(Toxocarosis) is a helminth
infection of humans caused by the dog
or cat roundworm
, Toxocara canis
or Toxocara cati
, respectively. Humans can become infected by ingestion of embryonated eggs (containing fully developed larva
L3) from contaminated sources. There are two main syndromes; visceral larva migrans (VLM), which encompasses diseases associated with major organs, and ocular larva migrans (OLM), in which toxocariasis pathological effects on the host are restricted to the eye
and the optic nerve
Toxocariasis occurs around the world. Epidemiologic surveys show a 2-5% positive rate in healthy adults from urban Western countries and 14.2-37% in rural areas. In tropical countries, surveys show a positive rate of 63.2% in Bali
, 86% in Saint Lucia
, and 92.8% in Réunion
. Toxocariasis is most commonly a disease of children, typically children aged 2-7 years.
- Exposure to contaminated soil.
- Presence of unwormed pups, unhygenic conditions.
- Geophagia (pica)- 2-10% of children aged 1-3 indulge in habitual geophagia.
Adult worms of the Toxocara family often live in the small intestine of dogs and cats. They range from 4-12 cm in length. Almost all puppies are infected at or soon after birth. During the summer, Toxocara infective eggs are shed. They survive for years in the environment, and humans typically ingest the eggs orally by eating with contaminated hands (Most commonly from handling infected feces with bare hands). Once introduced into the human intestine, the eggs develop into larvae. The larval form is less than 0.5 mm in length and 0.02 mm wide. The larvae penetrate the bowel wall and migrate through blood vessels to reach the liver, muscles, and lungs. Sometimes the parasite penetrates into the eye and brain.
Disease severity is affected by the number of eggs ingested, duration of infection, tissue location of larvae, and the immune response to the infection.
In suspected cases, diagnosis is confirmed by an increase in the anti-Toxocara
excretory-secretory antigen IgE level
History of exposure to dogs and cats
High Sustained eosinophilia + hyperglobulinemia + hepatomegaly
shows degenerated larvae at the centre of an eosinophilic granuloma
See also: List of parasites (human)
treatment, e.g. mebendazole
is the more modern form of treatment.
Management with anti-inflammatory steroids
is also an option.
Toxocariasis is always a benign, asymptomatic, and self-limiting disease, although brain involvement can cause brain damage, meningitis
, or epilepsy
. Ocular involvement, also known as 'ocular larvae migrans,' may cause loss of visual acuity or unilateral blindness. Pulmonary and hepatic forms can cause protracted symptoms if the patient does not receive treatment.
The eggs of Toxocara
species are widespread in parks, playgrounds, yards, and in homes and apartments where the occupants have dogs or cats. Elimination of eggs from the environment is not possible; therefore, prevention depends on proper hygiene, including handwashing after contact with pets. Public policies that have attempted to eradicate Toxocara
infection in dogs and cats have had limited success.