| | - Milina Bezakova
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - Veronika Kirchlechner
- St. Anna Children's Hospital, Department of Pediatrics, Medical University Vienna, Vienna, Austria.
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2
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Henke K, Ntovas S, Xourgia E, Exadaktylos AK, Klukowska-Rötzler J, Ziaka M. Who Let the Dogs Out? Unmasking the Neglected: A Semi-Systematic Review on the Enduring Impact of Toxocariasis, a Prevalent Zoonotic Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6972. [PMID: 37947530 PMCID: PMC10649795 DOI: 10.3390/ijerph20216972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/28/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
Toxocariasis remains an important neglected parasitic infection representing one of the most common zoonotic infections caused by the parasite Toxocara canis or, less frequently, by Toxocara cati. The epidemiology of the disease is complex due to its transmission route by accidental ingestion of embryonated Toxocara eggs or larvae from tissues from domestic or wild paratenic hosts. Even though the World Health Organization and Centers for Disease Control classified toxocariasis amongst the top six parasitic infections of priority to public health, global epidemiological data regarding the relationship between seropositivity and toxocariasis is limited. Although the vast majority of the infected individuals remain asymptomatic or experience a mild disease, the infection is associated with important health and socioeconomic consequences, particularly in underprivileged, tropical, and subtropical areas. Toxocariasis is a disease with multiple clinical presentations, which are classified into five distinct forms: the classical visceral larva migrans, ocular toxocariasis, common toxocariasis, covert toxocariasis, and cerebral toxocariasis or neurotoxocariasis. Anthelmintic agents, for example, albendazole or mebendazole, are the recommended treatment, whereas a combination with topical or systemic corticosteroids for specific forms is suggested. Prevention strategies include educational programs, behavioral and hygienic changes, enhancement of the role of veterinarians, and anthelmintic regimens to control active infections.
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Affiliation(s)
- Katrin Henke
- Department of Internal Medicine, Thun Hospital, Krankenhausstrasse 12, 3600 Thun, Switzerland;
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3008 Bern, Switzerland; (S.N.); (A.K.E.); (J.K.-R.)
| | - Sotirios Ntovas
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3008 Bern, Switzerland; (S.N.); (A.K.E.); (J.K.-R.)
- Department of Visceral Surgery and Medicine, lnselspital, University Hospital, University of Bern, 3008 Bern, Switzerland
| | - Eleni Xourgia
- Department of Heart Surgery, lnselspital, University Hospital, University of Bern, 3008 Bern, Switzerland;
| | - Aristomenis K. Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3008 Bern, Switzerland; (S.N.); (A.K.E.); (J.K.-R.)
| | - Jolanta Klukowska-Rötzler
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3008 Bern, Switzerland; (S.N.); (A.K.E.); (J.K.-R.)
| | - Mairi Ziaka
- Department of Internal Medicine, Thun Hospital, Krankenhausstrasse 12, 3600 Thun, Switzerland;
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, 3008 Bern, Switzerland; (S.N.); (A.K.E.); (J.K.-R.)
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3
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Kaneva E, Rainova I, Harizanov R, Kaftandjiev I. "Study of IgG avidity and the level of specific IgA antibodies and their significance in the diagnosis of human toxocarosis". Exp Parasitol 2022; 236-237:108236. [PMID: 35247381 DOI: 10.1016/j.exppara.2022.108236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 01/20/2022] [Accepted: 03/01/2022] [Indexed: 11/04/2022]
Abstract
Toxocarosis is a zoonotic disease caused by migration and subsequent localization of nematode larvae of Toxocara spp. in human organs and tissues, which is manifested with development of various non-specific clinical symptoms. Main diagnostic methods are serological and consists in proving the presence of anti-Toxocara IgG antibodies in patient's sera. In humans, anti-Toxocara IgG has been shown to persist in the serum for a long time and cannot be used to distinguish between past and recent infection. Aim of the present work is to investigate the diagnostic significance of the specific IgG avidity level, determined by an immuno enzyme test developed by us, and the presence of anti-Toxocara IgA for distinguishing between acute and chronic toxocarosis. The study included 130 patients with positive results in routine serological ELISA and Western blot tests and with clinical symptoms of visceral and ocular toxocarosis. The results revealed low IgG avidity (≤40%) in nine (7.3%) and presence of anti-Toxocara IgA antibodies in 36 (26.2%) of the subjects. Low avidity of IgG antibodies was found only in the first tests, and a presence of specific IgA for up to 9 months. The results of our study give us reason to believe that determination of the IgG avidity in toxocarosis is of greater diagnostic value than the presence of IgA to establish the stage of the disease.
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Affiliation(s)
- Eleonora Kaneva
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria; Department of Parasitology and Tropical Medicine, 1504, Sofia, 26, Yanko Sakazov Blvd, Bulgaria.
| | - Iskra Rainova
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria; Department of Parasitology and Tropical Medicine, 1504, Sofia, 26, Yanko Sakazov Blvd, Bulgaria.
| | - Rumen Harizanov
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria; Department of Parasitology and Tropical Medicine, 1504, Sofia, 26, Yanko Sakazov Blvd, Bulgaria.
| | - Iskren Kaftandjiev
- National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria; Department of Parasitology and Tropical Medicine, 1504, Sofia, 26, Yanko Sakazov Blvd, Bulgaria.
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Morelli S, Diakou A, Di Cesare A, Colombo M, Traversa D. Canine and Feline Parasitology: Analogies, Differences, and Relevance for Human Health. Clin Microbiol Rev 2021; 34:e0026620. [PMID: 34378954 PMCID: PMC8404700 DOI: 10.1128/cmr.00266-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cats and dogs are treated as family members by most pet owners. Therefore, a high quality of veterinary care and preventive medicine is imperative for animal health and welfare and for the protection of humans from zoonotic pathogens. There is a general perception of cats being treated as "small dogs," especially in the field of clinical parasitology. As a result, several important differences between the two animal species are not taken into proper consideration and are often overlooked. Dogs and cats are profoundly different under evolutionary, biological, ethological, behavioral, and immunological standpoints. These differences impact clinical features, diagnosis, and control of canine and feline parasites and transmission risk for humans. This review outlines the most common parasitoses and vector-borne diseases of dogs and cats, with a focus on major convergences and divergences, and discusses parasites that have (i) evolved based on different preys for dogs and cats, (ii) adapted due to different immunological or behavioral animal profiles, and (iii) developed more similarities than differences in canine and feline infections and associated diseases. Differences, similarities, and peculiarities of canine and feline parasitology are herein reviewed in three macrosections: (i) carnivorism, vegetarianism, anatomy, genetics, and parasites, (ii) evolutionary adaptation of nematodes, including veterinary reconsideration and zoonotic importance, and (iii) behavior and immune system driving ectoparasites and transmitted diseases. Emphasis is given to provide further steps toward a more accurate evaluation of canine and feline parasitology in a changing world in terms of public health relevance and One Health approach.
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Affiliation(s)
- Simone Morelli
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - Anastasia Diakou
- Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angela Di Cesare
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | | | - Donato Traversa
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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Chieffi PP, Zevallos Lescano SA, Rodrigues E Fonseca G, Dos Santos SV. Human Toxocariasis: 2010 to 2020 Contributions from Brazilian Researchers. Res Rep Trop Med 2021; 12:81-91. [PMID: 34040480 PMCID: PMC8141392 DOI: 10.2147/rrtm.s274733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/26/2021] [Indexed: 01/18/2023] Open
Abstract
This is a review of the published contributions made by Brazilian researchers between 2010 and 2020 on the natural history of human toxocariasis and the effects of human toxocariasis on nonhuman paratenic hosts.
