pica and Larva-Migrans--Visceral

The authors selected among 5 diagnosed cases of larva migrans. In this study, the authors reported a review of this disease.

Topics: Aged; Child, Preschool; Eosinophilia; Humans; Larva Migrans, Visceral; Pica; Syndrome; Thiabendazole

Topics: Animals; Anthelmintics; Child; Humans; Larva Migrans, Visceral; Male; Multiple Pulmonary Nodules; Myasthenia Gravis; Pica; Toxocara; Toxocariasis

The occurrence of the first seven cases of visceral larva migrans in Trinidad and Tobago is described. All cases occurred in children of the same family. The ELISA test was used to confirm the clinical diagnosis.. Visceral larva migrans is a syndrome caused by the extraintestinal migration of larval nematodes of wild and domestic animals through human tissues. Most cases occur in children under 5 years of age, with the common dog round worm apparently being the primary causative agent. This paper describes the occurrence of the first 7 cases of visceral larva migrans in Trinidad and Tobago. Cases occurred among siblings in the same family and were confirmed using the ELISA test. A mentally retarded 10-year old East Indian male was admitted to the Port of Spain General Hospital with a strong history of pica, recurrent wheezing, and epilepsy. Five siblings and one cousin were found living under extremely unsanitary conditions and in dire poverty. All had pica and Toxocara canis eggs were found in the dirt surrounding the dwelling. These eggs are most probably the common source of infection. Infection with Toxocara species is probably far more common than reported in Trinidad, given the large stray dog population and areas of primitive sanitary conditions. ELISA tests could be used to reveal additional infections in the country.

Topics: Blood Grouping and Crossmatching; Child; Child, Preschool; Enzyme-Linked Immunosorbent Assay; Eosinophilia; Family Characteristics; Female; Hepatomegaly; Humans; Larva Migrans, Visceral; Male; Pica; Sensitivity and Specificity; Space-Time Clustering; Trinidad and Tobago

Sera from 4,652 children whose blood was submitted to the New York City Department of Health for lead analysis were tested for antibodies to Toxocara canis using an enzyme-linked immunosorbent assay (ELISA). Standardized to the age distribution of the study population, T. canis seropositivity (inverse titers greater than or equal to 16) was 5.7 per cent in males and 5.1 per cent in females. T. canis antibody titers and lead exposures as measured by Centers for Disease Control lead classes were positively correlated. Children who were seropositive to T. canis (cases) were compared to seronegatives (controls) matched on age (+/- 6 months), sex, time-of-screening (+/- 3 months) and CDC lead class. Logistic regression analysis of 155 case-control pairs demonstrated elevated relative risks (RRs) for geophagia (RR = 3.14; 95% CI = 1.75, 5.64) and having had a litter of puppies in the home (RR = 5.22; 95% CI = 1.63, 16.71). Compared to controls, cases had increased eosinophil counts, serum immunoglobulin E concentrations, and anti-hemagglutinin-A titers. Small deficits in cases compared to controls were found in performance on several neuropsychological tests after adjustment for potential confounders including case-control differences in race, socioeconomic status, and current blood lead concentrations. The study thus confirmed that T. canis infection is common in urban children and suggested that infection may be associated with adverse neuropsychological effects.

Topics: Adolescent; Animals; Animals, Domestic; Child; Child, Preschool; Dogs; Enzyme-Linked Immunosorbent Assay; Epidemiologic Methods; Female; Humans; Infant; Infant, Newborn; Larva Migrans, Visceral; Lead; Male; Neuropsychological Tests; New York City; Pica

To determine epidemiological and clinical associations with Toxocara canis seropositivity, we studied 333 (87%) children of a cohort of 383 five- to seven-year-olds. The prevalence of seropositivity (antibody titer to T canis, greater than or equal to 1:32) was 23.1%. Black children were more frequently seropositive than were white children, as were children of parents who did not graduate from high school. In a sample of seropositive and seronegative children, seropositivity was associated with both a history of pica and puppy ownership, but not with a greater frequency of symptoms and signs that occur in visceral larva migrans or with poor growth. No child had evidence of ocular toxocariasis on retinal examination. For the whole sample, poor reading achievement, marked distractibility, and lower intelligence were associated with seropositivity, but by using multiple regression analysis, we found that these associations may be attributable to confounding variables.

