Toxocariasis as a cause of new pulmonary infiltrates

Yr, Kang; Sa, Kim; Jeon, Kyeongman; Wj, Koh; Gy, Suh; Mp, Chung; Kim, Ho; Oj, Kwon; Es, Kang; Sh, Um

doi:10.5588/ijtld.12.0273

Cited by 15 publications

(11 citation statements)

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“…When the serum antibody positive rate was analyzed in detail by area, the correlation between eosinophil counts and antibody positivity was not significant in Seoul ( P =0.698) but significant in Gyeongsangnam-do ( P =0.014). The correlation has been consistently confirmed by several studies ( 10 , 11 , 12 , 23 , 24 , 25 , 26 , 27 ). The insignificant correlation in Seoul might have been caused by small number of antibody positive subjects in each group.…”

Section: Discussionsupporting

confidence: 74%

Significance of Serum Antibody Test for Toxocariasis in Healthy Healthcare Examinees with Eosinophilia in Seoul and Gyeongsangnam-do, Korea

et al. 2014

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There have been numerous reports on the relationship between eosinophilia and toxocariasis. The present study investigated seropositive rates of toxocariasis among healthy people with or without eosinophilia in urban and rural areas, and assessed risk factors for positive antibody test. A total of 610 healthy people, who visited health check-up (Medicheck®, Korea Association of Health Promotion), 310 from Seoul and 300 from Gyeongsangnam-do, were subjected for this study. Their serum samples were tested by ELISA with the crude antigen of Toxocara canis larvae. Cross-reactions with other tissue invading helminth antigens were also investigated. Total antibody positive rate of toxocariasis was 8.7% of the 610 subjects. When the subjects were grouped into 3 by their eosinophil counts, the antibody positive rates significantly differed by the groups; 5.9% (18/306) in the group<350/µL, 10.0% (11/110) in the group 350-500/µL, and 12.4% (24/194) in the group>500/µL (P=0.028). A total of 22 serum samples cross-reacted with other tissue-invading helminth antigens. A questionnaire analysis recognized drinking alcohol and smoking as significant risk factors of toxocariasis. In conclusion, toxocariasis antibody positive rate is correlated with eosinophil counts. It is recommended that healthy subjects with eosinophilia by routine health examination and risk factors undergo Toxocara serology by multiantigen ELISA to investigate etiology.Graphical Abstract

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Section: Discussionsupporting

confidence: 74%

Significance of Serum Antibody Test for Toxocariasis in Healthy Healthcare Examinees with Eosinophilia in Seoul and Gyeongsangnam-do, Korea

et al. 2014

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“…Such findings are associated with several pulmonary processes. Regarding inflammatory diseases, a pulmonary nodule with a halo is occasionally seen in patients with eosinophilic lung diseases such as simple pulmonary eosinophilia, idiopathic hypereosinophilic syndrome and parasitic infections [16]. Kim et al reported that a halo of ground-glass attenuation resulted histopathologically from pulmonary infiltrations by eosinophils and other inflammatory cells; however, they did not mention the locamanifestations of larval migration in the human body.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Presentation of Toxocara sp. Infection in Children

Mazur‐Melewska¹,

Jończyk‐Potoczna²,

Kemnitz³

et al. 2015

Advances in Respiratory Medicine

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Introduction: The aim of this study was to investigate the associations between radiological findings, blood eosinophilia, hyperimmunoglobulinemia E and G and Toxocara seropositivity in Polish children with newly diagnosed pulmonary infiltration. Material and methods:We retrospectively analyzed the documentation of 119 patients, aged 1 to 18 years (mean age: 7.21 ± 4.82), who were seropositive in regards to Toxocara sp. antibodies. In all cases, peripheral blood eosinophils and leukocyte counts, serum total IgE, IgG levels and specific IgG antibodies against excretory and secretory Toxocara sp. antigens were measured at the first presentation. After the confirmation of seropositivity, all children had a routine radiological examination. Results: In the documentation of 23 children (mean age 3.58 ± 2.63 years) we found abnormalities in the radiological examination of their lungs. Fifteen children who had abnormalities in radiological findings presented clinical respiratory complaints such as chronic cough, wheezing, asthma and haemoptysis. Eight children were asymptomatic. The analysis of peripheral eosinophils and leukocyte number, the level of IgE and specific anti-Toxocara IgG presented significantly higher values in children with radiological lesions than in children who had correct radiology. The levels of total IgG and gamma globulins were not significantly different. In 10 patients CT showed irregular round nodules with and without halo ranging from 1 to 13 mm. The number of nodules varied from a single lesion to multiple, disseminated ones. All nodules were located in peripheral areas of the lungs. None of them were found in the central areas. In 13 patients, CT images showed ground-glass opacities with ill-defined margins. None of the CT images presented lymphadenopathy and pleural effusion. Conclusion:The pulmonary lesions in small children with high eosinophilia and hyperimmunoglobulinemia E could be related to toxocariasis and for this reason they are eligible to undergo therapy with prolonged observation for several months, rather than start invasive malignancy investigations.

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“…As previously reported, most cases of pulmonary toxocariasis are asymptomatic, manifesting as transient and migratory pulmonary infiltrates [19]. In symptomatic cases, a short course of albendazole treatment (400 mg twice daily for 5 days) is recommended, and adjunctive steroid therapy produces rapid improvement in the clinical course [2].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

et al. 2014

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A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

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Toxocariasis as a cause of new pulmonary infiltrates

Abstract: Transient and migratory pulmonary infiltrates on chest CT scans were associated with blood eosinophilia and Toxocara seropositivity. Clinicians should consider asymptomatic toxocariasis as a cause of unexplained new pulmonary infiltrates in countries with dietary habits of raw meat intake.

Cited by 15 publications

References 0 publications

Significance of Serum Antibody Test for Toxocariasis in Healthy Healthcare Examinees with Eosinophilia in Seoul and Gyeongsangnam-do, Korea

Significance of Serum Antibody Test for Toxocariasis in Healthy Healthcare Examinees with Eosinophilia in Seoul and Gyeongsangnam-do, Korea

Pulmonary Presentation of Toxocara sp. Infection in Children

Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

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