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Affiliation(s)
- Pedro Paulo Chieffi
- Department of Pathological Sciences, Santa Casa Medical School, São Paulo, Brazil
| | | | - Gabriela Rodrigues E Fonseca
- Department of Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Acute-Onset Eosinophilic Gastroenteritis and Ascites Secondary to Occult Toxocariasis. ACG Case Rep J 2021; 8:e00556. [PMID: 33898627 PMCID: PMC8059999 DOI: 10.14309/crj.0000000000000556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/04/2020] [Indexed: 11/17/2022] Open
Abstract
Eosinophilic gastroenteritis is a rare entity, and although usually idiopathic, it may arise from gastrointestinal infections. We report a case of a 33-year-old woman from Vietnam presenting with acute abdominal pain, new-onset eosinophilic ascites, peripheral eosinophilia, and a positive Toxocara antibody. The patient had no recent international travel, known animal host contact, or other toxocariasis risk factors. She was treated with ivermectin and mebendazole with complete resolution of symptoms. This case emphasizes the consideration of a broad differential for eosinophilic ascites, including atypical presentations of infectious pathogens.
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7
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Morales-Yánez F, Trashin S, Sariego I, Roucher C, Paredis L, Chico M, De Wael K, Muyldermans S, Cooper P, Polman K. Electrochemical detection of Toxocara canis excretory-secretory antigens in children from rural communities in Esmeraldas Province, Ecuador: association between active infection and high eosinophilia. Parasit Vectors 2020; 13:245. [PMID: 32398157 PMCID: PMC7216625 DOI: 10.1186/s13071-020-04113-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background The diagnosis of active Toxocara canis infections in humans is challenging. Larval stages of T. canis do not replicate in human tissues and disease may result from infection with a single T. canis larva. Recently, we developed a nanobody-based electrochemical magnetosensor assay with superior sensitivity to detect T. canis excretory-secretory (TES) antigens. Here, we evaluate the performance of the assay in children from an Ecuadorian birth cohort that followed children to five years of age. Methods Samples were selected based on the presence of peripheral blood eosinophilia and relative eosinophil counts. The samples were analyzed by the nanobody-based electrochemical magnetosensor assay, which utilizes a bivalent biotinylated nanobody as capturing agent on the surface of streptavidin pre-coated paramagnetic beads. Detection was performed by a different nanobody chemically labelled with horseradish peroxidase. Results Of 87 samples tested, 33 (38%) scored positive for TES antigen recognition by the electrochemical magnetosensor assay. The average concentration of TES antigen in serum was 2.1 ng/ml (SD = 1.1). The positive result in the electrochemical assay was associated with eosinophilia > 19% (P = 0.001). Parasitological data were available for 57 samples. There was no significant association between positivity by the electrochemical assay and the presence of other soil-transmitted helminth infections. Conclusions Our nanobody-based electrochemical assay provides highly sensitive quantification of TES antigens in serum and has potential as a valuable tool for the diagnosis of active human toxocariasis.![]()
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Affiliation(s)
- Francisco Morales-Yánez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium. .,Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Stanislav Trashin
- AXES Research Group, Department of Chemistry, University of Antwerp, Antwerp, Belgium
| | - Idalia Sariego
- Institute of Tropical Medicine "Pedro Kourí", Havana, Cuba
| | - Clémentine Roucher
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Linda Paredis
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Martha Chico
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador
| | - Karolien De Wael
- AXES Research Group, Department of Chemistry, University of Antwerp, Antwerp, Belgium
| | - Serge Muyldermans
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Philip Cooper
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador.,Facultad de Ciencias Médicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.,Institute of Infection and Immunity, St George's University of London, London, UK
| | - Katja Polman
- Department of Biomedical Sciences, Unit of Medical Helminthology, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Health Sciences, Section Infectious Diseases, VU University Amsterdam, Amsterdam, The Netherlands
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Abstract
Toxocara canis and T. cati are among the most widely distributed helminthic species in the world with a high zoonotic impact. Millions of people are infecteda and hundreds of thousands are suffering from toxocarosis, a disease encompassing four different entities: larva migrans visceralis (VLM) syndrome, ocular larva migrans (OLM) syndrome, covert toxocarosis (covT), common toxocarosis (comT) and neurotoxocarosis (NT). Toxocara infections in humans may remain clinically inapparent but may also induce severe diseases. This contribution gives a synoptic overview of the most important historical, clinical, diagnostic and therapeutical aspects of toxocarosis in humans.
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Adeel AA. Seroepidemiology of human toxocariasis in North Africa. ADVANCES IN PARASITOLOGY 2020; 109:501-534. [PMID: 32381215 DOI: 10.1016/bs.apar.2020.01.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Seroprevalence studies on human toxocariasis help to assess the burden and the morbidity associated with this zoonosis. This review searched the seroprevalence studies and case reports in six North African countries: Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, since 1990. The search also included studies on the environmental factors related to the risk of transmission. Most of the published epidemiological studies were done in Egypt. Cross-sectional and case-control studies in Egypt demonstrated that toxocariasis is a significant zoonosis that could be associated with conditions like bronchial asthma allergies and certain neuropsychiatric disorders. The population at risk of this infection includes all ages, both genders, in contact with dogs, resident in rural areas with poor housing conditions. The publications from Tunisia, Morocco and Algeria are limited to case reports and retrospective analyses of cases, but the disease is probably under-diagnosed in these three countries. There are no published reports on human toxocariasis in Libya and Sudan during the period covered by the review. Animal studies confirm high infection rates of dogs with Toxocara canis in North Africa. There is also evidence of wide-spread contamination of soil and water with Toxocara spp. eggs. Moreover, the use of untreated wastewater for irrigation in parts of North Africa could be a source of contamination of agricultural products with eggs of Toxocara spp. Population-based studies on human toxocariasis are recommended, using standardized diagnostic tests. These surveys should also assess risk factors to guide preventive measures.
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Seroprevalence of human toxocarosis in Europe: A review and meta-analysis. ADVANCES IN PARASITOLOGY 2020; 109:375-418. [PMID: 32381208 DOI: 10.1016/bs.apar.2020.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Toxocarosis is distributed worldwide and represents the most prevalent zoonotic helminth infection in industrialized countries, thereby posing a substantial risk for public health. Thus, toxocarosis is one of CDC's Neglected Parasitic Infections that has been targeted for public health action. This systematic review and meta-analysis summarizes Toxocara seroprevalence in general populations from Europe, populations suspected of Toxocara infection and defined risk groups. Random-effects meta-analysis of proportions based on 41 publications resulted in an overall seroprevalence of 6.2% (95% CI: 4.7-8.3%) in the general population of Europe. Subgroup analysis according to decades (1970-2010s) revealed a significant increase in seroprevalence, with the highest value (12.4%; 95% CI: 6.5-22.3%) in the 2010s (χ2=17.87, df=4, P=0.001). There were no significant differences between pooled prevalence rates of European sub-regions (χ2=3.01, df=3, P=0.389). Furthermore, meta-analysis of seroprevalence according to age groups, based on data from 22 publications, indicated a significantly higher pooled seroprevalence of 14.9% (95% CI: 8.5-24.8%) in people more than 50 years of age than in younger age cohorts (χ2=8.33, df=2, P=0.016). Occupational groups exposed to contaminated soil and infected animals bear substantial risk for acquiring Toxocara infection. Due to the close link between animal infection and human Toxocara exposure, a "One Health" approach for the prevention of Toxocara infection in both humans and animals is required.
