Journal List > Korean J Pediatr Gastroenterol Nutr > v.13(1) > 1043482

Korean J Pediatr Gastroenterol Nutr. 2010 Mar;13(1):70-74. Korean.
Published online March 31, 2010.  https://doi.org/10.5223/kjpgn.2010.13.1.70
Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Familial Case of Visceral Larval Migrans of Toxocara Canis after Ingestion of Raw Chicken Liver
Min Su Park, M.D., Young Joon Ahn, M.D.,* and Kyung Rye Moon, M.D.
Department of Pediatrics, School of Medicine, Chosun University, Gwangju, Korea.
*Department of Medical Education, School of Medicine, Chosun University, Gwangju, Korea.

Responsible author (Email: krmoon@chosun.ac.kr )
Received February 16, 2010; Accepted March 08, 2010.

Abstract

We report a familial case of visceral larva migrans of Toxocara canis after eating raw chicken liver. A 9-year-old female ate raw chicken liver with her father and older brother and was admitted to the hospital with periumbilical pain, a mild fever, and headache. The total peripheral eosinophil count was 9,884/mm3 and the total lgE concentration was 2,317 IU/dL. Chest and abdominal computed tomography (CT) scans demonstrated multiple, poorly-defined, small, nodular lesions scattered in the liver and lung parenchyma. Toxocara ELISA and Western blot tests were positive in the patient, and her father and brother. A liver biopsy revealed extensive eosinophilic infiltrations in the portal and lobular areas. She took albendazole for 5 days and was discharged in good condition. These results suggest that clinicians should consider foodborne toxocariasis in patients with multiple, small nodules in the liver and lung parenchyma with eosinophilia and a history of raw meat ingestion.

Keywords: Visceral larva migrans; Toxocara canis; Raw liver

Figures


Fig. 1
IgG immunoblot to Toxocara canis TES-Ag. Patients 1 and 2, and positive control revealed the same banding pattern.
Click for larger image


Fig. 2
Chest and abdominal CT images of patient 1. (A) Chest CT scan shows multiple, small nodules with poorly-defined margins and a ground-glass opacity. (B) Abdominal CT scan shows multiple, low-attenuated small nodules.
Click for larger image


Fig. 3
Liver biopsy finding of patient 1 shows extensive eosinophilic infiltration in the portal and lobular areas (H&E, ×200).
Click for larger image

Tables


Table 1
Patients' Laboratory Data
Click for larger image

References
1. Snyder CH. Visceral larva migrans. ten years' experience. Pediatrics 1961;28:85–91.
2. Schantz PM, Glickman LT. Toxocaral visceral larva migrans. N Engl J Med 1978;298:436–439.
3. Magnaval JF, Glickman LT, Dorchies P, Morassin B. Highlights of human toxocariasis. Korean J Parasitol 2001;39:1–11.
4. Glickman LT, Schantz PM. Epidemiology and pathogenesis of zoonotic toxocariasis. Epidemiol Rev 1981;3:230–250.
5. Sturchler D, Weiss N, Gassner M. Transmission of toxocariasis. J Infect Dis 1990;162:571.
6. Nagakura K, Tachibana H, Kaneda Y, Keto Y. Toxocariasis possibly caused by ingesting raw chicken. J infect Dis 1989;160:735–736.
7. Obweller A, Jensen-Jarolim E, Auer H, Huber A, Kraft D, Aspock H. Toxocara infections in humans: symptomatic course of toxocarosis correlates significantly with levels of IgE/anti-IgE immune complexes. Parasite Immunol 1998;20:311–317.
8. Park HY, Lee SU, Huh S, Kong Y, Magnaval JF. A seroepidemiological survey for toxocariasis in apparently healthy residents in Gwangwon-do, Korea. Korean J Parasitol 2002;40:113–117.
9. Kwon NH, Oh MJ, Lee SP, Lee BJ, Choi DC. The Clinical impact of toxocariasis in patients with unknown eosinophilia. J Asthma Allergy Clin Immunol 2005;25:299–304.
10. Magnaval JF, Fabre R, Maurieres P, Charlet JP, de Larrard B. Application of the western blotting procedure for the immunodiagnosis of human toxocariasis. Parasitol Res 1991;77:697–702.
11. Magnaval JF, Fabre R, Maurieres P, Charlet JP, de Larrard B. Evaluation of an immunoenzymatic assay detecting specific anti-Toxocara immunoglobulin E for diagnosis and posttreatment follow-up of human toxocariasis. J Clin Microbiol 1992;30:2269–2274.
12. Yoshikawa M, Nishiofuku M, Moriya K, Ouji Y, Ishizaka S, Kasahara K, et al. A familial case of visceral toxocariasis due to consumption of raw bovine liver. Parasitol Int 2008;57:525–529.
13. Magnaval JF. Comparative efficacy of diethylcarbamazine and mebendazole for the treatment of human toxicariasis. Parasitolotgy 1995;110:529–533.
14. Lim YH, Lee BJ, Lee SP, Jang SI, Kang SY, Choi DC. Comparison between steroid alone and steroid/albendazole combination therapy in human toxocariasis with eosinophilia. J Asthma Allergy Clin Immunol 2001;21:427.
(abstract).
15. Despommier D. Toxacariasis: clinical aspects, epidemiology, medical ecology, and molecular aspects. Clin Microbiol Rev 2003;16:265–272.
16. Sturchler D, Schubarth P, Gualzata M, Gottstein B, Oettli A. Thiabendazole vs albndazole in treatment of toxocariasis; a clinical trial. Ann Trop Med Parasitol 1989;83:473–478.
17. Hossack J, Ricketts P, Te HS, Hart J. A case of adult hepatic toxocariasis. Nat Clin Pract Gastroenterol Hepatol 2008;5:344–348.
18. Matsuki Y, Fujii T, Nakamura-Uchiyama F, Hiromatsu K, Nawa Y, Hayashi T, et al. Toxocariasis presenting with multiple effusions in the pericardial space, thoracic cavity, and Morrison's pouch. Intern Med 2007;46:913–914.