http://www.fpnotebook.com/
Visceral Larva Migrans
Aka: Visceral Larva Migrans, Toxocariasis
- See Also
- Ocular Larva Migrans
- Epidemiology
- Incidence: 10,000 cases per year in United States
- Causes: Roundworms (Nematodes)
- Toxocara canis (dogs)
- Toxocara cati (cats)
- Transmission
- Spread via dog or cat feces contaminating soil
- Young children (age <3 years) eating contaminated soil
- Common in playgrounds and sandboxes
- Adults ingesting raw liver
- Pathophysiology
- Infectious eggs ingested and hatch in Intestine
- Larvae trapped in liver or circulate
- Symptoms
- Nausea
- Fever
- Myalgia
- Hepatomegaly
- Edema
- Urticaria
- Complications
- Epilepsy may develop in toddlers
- Ocular Larva Migrans (Endophthalmitis)
- Differential Diagnosis
- Hepatitis
- Encephalitis
- Viral myalgia
- Epilepsy
- Pneumonia
- Trichinosis
- Eosinophilic Leukemia
- Periarteritis nodosa
- Labs
- Complete Blood Count
- Leukocytosis with >20% Eosinophilia
- Larval antigen ELISA Test
- Course
- Self limited
- Generally benign
- Management
- Indications
- Severe cardiac or pulmonary disease
- Neurologic involvement
- Preparations
- Mebendazole (Vermox)
- Dose: 100-200 bid for 5 days
- Not available as of 2012 (use Albendazole instead)
- Diethylcarbamazine (Hetrazan)
- Dose: 6 mg/kg/day divided tid for 7-10 days
- Prevention
- Careful child supervision
- Prevent soil ingestion
- Encourage hand washing
- Regular worming of cats and dogs
- Clean up after pets
- Cover sandbox between use
- Cook liver and other organ meats well before eating