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Seroprevalence of Toxocara Canis in the city of Catania, Italy. Mediterr J Hematol Infect Dis 2019; 11:e2019031. [PMID: 31205635 PMCID: PMC6548209 DOI: 10.4084/mjhid.2019.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/13/2019] [Indexed: 11/08/2022] Open
Abstract
Toxocariasis is one of the most common helminthiases worldwide. However, there is a lack of data regarding Southern Italy. We have evaluated the seroprevalence and associated environmental factors of toxocariasis in a sample of adults living in the city of Catania. Presence of anti-Toxocara canis IgG antibodies was searched using an ELISA test using excretory/secretory antigens. Environmental risk factors have been evaluated with a face-to-face questionnaire. Two hundred eighty-seven subjects (193 [67.3%] women, mean age 48.1±15.6 years) were enrolled, and presence of anti T. canis antibodies was found in 23 participants, of whom 18 (78.3%) were women with a mean age of 51.1±14.0 years, giving a seroprevalence of 8.0% (95%CI 5.4–11.7). At multivariate analysis, a positive association for subjects with more than three siblings (adjOR 3.17; 95%CI 1.09–9.25) was recorded. Our study confirms that exposition to T. canis is frequent also in urban areas of western countries.
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12
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Fialho PMM, Correa CRS, Lescano SZ. Asthma and Seroconversion from Toxocara spp. Infection: Which Comes First? BIOMED RESEARCH INTERNATIONAL 2018; 2018:4280792. [PMID: 29888264 PMCID: PMC5977020 DOI: 10.1155/2018/4280792] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/09/2018] [Accepted: 04/08/2018] [Indexed: 01/15/2023]
Abstract
The aim of this study was to estimate the incidence of seroconversion of Toxocara spp. infection and related variables. We conducted a cohort study of 77 children aged 2-12 years who had negative serology in a previous cross-sectional study. Univariate and bivariate analyses were performed to describe the cohort, using socioeconomic, behavioral, and health conditions as variables. Logistic regression analysis was performed using seroconversion as the dependent variable, and the remaining variables are treated as independent variables. Asthma was the only independent variable that showed an association with seroconversion, with an odds ratio = 3.57 (1.01-12.6). The incidence of seroconversion from Toxocara spp. infection in the children followed was 10.4 per 100 per year. Previous studies reporting an association of asthma with toxocariasis have only been carried out using cross-sectional studies. Therefore, this study is one of only a few describing the incidence of seroconversion from Toxocara spp. infection, which is relevant for understanding the burden of this parasite.
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Affiliation(s)
| | | | - Susana Zevallos Lescano
- Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Imunopatologia da Esquistossomose (LIM 06), São Paulo, SP, Brazil
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Sánchez SS, García HH, Nicoletti A. Clinical and Magnetic Resonance Imaging Findings of Neurotoxocariasis. Front Neurol 2018; 9:53. [PMID: 29472889 PMCID: PMC5809457 DOI: 10.3389/fneur.2018.00053] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/19/2018] [Indexed: 01/08/2023] Open
Abstract
Human toxocariasis is one of the most prevalent helminthiases worldwide. Toxocara canis larvae can cross the blood-brain barrier leading to the neurotoxocariasis. The clinical presentation consists of a wide spectrum of neurological manifestations, but asymptomatic infection is probably common. Neurotoxocariasis is not a frequent diagnosis probably due to the non-specific nature of its symptoms as well as the lack of confirmatory diagnostic tests. Diagnosis of neurotoxocariasis is based on the presence of a high titer of anti-Toxocara antibody in the cerebrospinal fluid or in the serum, presence of eosinophilia in the serum or cerebrospinal fluid, and clinical and radiological improvement after anthelmintic therapy; however, universally accepted diagnostic criteria are lacking. Magnetic resonance imaging (MRI) findings include single or multiple, subcortical, cortical or white matter hyperintense lesions, best visualized on FLAIR and T2-weighted imaging, and usually isointense or hypointense on T1. These imaging findings are suggestive but not specific to neurotoxocariasis. Definitive diagnosis is made by histological confirmation, but it is rarely followed. This review provides an overview of the clinical manifestations, management options, and MRI findings of neurotoxocariasis.
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Affiliation(s)
- Sofia S Sánchez
- Department of Microbiology, School of Public Health (SSS), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Sciences (HHG), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hector H García
- Department of Microbiology, School of Public Health (SSS), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru.,School of Sciences (HHG), Center for Global Health - Tumbes (HHG), Universidad Peruana Cayetano Heredia, Lima, Peru.,Cysticercosis Unit, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Alessandra Nicoletti
- Department G. F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
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Rudzińska M, Kowalewska B, Sikorska K. Clinical usefulness of Western blotting and ELISA avidity for the diagnosis of human toxocariasis. Parasite Immunol 2017; 39. [PMID: 27809350 DOI: 10.1111/pim.12400] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/25/2016] [Indexed: 11/30/2022]
Abstract
The serodiagnosis of human toxocariasis is difficult. Specific IgGs detected routinely with ELISA based on Toxocara excretory-secretory (TES) antigens often persist for years at an elevated level, which does not allow either the differentiation between an active and persistent infection or monitoring of the effect of treatment. Additionally, false-positive results may occur in co-infections with other helminths due to cross-reactions. We evaluated the usefulness of an IgG avidity index (AI) and a Western blotting (WB) IgG in the diagnosis of patients suspected of Toxocara infection. We studied 138 subjects who were submitted to serological testing two or more times. Confirmation of an infection by WB was achieved in 73.2% of patients. A high AI was obtained in 89.1% of patients, and low AI and borderline AI were found in only 10.9%. Low and borderline values of AI remained at similar levels in subsequent studies over 2-3 years. The results showed the necessity of obligatory verification of all ELISA IgG positive and questionable results by WB. The index of IgG avidity may be helpful in excluding recent infection, but its usefulness in detecting an active phase of invasion requires further research.
