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    Visceral larva migrans

    Toxocariasis; Ocular larva migrans; Larva migrans visceralis

    Visceral larva migrans is a human infection with certain parasites found in the intestines of dogs and cats.

    Causes

    Visceral larva migrans (VLM)is caused by worms (parasites) that are found in the intestines of dogs and cats. The dog parasite is called Toxocara canis and the cat parasite is called Toxocara cati.

    Eggs produced by these worms are in the feces of the infected animals. The feces mix with soil.Humans can get sick if they accidentally eat soil that has the eggs. This can be through eatingfruit or vegetables that were in contact with infected soil and not washed thoroughly before eating. People can also become infected by eating raw liver of chicken, lamb, or cow.

    Young children with picaare at high risk of getting VLM. Pica isa disorder involving eating inedible things such as dirt and paint.Most infectionsin the United Statesoccur in children who play in areas with soil contaminated by dog or cat feces.

    After the worm eggs are swallowed, theybreak open in the intestine. The worms travel throughout the body to various organs, such as the lungs, liver, and eyes. They may also travel to thebrain and heart.

    Symptoms

    Mild infections may not cause symptoms.

    Serious infections cancause the following symptoms:

    • Abdominal pain
    • Cough
    • Fever
    • Irritability
    • Itchy skin (hives)
    • Shortness of breath
    • Wheezing

    If the eyes are infected (called ocular larva migrans), loss of vision and crossed eyes (strabismus)can occur.

    Exams and Tests

    If you have visceral larva migrans, you may have a high level of white blood cells.

    People with this condition may also have signs of a swollen liver, rash, and lung or eye problems.

    Tests may include:

    • Complete blood count with differential
    • Blood tests to detect antibodies to Toxocara

    Treatment

    This infection usually goes away on its own and may not require treatment. Some people need to take anti-parasitic drugs such as albendazole.

    Outlook (Prognosis)

    Mild infections may go away without treatment. Severe infections involving the brain or heart can result in death, but this is rare.

    Possible Complications

    • Blindness
    • Decreased visual acuity (worsened eyesight)
    • Encephalitis (infection of the brain)
    • Heart arrhythmias
    • Respiratory distress

    When to Contact a Medical Professional

    Contact your health care provider if you develop any of the following symptoms:

    • Cough
    • Difficulty breathing
    • Eye problems
    • Fever
    • Rash

    A full medical exam is needed to rule out visceral larva migrans. There are many conditions that cause similar symptoms.

    Prevention

    Prevention includes deworming dogs and cats andpreventing dogs and cats from defecating in public areas. Children should be kept away from areas where dogs and cats may defecate.

    It is very important to wash your hands thoroughlyafter touching soil or after touching cats or dogs. Teach your children to wash their hands thoroughly as wellafter being outdoors or after touching cats or dogs.

    Do not eat raw liver of chicken, lamb, or cow.

    References

    Despommier DD, Hotez PJ. Tissue nematodes. In: Long SL, ed. Principles and Practice of Pediatric Infectious Diseases.4th ed. Philadelphia, PA: Elsevier Saunders; 2012: chap 277.

    Diemert DJ. Tissue nematode infections. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011: chap 366.

    Nash TE. Visceral larvae migrans and other unusual helminth infections. In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2009:chap 291.

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      Review Date: 11/10/2012

      Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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