Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Visceral involvement, including hepatomegaly, marked eosinophilia, and anemia Posterior or peripheral ocular inflammatory mass Elevated antibody titers in serum or aqueous fluid; demonstration of Toxocara larvae in biopsy specimen +++ Clinical Findings ++ Visceral larva migrans Usually asymptomatic Anorexia, fever, fatigue, pallor, abdominal pain and distention, nausea, vomiting, and cough may be present in children aged 1–5 years Hepatomegaly is common, splenomegaly is unusual, and adenopathy is absent Lung involvement, usually asymptomatic, can be demonstrated readily by radiologic examination Seizures are common, but more severe neurologic abnormalities are infrequent Ocular larva migrans Occurs in older children and adults who have a unilateral posterior or peripheral inflammatory eye mass History of visceral larva migrans and eosinophilia are typically absent Anti-Toxocara antibody titers are low in the serum and high in vitreous and aqueous fluids +++ Diagnosis ++ Eosinophilia with leukocytosis, anemia, and elevated liver function tests are typical Hypergammaglobulinemia may be present and elevated isohemagglutinins sometimes result from cross-reactivity between Toxocara antigens and human group A and B blood antigens Diagnosis is confirmed by finding larvae in granulomatous lesions High ELISA serology and the exclusion of other causes of hypereosinophilia provide a presumptive diagnosis in typical cases +++ Treatment ++ Albendazole (400 mg twice a day for 5 days) or mebendazole (100–200 mg twice a day for 5 days) is indicated for severe complications involving the brain, lung, or heart Treating any cause of pica, such as iron deficiency, is important Corticosteroids are used to treat marked inflammation of lungs, eyes, or other organs Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.