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Affiliation(s)
- M Rudzińska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, Gdańsk, Poland
| | - B Kowalewska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, Gdańsk, Poland
| | - K Sikorska
- Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, Gdańsk, Poland
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15
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De Brito T, Chieffi P, Peres B, Santos R, Gayotto L, Regina Vianna M, Porta G, Alves V. Immunohistochemical Detection of Toxocaral Antigens in Human Liver Biopsies. Int J Surg Pathol 2016. [DOI: 10.1177/106689699400200206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The distribution of Toxocara species larval antigens in tissue was studied by immunohis tochemical techniques in five human cases of toxocariasis. Patients had a clinical his tory suggestive of the infection, a positive enzyme-linked immunosorbent assay test for toxocaral antibodies, and histopathologic patterns of toxocariasis. Liver biopsies were taken from all five patients, usually under suspicion of liver abscess or of meta static or primary liver neoplasia. In one case a segment of the right colon adjacent to the liver lesions was also examined. Immunohistochemical techniques using polyclonal antiserum raised in rabbits against excretory secretory (TES) antigens of Toxocara canis larvae detected antigen deposits phagocyte ed by macrophages at the periphery of eosinophil-rich granulomas, in the portal inflammatory infiltrate, between epithelioid cells close to the areas of necrosis, and sequestered in the collagen of the periportal region. Both nonabsorbed and Strongyloides venezuelensis and Ascaris suum absorbed sera essentially detected similar antigenic sites, but these sites were more frequently observed and more evident when the former was used. The importance of antigen detection for the etiologic diagnosis of eosinophilic granulomatous inflammation and eosinophil-rich inflammatory infiltrates is stressed. Int J Surg Pathol 2(2):117-124, 1994
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Affiliation(s)
- T. De Brito
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - P.P. Chieffi
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - B.A. Peres
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - R.T. Santos
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - L.C.C. Gayotto
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - M. Regina Vianna
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - G. Porta
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
| | - V.A.F. Alves
- Department of Pathology, Institute of Tropical Medicine and Pediatric Clinic, Hospital das Clinicas, University of São Paulo Medical School; and Instituto Adolfo Lutz, São Paulo Health Service, São Paulo, Brazil
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Larva migrans syndrome caused by Toxocara and Ascaris roundworm infections in Japanese patients. Eur J Clin Microbiol Infect Dis 2016; 35:1521-9. [PMID: 27272122 PMCID: PMC4982883 DOI: 10.1007/s10096-016-2693-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/20/2016] [Indexed: 01/21/2023]
Abstract
Larva migrans syndrome (LMS) caused by Toxocara and Ascaris roundworms is generally believed to be more common in children, while a report from Japan suggests that it is more common in adults. We conducted a large-scale retrospective study to confirm these findings and to clarify what caused the difference between Japan and other countries, to reveal overlooked aspects of this disease. The clinical information of 911 cases which we diagnosed as Toxocara or Ascaris LMS during 2001 and 2015 was analysed. Information used included age, sex, address (city or county), chief complaint, present history, dietary history, overseas travelling history, medical imaging findings and laboratory data (white blood cell count, peripheral blood eosinophil number and total IgE). The sex ratio of the disease was 2.37 (male/female = 641/270). The number of patients not younger than 20 years old were 97.8 and 95.1 % among males and females, respectively. Major disease types were visceral, ocular, neural and asymptomatic. The visceral type was more prevalent in older patients, while younger patients were more vulnerable to ocular symptoms. More than two-thirds of the patients whose dietary habits were recorded had a history of ingesting raw or undercooked animal meat. LMS caused by Toxocara or Ascaris is primarily a disease of adult males in Japan, who probably acquired infections by eating raw or undercooked animal meat/liver. Healthcare specialists should draw public attention to the risk of raw or undercooked animal meat in Europe as well.
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Toxocariasis-associated cardiac diseases--A systematic review of the literature. Acta Trop 2016; 154:107-20. [PMID: 26571071 DOI: 10.1016/j.actatropica.2015.11.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/05/2015] [Accepted: 11/07/2015] [Indexed: 11/23/2022]
Abstract
Toxocariasis, caused by Toxocara canis or Toxocara catis, is a worldwide occurring parasitic disease, reaching high prevalences especially in tropical and subtropical countries. The clinical presentation can range from asymptomatic seropositivity to life threatenting disease, depending on the organ system involved. Cardiac involvement, one of the possible manifestations of human Toxocara spp. infection, is rarely reported in case reports. As far as we know, no systematic reviews of clinical presentations have been published till now and no clear recommendations regarding the treatment of Toxocara spp. infection involving the heart exist. In a systematic review of the literature, 24 published cases of Toxocara spp. infection involving the heart were identified. The cardiac entities described included myocarditis, pericarditis, and Loeffler's endocarditis. The clinical presentation ranged from asymptomatic or mild disease to life threatening myocarditis/pericarditis with heart failure or cardiac tamponade, leading to death. In most cases, the diagnosis was based on a combination of clinical, laboratory and radiological findings. Only in three of the nine cases in which histological analysis was performed (either pre- or post-mortem), granulomas or remnants of the parasite were detected. In the other six cases, findings were non-specific; the damage of the heart was equally caused by direct invasion of the larvae and by immunological reactions, either caused by the systemic hypereosinophilia or by the presence of the larvae in the tissue. The treatment regimen described mostly consisted of anthelmintic drugs in combination with corticosteroids. Even though dosage and duration of treatment varied widely, ranging from days to months, most patients were treated successfully. Cardiac involvement in Toxocara spp. infection is a rare but potentially life-threatening complication of a very common disease. The therapeutic regimens vary widely especially with regard to the duration of therapy, however, the combination of an anthelmintic drug and a corticosteroid appears to be a valuable option. For the daily clinical work, tissue manifestation by parasites should be considered in cases of unspecific organ manifestations, (i.e. heart, lungs, liver), accompanied by fever and eosinophilia with or without allergic skin rashes.
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Abstract
SUMMARYToxocara species infect a wide range of companion, domestic and wild animals as definitive and paratenic hosts, via multiple routes of transmission, producing long-lived tissue-inhabiting larvae and resistant eggs that can survive in the external environment. Therefore Toxocara and the disease it causes in humans, toxocariasis, represents an ideal aetiological agent for the development of the one health approach. However, despite increasing awareness of the public health significance of toxocariasis, gaps in our understanding of certain key aspects of the parasite's biology and epidemiology remain. These gaps hinder our ability to integrate research effort within the veterinary, medical and environmental disciplines. This review will highlight key deficits in our understanding of nine dimensions of Toxocara epidemiology and discuss a potential scenario to develop a more integrated, one health approach to improve our understanding of the prevention and control of this complex and cryptic zoonosis.
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Abstract
Toxocara canis and T. cati are highly prevalent nematode infections of the intestines of dogs and cats. In paratenic hosts, larvae do not mature in the intestine but instead migrate through the somatic tissues and organs of the body. The presence of these migrating larvae can contribute to pathology. Toxocara larvae can invade the brains of humans, and while case descriptions of cerebral toxocariasis are historically rare, improved diagnosis and greater awareness have contributed to increased detection. Despite this, cerebral or neurological toxocariasis (NT) remains a poorly understood phenomenon. Furthermore, our understanding of cognitive deficits due to toxocariasis in human populations remains particularly deficient. Recent data describe an enhanced expression of biomarkers associated with brain injury, such as GFAP, AβPP, transforming growth factor β1 (TGF-β1), NF-L, S100B, tTG, and p-tau, in mice receiving even low doses of Toxocara ova. Finally, this review outlines a hypothesis to explore the relationship between the presence of T. canis larvae in the brain and the progression of Alzheimer's disease (AD) due to enhanced AD-associated neurodegenerative biomarker expression.
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Cong W, Meng QF, You HL, Zhou N, Dong XY, Dong W, Wang XY, Qian AD, Zhu XQ. Seroprevalence and risk factors of Toxocara infection among children in Shandong and Jilin provinces, China. Acta Trop 2015; 152:215-219. [PMID: 26384456 DOI: 10.1016/j.actatropica.2015.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/05/2015] [Accepted: 09/12/2015] [Indexed: 11/18/2022]
Abstract
This cross-sectional study was aimed to investigate the Toxocara serology in children in Shandong and Jilin provinces, China using an enzyme-linked immunosorbent assay (ELISA). The overall Toxocara seroprevalence among the study population (n=1458) was 19.3%, sick children (26.4%) had significantly higher seroprevalence than clinically healthy children (14.4%) (P<0.05), and the highest Toxocara seroprevalence was found in children suffering from chronic cough (40.6%), followed by recurrent abdominal pain (40.0%), recurrent headache (38.1%), slight fever (36.2%), and recurrent vomiting (31.6%). Place of residence, education level, type of school, keeping dogs at home, contact with dogs and cats and exposure with soil were found to be associated with Toxocara infection. Our findings show that children infection with Toxocara is common in Shandong and Jilin provinces, eastern and northeastern China, indicating an immediate need for implementing strategies and measures to prevent and control Toxocara infection in children in China.
