Toxocariasis: clinical and laboratory features in 54 patients

ALTCHEH J; NALLAR M; CONCA M; BIANCARDI M; FREILIJ H

ANALES DE PEDIATRIA

EDICIONES DOYMA S A

Lugar: Madrid; Año: 2003 vol. 58 p. 425 - 431

1695-4033

OBJECTIVE: To describe the clinical and laboratory findings in children withtoxocariasis.METHODS: Fifty-four children with reactive serology to Toxocara determined byELISA were prospectively identified between January 1998 and September 2000. The patients were divided into three groups: asymptomatic children (n 24), those withvisceral larva migrans (n 16) and those with ocular larva migrans (n 14). Age,serology titers, and eosinophil count at diagnosis were compared among thegroups. The patients received treatment with albendazole 10-15 mg/kg/day for 15days or thiabendazole 25 mg/kg/day in two series of 7 days.RESULTS: The clinical features were as follows: 24 children (44.4 %) wereasymptomatic, pneumonitis was found in 9 (16.7 %), hepatomegaly in 6 (11.1 %),acute posterior uveitis in 5 (9.3 %), strabismus in 5 (9.3 %), leukocoria in 4(7.4 %), fever in 3 (5.6 %). There was 1 case of keratitis, 1 of cataracts, 1 of myocarditis and 1 case of pneumonia with pleural effusion. Some patients showedmore than one clinical feature. Four children experienced loss of vision in theaffected eye. No differences in age or serology titers were found among thegroups. Eosinophil count was lower in the group with ocular larva migrans than inthe other groups (p < 0.001). Children with active disease showed clinicalimprovement and a 70.4 % decrease in eosinophilic count one year after treatment.Serological titers showed an unpredictable pattern during the follow-up.CONCLUSIONS: Most of the infected children were asymptomatic. In thepost-treatment follow-up, clinical improvement and a decrease in eosinophiliccount were observed. Further studies are needed to evaluate the efficacy oftreatment, especially in asymptomatic children.