Toxocaríase: larva migrans visceral em crianças e adolescentes

Abstract

Objectives: To present a detailed investigation of risk factors, symptoms, and laboratory and imaging tests that may be useful to establish the clinical laboratory diagnosis of visceral larva migrans (VLM) in children, demonstrating the importance of diagnosis and treatment to prevent complications in the eyes, liver, and other organs.Sources: Literature review using the MEDLINE and LILACS (1952-2009) databases, selecting the most recent and representative articles on the topic. Summary of the findings:VLM is an infectious disease with non-specific clinical presentation, whose transmission is related to contact with dogs, especially puppies, and which may progress to late systemic complications in vital organs such as the eyes and the central nervous system. IgG (ELISA) anti-T. canis can be used to establish the laboratory diagnosis. Higher cutoff points suggest recent illness and lower cutoff points demonstrate mild infection or infection in remission. Therapeutic response may be assessed by means of eosinophil blood cell count. The present article provides the pediatrician with updated information regarding VLM, a disease of high prevalence worldwide and in Brazil. Conclusions:The diagnosis of VLM depends mainly on the presence of dogs in the child's household, associated with ELISA (IgG anti-T. canis), using excretory-secretory antigens of Toxocara canis. Prospective studies are warranted to assess the best drug therapy. Prevention is the most important strategy because of the high prevalence of T. canis in urban areas. Adult worms live on average 4 months and, after about 6 months, almost all are spontaneously eliminated by the host. 4

Contamination of public parks and squares from Guarulhos (São Paulo State, Brazil ) by Toxocara spp. and Ancylostoma spp.

“…and Ancylostoma spp., respectively 2,12,17,18 . Studies on the prevalence of parasites causing larva migrans have been conducted in various regions of the world, especially by either stool examinations of dogs and cats, or soil contamination assessments for helminth eggs and larvae 2,4,20,26 . In general, many authors have sought to assess the degree of soil contamination in public places by measuring Toxocara spp.…”

“…For example, the percentage of soil contaminated by Toxocara spp. eggs has ranged between 12% and 60.3% in Brazil 4 …”

Análise epistemológica dos conhecimentos científicos sobre Toxocara sp. com ênfase na infecção humana

“…Estudos demonstram a prevalência sorológica da toxocaríase no Brasil variando de 2,2 a 54,8% 10,22,24,32,34,50,51,57,59,64,65,72,73,75,76 . As diferenças entre as taxas verificadas nos artigos citados pode ser justificada pela faixa etária dos indivíduos incluídos no estudo.…”

“…Um dos helmintos zoonóticos mais conhecidos é Toxocara sp. que compreende 21 espécies, tendo as espécies Toxocara canis e Toxocara cati como as mais implicadas na síndrome da Larva Migrans Visceral (LMV) 9,10 . O hospedeiro definitivo são animais domésticos, nos quais o parasito vive como adulto dentro do lúmen do intestino delgado 11 .…”

Helminth eggs with zoonotic potential in the vicinity of public schools in southern Brazil

“…Close relationships between humans and domestic animals such as dogs and cats do not just become established in households. These animals also frequent public spaces that are used for leisure activities, especially by children, who thus are exposed to the risk of infection caused by some helminth species (Carvalho & Rocha, 2011).…”