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Affiliation(s)
- Wei Cong
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China
| | - Qing-Feng Meng
- Jilin Entry-Exit Inspection and Quarantine Bureau, Changchun, Jilin Province 130000, PR China
| | - Hai-Long You
- The First Affilliated Hospital of Jilin University, Changchun, Jilin Province 130000, PR China
| | - Na Zhou
- Affilliated Hospital of Medical College, Qingdao University, Qingdao, Shandong Province 266000, PR China
| | - Xiao-Yan Dong
- Wendeng Stomatological Hospital, Weihai, Shandong Province 264400, PR China
| | - Wei Dong
- Weihaiwei People's Hospital, Weihai, Shandong Province 264200, PR China
| | - Xiang-Yang Wang
- Wendeng Municipal Hospital, Weihai, Shandong Province 264400, PR China
| | - Ai-Dong Qian
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China.
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Roldán W, Elefant GR, Ferreira AW. Deglycosylation ofToxocaraexcretory-secretory antigens improves the specificity of the serodiagnosis for human toxocariasis. Parasite Immunol 2015; 37:557-67. [DOI: 10.1111/pim.12248] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 08/21/2015] [Indexed: 11/26/2022]
Affiliation(s)
- W.H. Roldán
- Laboratório de Soroepidemiologia e Imunobiologia; Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo SP Brazil
- Programa de Pós-graduação em Doenças Infecciosas e Parasitárias; Faculdade de Medicina; Universidade de São Paulo; São Paulo SP Brazil
- Departamento de Microbiologia Médica; Facultad de Medicina; Universidad Nacional Mayor de San Marcos; Lima Peru
| | - G. R. Elefant
- Laboratório de Soroepidemiologia e Imunobiologia; Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo SP Brazil
| | - A. W. Ferreira
- Laboratório de Soroepidemiologia e Imunobiologia; Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo SP Brazil
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Toxocariasis diagnosed in international travelers at the Institute of Tropical Medicine, Antwerp, Belgium, from 2000 to 2013. PLoS Negl Trop Dis 2015; 9:e0003559. [PMID: 25746418 PMCID: PMC4351981 DOI: 10.1371/journal.pntd.0003559] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 01/22/2015] [Indexed: 11/19/2022] Open
Abstract
Although infection with Toxocara canis or T. catis (commonly referred as toxocariasis) appears to be highly prevalent in (sub)tropical countries, information on its frequency and presentation in returning travelers and migrants is scarce. In this study, we reviewed all cases of asymptomatic and symptomatic toxocariasis diagnosed during post-travel consultations at the reference travel clinic of the Institute of Tropical Medicine, Antwerp, Belgium. Toxocariasis was considered as highly probable if serum Toxocara-antibodies were detected in combination with symptoms of visceral larva migrans if present, elevated eosinophil count in blood or other relevant fluid and reasonable exclusion of alternative diagnosis, or definitive in case of documented seroconversion. From 2000 to 2013, 190 travelers showed Toxocara-antibodies, of a total of 3436 for whom the test was requested (5.5%). Toxocariasis was diagnosed in 28 cases (23 symptomatic and 5 asymptomatic) including 21 highly probable and 7 definitive. All but one patients were adults. Africa and Asia were the place of acquisition for 10 and 9 cases, respectively. Twelve patients (43%) were short-term travelers (< 1 month). Symptoms, when present, developed during travel or within 8 weeks maximum after return, and included abdominal complaints (11/23 symptomatic patients, 48%), respiratory symptoms and skin abnormalities (10 each, 43%) and fever (9, 39%), often in combination. Two patients were diagnosed with transverse myelitis. At presentation, the median blood eosinophil count was 1720/μL [range: 510-14160] in the 21 symptomatic cases without neurological complication and 2080/μL [range: 1100-2970] in the 5 asymptomatic individuals. All patients recovered either spontaneously or with an anti-helminthic treatment (mostly a 5-day course of albendazole), except both neurological cases who kept sequelae despite repeated treatments and prolonged corticotherapy. Toxocariasis has to be considered in travelers returning from a (sub)tropical stay with varying clinical manifestations or eosinophilia. Prognosis appears favorable with adequate treatment except in case of neurological involvement.
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Auer H, Aspöck H. Helminths and helminthoses in Central Europe: diseases caused by nematodes (roundworms). Wien Med Wochenschr 2014; 164:424-34. [DOI: 10.1007/s10354-014-0317-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 11/28/2022]
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Cassenote AJF, de Abreu Lima AR, Pinto Neto JM, Rubinsky-Elefant G. Seroprevalence and modifiable risk factors for Toxocara spp. in Brazilian schoolchildren. PLoS Negl Trop Dis 2014; 8:e2830. [PMID: 24874504 PMCID: PMC4038482 DOI: 10.1371/journal.pntd.0002830] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 03/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Toxocariasis is a worldwide helminthic zoonosis caused by infection with the larvae of the ascarid worms that comprise the Toxocara spp. Children are particularly prone to infection because they are exposed to the eggs in sandboxes and playgrounds contaminated with dog and cat feces. Certain behaviors, such as a geophagy habit, poor personal hygiene, a lack of parental supervision, close contact with young dogs, and ingestion of raw meat, as well as gender, age, and socioeconomic status, affect the prevalence of the disease. However, previous studies of the risk factors for toxocariasis have generally produced inconsistent results. An epidemiological cross-sectional study was conducted to evaluate the seroprevalence of IgG anti-Toxocara spp. antibodies and associated factors in schoolchildren from a region in the southeast of Brazil. METHODOLOGY/PRINCIPAL FINDINGS A total of 252 schoolchildren aged 1 to 12 years (120 males and 132 females) were assessed. An enzyme-linked immunosorbent assay based on Toxocara canis larval excretory-secretory antigens was used to determine outcomes. A questionnaire was used to collect information on children, family, and home characteristics. Clinical and laboratory data completed the dataset investigated in this study. Seroprevalence was 15.5% (95%CI 11.5-19.8). Geophagy (aPR 2.38 [95%CI 1.36-4.18], p-value 0.029) and the habit of hand washing before meals (aPR 0.04 [95%CI 0.01-0.11], p-value ≤ 0.001) were factors associated with increased and decreased seroprevalence, respectively. The income factor and its related variables lost statistical significance after adjustment with a multiple Poisson regression model. CONCLUSIONS/SIGNIFICANCE The current study confirms that toxocariasis is a public health problem in the evaluated area; modifiable factors such as soil contact and personal hygiene appear to have a greater influence on the acquisition of infection than sociodemographic attributes, thus representing direct targets for disease prevention and control.
