Visceral larva migrans associated with earthworm and gecko ingestion: a case report

Abstract

IntroductionVisceral larva migrans is a syndrome caused by an infection with larval helminths, which may result in partial or general pathological changes in host tissues. Due to the difficulty in finding the causative parasites, the diagnosis of visceral larva migrans is generally based on compatible clinical signs, epidemic history, marked eosinophilia and pathological examination, especially positive serological test results and the disappearance of symptoms after specific treatment.Case presentationWe report here the case of a 21-year-old Chinese man who, having ingested living earthworms and geckos at a witch’s suggestion, presented with fatigue and wordlessness lasting for one year along with elevated transaminase levels for one month. Clinical examination showed eosinophilia, elevated transaminase levels, nodular lesions in his liver and typical pathological characteristics of hepatic visceral larva migrans. After four courses of anthelmintic therapy, our patient presented with sustaining improvement of clinical manifestations and normalization of laboratory data.ConclusionsBecause of the difficulty in making a definite diagnosis, anthelmintic therapy should be performed in patients with a suspected diagnosis of visceral larva migrans based on their epidemic history and presence of typical manifestations, especially when the serological test results are negative. Furthermore, patients with severe parasite infection may require multiple anthelmintic therapies in order to eliminate the parasites.

Gallbladder ascariasis in Kosovo – focus on ultrasound and conservative therapy: a case series

“…The characteristic sonographic features of worms in the bile duct are the presence in the gallbladder of a single, long, linear or curved echogenic structure without acoustic shadowing, looking like an anechogenic tube, and characteristic movement of these long echogenic structures within the bile duct. Other features are less specific or are an expression of the complications and consist of gallbladder distention, edema of the gallbladder wall, sludge within the gallbladder, a coiled echogenic structure within the gallbladder, multiple liver abscesses, and edematous pancreatitis [ 7 ].…”

Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center

“…It has been demonstrated that albendazole in the dose of 400 mg/day in three repeated cycles (initial two cycles for 14 days and third cycle for a week) for hepatic VLM is effective as treatment. [ 25 ] The laboratory markers used for monitoring the treatment efficacy included white blood cell, eosinophil counts, as well as liver transaminase enzymes. [ 25 ] They added a fourth course of praziquantel at a dose of 120 mg/kg for a short period of 3 days for the final normalization of the laboratory markers.…”

“…[ 25 ] The laboratory markers used for monitoring the treatment efficacy included white blood cell, eosinophil counts, as well as liver transaminase enzymes. [ 25 ] They added a fourth course of praziquantel at a dose of 120 mg/kg for a short period of 3 days for the final normalization of the laboratory markers. The role of high dose albendazole therapy has also been described by some authors.…”

A Case of Strange Worm Infection in a 21 Months Old Female in Karaj, Alborz Province, Iran

“…These infections are highest in communities with low hygienic condition but also take place in developed countries in susceptible persons (3). Infections by earthworms an uncommon parasitic worms that infect humans have been reported rarely (4). This article reports on a rare case of infection with a kind of earthworm diagnosed by optical microscopy in an Iranian 21-months-old female from Karaj.…”