Topics: Animals; Animals, Domestic; Antibodies; Attention; Black People; Child; Child, Preschool; Dogs; Female; Humans; Intelligence; Larva Migrans, Visceral; Male; Pica; Reading; Regression Analysis; Toxocara

Blood samples were obtained during a lead screening program from 100 children aged 1-6 years in Allegheny County, Pennsylvania, to determine whether there was any association between specific forms of pica and infection with Toxocara canis, the principal cause of visceral larva migrans in the United States, or elevated blood lead levels. Significant associations were found between: 1) feces, soil, or grass pica and Toxocara infection; 2) paint or plaster pica and elevated blood lead; and 3) dog ownership and Toxocara infection. These findings suggest that an accurate pica history may be useful in identifying potential health problems in children.

Topics: Animals; Child; Child, Preschool; Dogs; Feces; Female; Humans; Infant; Larva Migrans, Visceral; Lead; Male; Pica; Toxocara

Clinical, serologic, and epidermiologic evidence documents an outbreak of toxoplasmosis involving ten of 30 members of an extended family. The index patient had unusual clinical manifestations including brain abscesses, progressive chorioretinitis, seizures, neurologic deficits, hepatosplenomegaly, pneumonitis, and eosinophilia. Toxoplasmosis was confirmed by demonstrating the organism in brain tissue and cerebrospinal fluids; clinical and serologic evidence also indicated infection with Toxocara (viscd children. Of the 11 such children, seven (68%) were seropositive, six of whom had high acute-phase titers (greater than or equal to 1024) to Toxoplasma and a disease consistent with acute toxoplasmosis. All six of the latter group required specific chemotherapy. Geophagia was associated statistically with acute toxoplasmosis among the children; it also increased the risk of infection with Toxocara and enteroparasites. Two school-aged children and two adults had serologic evidence of acute toxoplasmosis, but only one of the group was symptomatic. Epidemiologic evidence indicates that this outbreak was probably caused by ingesting oocysts from cat feces. We suggest that the severe and unusual clinical manifestations of the index patient resulted from simultaneous infection with Toxoplasma and Toxocara.

Topics: Adult; Alabama; Animals; Cats; Child, Preschool; Disease Outbreaks; Disease Reservoirs; Disease Vectors; Female; Humans; Infant; Larva Migrans, Visceral; Male; Middle Aged; Pica; Soil; Toxoplasmosis

Visceral larva migrans, Entamoeba coli, evidence of latent toxoplasmosis and a history of plumbism were found in an emotionally disturbed, retarded child. Patients with pica should be screened for parasitism and other diseases transmitted orally.

Topics: Child; Diagnosis, Differential; Drug Hypersensitivity; Entamoebiasis; Eosinophilia; Humans; Intellectual Disability; Larva Migrans, Visceral; Lead Poisoning; Male; Pica; Psychotic Disorders

Visceral larva migrans is a disease in which the larvae of animal parasites invade human tissues but do not complete their life cycles. The most frequent cause of this illness in children is the dog roundworm, Toxocara canis. A review of the literature, as well as our clinical experience, indicates that there are two forms of clinical expression: one, visceral, and the other, ocular. In general the clinical and laboratory abnormalities (hepatomegaly, recurrent pneumonia, eosinophilia, and hyperglobulinemia) usually associated with visceral disease are absent in children with ocular abnormalities. Conversely, there is a general lack of eye complications in patients with systemic disease. Reasons for these variations in clinical expression are unknown, but immune responses of the host and the antigenic composition of the parasite may be contributing factors.

Topics: Adrenal Cortex Hormones; Animals; Cats; Child; Child, Preschool; Citrates; Diethylcarbamazine; Dogs; Endophthalmitis; Eosinophilia; Female; History, 20th Century; Humans; Larva Migrans, Visceral; Male; Pica; Thiabendazole; Toxocara

Topics: Animals; Ascariasis; Biopsy; Child, Preschool; Diethylcarbamazine; Dogs; Eosinophilia; Hepatomegaly; Humans; Hypergammaglobulinemia; Infant; Larva Migrans, Visceral; Liver; Male; Parasite Egg Count; Pica; Prognosis; Toxocara; Zoonoses

Topics: Child, Preschool; Eosinophilia; Female; Hemagglutination Tests; Hepatomegaly; Humans; Larva Migrans, Visceral; Leukocytosis; Lung Diseases, Parasitic; Male; Pica; Soil; Time Factors