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Affiliation(s)
- Alex J. F. Cassenote
- Postgraduate Program in Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, Cerqueira César, São Paulo, Brazil
| | - Alba R. de Abreu Lima
- Faculty of Medicine of São José do Rio Preto, Department of Molecular Biology, Vila São José, São José do Rio Preto, Brazil
| | - José M. Pinto Neto
- Faculty of Health Sciences, University Camilo Castelo Branco, São Paulo, Brazil
| | - Guita Rubinsky-Elefant
- Institute of Tropical Medicine of São Paulo, University of São Paulo, Cerqueira César, São Paulo, Brazil
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McGuinness SL, Leder K. Global Burden of Toxocariasis: A Common Neglected Infection of Poverty. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-013-0012-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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The epidemiology and public health importance of toxocariasis: A zoonosis of global importance. Int J Parasitol 2013; 43:999-1008. [DOI: 10.1016/j.ijpara.2013.07.004] [Citation(s) in RCA: 264] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 07/16/2013] [Accepted: 07/18/2013] [Indexed: 11/21/2022]
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Rubinsky-Elefant G, Hirata CE, Yamamoto JH, Ferreira MU. Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2013; 104:3-23. [DOI: 10.1179/136485910x12607012373957] [Citation(s) in RCA: 258] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Fan CK, Liao CW, Cheng YC. Factors affecting disease manifestation of toxocarosis in humans: Genetics and environment. Vet Parasitol 2013; 193:342-52. [DOI: 10.1016/j.vetpar.2012.12.030] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Noh Y, Hong ST, Yun JY, Park HK, Oh JH, Kim YE, Jeon BS. Meningitis by Toxocara canis after ingestion of raw ostrich liver. J Korean Med Sci 2012; 27:1105-8. [PMID: 22969260 PMCID: PMC3429831 DOI: 10.3346/jkms.2012.27.9.1105] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 05/25/2012] [Indexed: 01/22/2023] Open
Abstract
Recently reports on toxocariasis are increasing by serodiagnosis in Korea. A previously healthy 17-yr-old boy complained of headache, fever, dyspnea, and anorexia. He showed symptoms and signs of eosinophilic meningitis with involvement of the lungs and liver. Specific IgG antibody to Toxocara canis larval antigen was positive in serum and cerebrospinal fluid by ELISA. He took raw ostrich liver with his parents 4 weeks before the symptom onset. His parents were seropositive for T. canis antigen but had no symptoms or signs suggesting toxocariasis. This is the first report of toxocariasis in a family due to ingestion of raw ostrich liver in Korea.
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Affiliation(s)
- Young Noh
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Sung-Tae Hong
- Department of Parasitology and Tropical Medicine, Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Medical Center, Seoul, Korea
| | - Hong-Kyun Park
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Hwan Oh
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Eun Kim
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Beom S. Jeon
- Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Traversa D. Pet roundworms and hookworms: a continuing need for global worming. Parasit Vectors 2012; 5:91. [PMID: 22574783 PMCID: PMC3418564 DOI: 10.1186/1756-3305-5-91] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 04/22/2012] [Indexed: 11/10/2022] Open
Abstract
Ascarids and ancylostomatids are the most important parasites affecting dogs and cats worldwide, in terms of diffusion and risk for animal and human health. Different misconceptions have led the general public and pet owners to minimize the importance of these intestinal worms. A low grade of interest is also registered among veterinary professions, although there is a significant merit in keeping our guard up against these parasites. This article reviews current knowledge of ascarids and ancylostomatids, with a special focus on pathogenicity, epidemiology and control methods in veterinary and human medicine.
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Affiliation(s)
- Donato Traversa
- Department of Comparative Biomedical Sciences, University of Teramo, Teramo, Italy.
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Dattoli VCC, Freire SM, Mendonça LR, Santos PC, Meyer R, Alcantara-Neves NM. Toxocara canis infection is associated with eosinophilia and total IgE in blood donors from a large Brazilian centre. Trop Med Int Health 2011; 16:514-7. [DOI: 10.1111/j.1365-3156.2010.02719.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Roldán WH, Cavero YA, Espinoza YA, Jiménez S, Gutiérrez CA. Human toxocariasis: a seroepidemiological survey in the Amazonian city of Yurimaguas, Peru. Rev Inst Med Trop Sao Paulo 2010; 52:37-42. [PMID: 20305953 DOI: 10.1590/s0036-46652010000100006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Accepted: 11/30/2009] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to determine the seroprevalence of the infection by Toxocara in the general population of the Amazonian city of Yurimaguas, Peru. From March to August 2008, a total of 300 subjects were sampled and tested by means of a Toxocara ELISA-IgG test. A clinical and epidemiological questionnaire was used to assess the symptomatology and risk factors associated with human toxocariasis. The overall rate of seropositivity was 35.66%, with a significant high proportion in children (p < 0.001). The clinical evaluation revealed that 95.33% of the seropositive group had some type of symptomatology: headache (66.36%), respiratory compromise (63.55%), abdominal pain (54.21%), cutaneous signs (40.19%) and ocular manifestations (36.45%), and almost all of them were statistically significant (p < 0.001). Furthermore, 56.07% of the seropositive subjects presented at least one intestinal pathogen parasite with predominance of helminthes, but without significant association (p = 0.334). The analysis of risk factors showed only that the use of public places and geophagia exhibited a significant association with the seropositivity (p < 0.001). Clinical, serological and epidemiological findings associated to infection with Toxocara were observed in the present study and future studies should be done to assess this serious health problem.
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Affiliation(s)
- William H Roldán
- Departamento de Microbiología Médica, Universidad Nacional Mayor de San Marcos, Perú.
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Frassy LN, Braga FR, Silva ARE, Araújo JVD, Ferreira SR, Freitas LGD. Destruição de ovos de Toxocara canis pelo fungo nematófago Pochonia chlamydosporia. Rev Soc Bras Med Trop 2010; 43:102-4. [DOI: 10.1590/s0037-86822010000100024] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 12/10/2009] [Indexed: 05/26/2023] Open
Abstract
INTRODUÇÃO: Toxocara canis é um ascarídeo parasita do intestino delgado de cães, causador da larva migrans visceral em seres humanos. MÉTODOS: Com o objetivo de demonstrar a eficácia do fungo Pochonia chlamydosporia sobre ovos de Toxocara canis em condições laboratoriais, foi montado ensaio experimental em placas de Petri com ágar-água 2%. RESULTADOS: Houve atividade ovicida de 43,8% (p<0,01) do grupo tratado em relação ao grupo controle durante os intervalos estudados. CONCLUSÕES: Os resultados demonstrados no presente trabalho sugerem a empregabilidade de Pochonia chlamydosporia como uma alternativa de controle biológico dos ovos embrionados de Toxocara canis.
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Zanandréa LIDC, Oliveira GM, Abreu AS, Pereira FEL. Ocular lesions in gerbils (Meriones unguiculatus) infected with low larval burden of Toxocara canis: observations using indirect binocular ophthalmoscopy. Rev Soc Bras Med Trop 2009; 41:570-4. [PMID: 19142434 DOI: 10.1590/s0037-86822008000600005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2007] [Accepted: 10/09/2008] [Indexed: 11/21/2022] Open
Abstract
To study the frequency of ocular lesions in 30 gerbils infected with 100 embryonated eggs of Toxocara canis, indirect binocular ophthalmoscopy was performed 3, 10, 17, 24, 31 and 38 days after infection. All the animals presented larvae in the tissues and 80% presented ocular lesions. Hemorrhagic foci in the choroid and retina were present in 92% of the animals with ocular lesions. Retinal exudative lesions, vitreous lesions, vasculitis and retinal detachment were less frequent. Mobile larvae or larval tracks were observed in four (13.3%) animals. Histological examination confirmed the ophthalmoscopic observations, showing that the lesions were focal and sparse. In one animal, there was a larva in the retina, without inflammatory reaction around it. The results demonstrated that gerbils presented frequent ocular lesions after infection with Toxocara canis, even when infected with a small number of embryonated eggs. The lesions observed were focal, consisting mainly of hemorrhages with signs of reabsorption or inflammation in different segments of eye, and differing from the granulomatous lesions described in ocular larva migrans in humans.
