Toxocariasis presenting as eosinophilic ascites in a post-partum female

Abstract

Toxocariasis remains a problem throughout the world, and the overall prevalence is estimated to be 2.8 % within the United States. The clinical spectrum of toxocariasis in humans varies from asymptomatic infection to severe organ injury, and is determined by parasitic load, sites of larval migration from the gut, and the host's inflammatory response. We present a case of eosinophilic ascites with diarrhea in a post-partum woman attributed to toxocariasis. To our knowledge, this is the first reported case of toxocara infection presenting in the post-partum period.

Causes of eosinophilic ascites – A systematic review

“…A total of 17 cases of EA, 16 associated with parasitic infection and 1 with fungal infection, were identified. Six types of parasites were associated with EA development: Toxocariasis (6 cases) [86][87][88][89][90][91], Strongyloides stercoralis (5 cases) [92][93][94][95][96], Giardia (1 case) [97], Trichuris trichiura (1 case) [98], Ascaris (1 case) [99], Enterobius vermicularis (1 case) [100]. In one patient parasitic etiology [101] was assumed based on therapeutic response to Albendazole administration.…”

“…Endoscopy revealed signs of gastritis and duodenitis in 4 patients, 2 with toxocariasis [88,90], 1 with strongyloidiasis [93] and 1 with trichiuriasis [98].…”

“…Microscopic eosinophilic infiltration of the GI tract was present in subjects with toxocariasis (3) [86,88,90], strongyloidiasis (1) [93], enterobiasis (1) [100], and in 1 patient with trichuriasis in which biopsy specimen of the stomach included a female Trichuris trichiura covered by inflammatory cells [98].…”

Toxocariasis in Children: An Update on Clinical Manifestations, Diagnosis, and Treatment

“…On computed tomography, hepatic lesions are typically illdefined, low attenuating nodules that have sometimes been confused with metastatic cancer. 14 Also, eosinophilic cholecystitis, 15 ascites, 16 and large bowel masses 17 were reported.…”

A clinical case of visceral toxocariasis as a cause of eosinophilic polyserositis

“…В Соединенных Штатах общая распространенность оценивается в 2,8%. Более высокая серопозитивность ассоциируется с маркерами низкого социально-экономического статуса, нищеты, скученности и более низкого уровня образования [3]. Основные пути заражения токсокарозом -фекально-оральный (зараженные яйцами токсокар фекалии собак или кошек), фекально загрязненные овощи (редис, морковь), недожаренное мясо от зараженных цыплят, овец, ягнят или телят.…”