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Roldán WH, Espinoza YA, Atúncar A, Ortega E, Martinez A, Saravia M. Frequency of eosinophilia and risk factors and their association with Toxocara infection in schoolchildren during a health survey in the north of Lima, Peru. Rev Inst Med Trop Sao Paulo 2009; 50:273-8. [PMID: 18949344 DOI: 10.1590/s0036-46652008000500005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2008] [Accepted: 09/02/2008] [Indexed: 11/21/2022] Open
Abstract
During a health survey in a primary school from the district of Carabayllo (North of Lima, Peru), 200 schoolchildren (96 male and 104 female between five to 12 years old) were randomly selected and divided in two groups (as positive or negative group), according to the serologic result of the Toxocara ELISA test from a total population of 646 schoolchildren. All children were analyzed by hematologic tests to determinate the frequency of eosinophilia and leukocytosis. Additionally, all clinical and epidemiological data were also analyzed to determine their association with toxocariasis. From group of children with positive serology, 40% had some type of eosinophilia in contrast to 19% of children with negative serology, and their association was statistically significant (OR = 2.84, p < 0.001). From all signs and symptoms evaluated, only 'dry cough' was more frequent and statistically significant in the positive serology group (OR = 2.79, p < 0.001). Almost all risk factors evaluated were highly frequent and statistically associated to the positive serology. In conclusion, the presence of eosinophilia and the risk factors evaluated in this population were frequently associated to human toxocariasis.
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Affiliation(s)
- William H Roldán
- Sección de Parasitología, Instituto de Medicina Tropical Daniel A Carrión, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Callao, Perú.
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Smith H, Holland C, Taylor M, Magnaval JF, Schantz P, Maizels R. How common is human toxocariasis? Towards standardizing our knowledge. Trends Parasitol 2009; 25:182-8. [PMID: 19269251 DOI: 10.1016/j.pt.2009.01.006] [Citation(s) in RCA: 201] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 01/23/2009] [Accepted: 01/23/2009] [Indexed: 11/18/2022]
Abstract
Our understanding of the global impact and cost of human toxocariasis is poor because there is insufficient clinical awareness and no clear repository for the efficacy of clinical, laboratory and treatment interventions. Uniform clinical and laboratory investigative approaches maximize disease diagnosis. International collaboration is required to develop web-based, professional educational support, surveillance questionnaires and standardized serodiagnostic criteria. Determining clinical benefits and treatment outcomes using less crossreactive antigens will enhance clinical and treatment interventions. Increased liaison will identify realistic occurrence and prevalence data and cost benefits of intervention. Web-based centres of excellence and repositories of current knowledge, which augment current veterinary and public health educational sites, should be supported. Expected outcomes should be capable of addressing the clinical and financial burdens of this treatable disease.
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Affiliation(s)
- Huw Smith
- Scottish Parasite Diagnostic Laboratory, Stobhill Hospital, Glasgow G21 3UW, UK.
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Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol 2008; 59:1031-42. [DOI: 10.1016/j.jaad.2008.06.031] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Revised: 06/15/2008] [Accepted: 06/24/2008] [Indexed: 11/22/2022]
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41
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Finsterer J, Auer H. Neurotoxocarosis. Rev Inst Med Trop Sao Paulo 2008; 49:279-87. [PMID: 18026633 DOI: 10.1590/s0036-46652007000500002] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Accepted: 04/16/2006] [Indexed: 11/22/2022] Open
Abstract
Infection of humans with embryonated eggs of Toxocara canis (larva migrans) remains asymptomatic, or results in covert or common toxocarosis, visceral larva migrans syndrome, or ophthalmologic and neurologic impairment. Though neurological manifestations of Toxocara canis larvae are rare, toxocarosis remains an important differential diagnosis of various neurological disorders. Manifestations of the central nervous system are dementia, meningo-encephalitis, myelitis, cerebral vasculitis, epilepsy, or optic neuritis. Manifestations of the peripheral nervous system comprise radiculitis, affection of cranial nerves, or musculo-skeletal involvement. If toxocarosis is neglected, ignored, or refused as a differential of these abnormalities, it may be easily overlooked for years. Early recognition and treatment of the infection is, however, of paramount importance since it reduces morbidity and mortality and the risk of secondary superinfection. Like the visceral manifestations, neurological manifestations of toxocarosis are treated by benzimidazole components, most frequently albendazole, corticosteroids, or diethylcarbamazine. If detected and treated early, the prognosis of neurological manifestations of toxocarosis is favourable.
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Elefant GR, Shimizu SH, Sanchez MCA, Jacob CMA, Ferreira AW. A serological follow-up of toxocariasis patients after chemotherapy based on the detection of IgG, IgA, and IgE antibodies by enzyme-linked immunosorbent assay. J Clin Lab Anal 2006; 20:164-72. [PMID: 16874812 PMCID: PMC6807646 DOI: 10.1002/jcla.20126] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A serological follow-up study was carried out on 27 children (1-12 years old) with visceral and/or ocular toxocariasis, after treatment with thiabendazole. A total of 159 serum samples were collected in a period ranging from 22-116 months. Enzyme-linked immunosorbent assays (IgG, IgA, and IgE ELISA) were standardized, using excretory-secretory antigens obtained from the second-stage larvae of a Toxocara canis culture. The sensitivity found for the IgG, IgA, and IgE ELISA, as determined in visceral toxocariasis patients, was 100%, 47.8%, and 78.3%, respectively. Approximately 84% of the patients presented single or multiple parasitosis, as diagnosed by stool examination, yet such variables did not appear to affect the anti-Toxocara immune response. Titers of specific IgE antibody showed a significant decrease during the first year after treatment, followed by a decrease in the IgA titers in the second year, and in the IgG titers from the fourth year onwards. Sera from all patients presented high avidity IgG antibodies, indicating that they were in the chronic phase of the disease. Moreover, 1 year after treatment, the level of leukocytes, eosinophils, and anti-A isohemagglutinin in patients decreased significantly. The present data suggest that IgE antibodies plus eosinophil counts are helpful parameters for patient follow-up after chemotherapy.
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Affiliation(s)
- Guita Rubinsky Elefant
- Laboratório de Soroepidemiologia e Imunobiologia-Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.
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Wedrychowicz A, Goździk J, Krasowska-Kwiecień A, Kacińka E, Wiecha O, Kubiczek K, Ratajczak MZ. Manifestation of toxocariasis in children with neuroblastoma treated with autologous hematopoietic transplants. Pediatr Hematol Oncol 2006; 23:369-79. [PMID: 16728357 DOI: 10.1080/08880010600646738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Toxocariasis was diagnosed in 3 out of 22 children (14%) treated in our center with high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HSCT). The patients were coming from rural areas in the southeastern Poland and did not present any clinical symptoms of toxocariasis upon admission to the hospital. Although no neurological and ophthalmological abnormalities were noticed, the atypical form of toxacariasis was diagnosed based on elevated eosinophils counts, positive serological tests, and biochemical symptoms of liver damage. The authors conclude that toxocariasis should be taken into consideration in the differential diagnosis of eosinophilia in children undergoing high-dose chemotherapy and HSCT, especially if they are coming from rural areas.
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Affiliation(s)
- Anna Wedrychowicz
- Transplantation Centre, Department of Transplantation, University Children's Hospital, Polish-American Children's Hospital, Jagiellonian University, Cracow, Poland.
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Hamilton CM, Stafford P, Pinelli E, Holland CV. A murine model for cerebral toxocariasis: characterization of host susceptibility and behaviour. Parasitology 2006; 132:791-801. [PMID: 16476184 DOI: 10.1017/s0031182006009887] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 09/04/2005] [Accepted: 12/19/2005] [Indexed: 11/06/2022]
Abstract
Toxocara canis, the parasitic roundworm of dogs, can infect a number of paratenic hosts, such as mice and humans, due to the widespread dissemination of its ova in the environment. In these paratenic hosts, larvae have been shown to exhibit a predilection for the central nervous system, resulting in an increasing number of parasites migrating to the brain as infection progresses. In an initial experiment, we investigated the differential brain involvement of T. canis in 7 strains of inbred mice, and chose 2 strains, susceptible (BALB/c) and resistant (NIH) to cerebral infection. In a second experiment, both strains were investigated in terms of course of migration, larval accumulation, and behavioural response to T. canis infection. Results revealed that infected BALB/c mice took significantly longer to drink from a water source (following a period of deprivation), compared with control mice, indicating some degree of memory impairment. Cerebral larval recoveries from both strains of mice demonstrated variation between the two experiments, suggesting that larval burdens may not be a reliable indicator of susceptibility or resistance to T. canis infection. The percentage of total recovered larvae in each organ may be a better representation of larval distribution. Our model system may provide insights into the impact of chronic geohelminth infection on cognitive development.
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Affiliation(s)
- C M Hamilton
- Parasitology Research Group, School of Natural Sciences, Department of Zoology, University of Dublin, Trinity College, Dublin 2, Ireland
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Auer H, Aspöck H. Die Diagnostik der Toxocara-Infestationen und der Toxokarose des Menschen The diagnosis of Toxocara infestations and of human toxocarosis. ACTA ACUST UNITED AC 2006. [DOI: 10.1515/jlm.2006.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Deutz A, Fuchs K, Auer H, Kerbl U, Aspöck H, Köfer J. Toxocara-infestations in Austria: a study on the risk of infection of farmers, slaughterhouse staff, hunters and veterinarians. Parasitol Res 2005; 97:390-4. [PMID: 16151740 DOI: 10.1007/s00436-005-1469-5] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2005] [Accepted: 07/01/2005] [Indexed: 11/28/2022]
Abstract
A total of 585 persons from several occupational groups (farmers, slaughterhouse staff, hunters, veterinarians) exposed to Toxocara infestations and 50 persons of a control group were tested for the presence of specific antibodies to the Toxocara canis antigen using an enzyme-linked immunosorbent assay and a western blot. Farmers showed the highest seroprevalence (44%), followed by veterinarians (27%), slaughterhouse staff (25%) and hunters (17%), whereas only 2% of the individuals of the control group were seropositive. Thus, the risk to Toxocara infestation is 39, 18, 16 and 9 times higher for farmers, veterinarians, slaughterhouse staff (some workers were part-time farmers) and for hunters, respectively, when compared to the control group. The main source of infection in rural areas seems to be (roaming) farm cats and dogs that have not been dewormed. The results are discussed with a view to potential risk factors and preventive measures, in terms of veterinary and human medicine.
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Affiliation(s)
- Armin Deutz
- Animal Health Service, Department of Veterinary Administration, Styrian Provincial Government, Graz, Austria
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Lescano SAZ, Chieffi PP, Ikai DK, Ribeiro MCSA. Efeitos da ciclosporina A e betametasona na toxocaríase murina experimental. Rev Soc Bras Med Trop 2004; 37:22-4. [PMID: 15042177 DOI: 10.1590/s0037-86822004000100006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Estudou-se o efeito de ciclosporina A ou betametasona em camundongos experimentalmente infectados por larvas de Toxocara canis administrados 15 dias antes ou 45 dias após infecção por esse ascarídeo. Nos animais infectados determinou-se a cinética da resposta humoral por IgG 60 e 90 dias após infecção por meio de pesquisa de anticorpos anti-Toxocara, utilizando teste imunoenzimático, em amostras de sangue obtidas por punção do plexo orbitário. No 90º dia após a infecção todos os animais sobreviventes foram sacrificados e submetidos a digestão ácida da carcaça, pulmões, fígado e cérebro para recuperação de larvas de Toxocara canis encistadas nesses órgãos. Observou-se retardo na produção de anticorpos IgG anti-Toxocara nos animais tratados com ciclosporina A ou betametasona 15 dias antes da infecção, além de aumento significativo na quantidade de larvas de Toxocara canis recuperadas no grupo de animais que foi tratado com ciclosporina A 15 dias antes da infecção pelo ascarídeo.
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48
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Abstract
A new scheme of clarifying clinical forms of toxocariasis is proposed to include: (i) systemic forms: classical VLM and incomplete VLM; (ii) compartmentalized forms: ocular and neurological toxocariasis; (iii) covert toxocariasis; and (iv) asymptomatic toxocariasis. The following markers are helpful in defining clinical forms namely, patient characteristics and history, clinical symptoms and signs, positive serology, eosinophilia and increased levels of IgE. Amongst the available drugs albendazole is the most commonly used, although other benzimidazole compounds have a similar efficacy. The recommended dose of albendazole is 15 mg kg(-1) body weight daily for 5 days and in some cases with VLM syndrome the treatment needs to be repeated. An evaluation of treatment efficacy can be made by observing a rise in eosinophilia within a week followed by any improvement in clinical symptoms and signs, lower eosinophilia and serological tests taken over a period of at least 4 weeks. In addition to clinical rationales for the specific treatment of VLM and OLM, preventive treatment needs to be considered bearing in mind the increasing risk of larvae localizing in the brain during the course of an infection. To reduce migration of Toxocara larvae a single course of albendazole is suggested in cases where eosinophilia and serology are at least moderately positive.
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Affiliation(s)
- Z Pawlowski
- University of Medical Sciences, Poznań, Poland.
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Barisani-Asenbauer T, Maca SM, Hauff W, Kaminski SL, Domanovits H, Theyer I, Auer H. Treatment of ocular toxocariasis with albendazole. J Ocul Pharmacol Ther 2001; 17:287-94. [PMID: 11436948 DOI: 10.1089/108076801750295317] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose of this study was to evaluate the efficacy of combined albendazole and steroid treatment for uveitis caused by Toxocara canis in immunocompetent patients. Five patients (7 eyes) with ocular larva migrans syndrome (OLM) were used in this study. Toxocariasis was suspected based on clinical manifestations and confirmed by anti-toxocara IgG and Western blot analysis. Systemic albendazole (adults: 800 mg b.i.d.; children: 400 mg b.i.d.) was given in conjunction with steroids. Visual acuity before and after therapy, inflammatory response, side effects and toxicity were evaluated. Treatment resulted in an improved visual acuity in all patients. Mean initial Snellen visual acuity was 20/40, and mean final acuity was 20/20. There were no recurrences of uveitis throughout the observation period (average: 13.8 months; range: 3 days to 24 months). These findings suggest that albendazole, in combination with systemic steroids, is a useful regimen to treat ocular larva migrans syndrome.
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Minvielle MC, Taus MR, Raffo A, Ciarmela ML, Basualdo JA. Seroprevalence of toxocariasis in blood donors of Gualeguaychú, Argentina. Trans R Soc Trop Med Hyg 2000; 94:373-5. [PMID: 11127236 DOI: 10.1016/s0035-9203(00)90108-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- M C Minvielle
- Cátedra de Microbiología y Parasitología, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Calle 60 y 120 s/n. La Plata (1900), Argentina
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