Atypical Toxocara canis-Induced Hepatic Visceral Larva Migrans: Diagnostic Challenges and Literature Review

Korean J Gastroenterol. 2024 Jun 25;83(6):247-252. doi: 10.4166/kjg.2024.051.

Abstract

Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.

Keywords: Larva migrans; Liver abscess; Toxocariasis; Vietnam.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Albendazole* / therapeutic use
  • Animals
  • Anthelmintics / therapeutic use
  • Antibodies, Helminth / blood
  • Dogs
  • Humans
  • Immunoglobulin E / blood
  • Larva Migrans, Visceral* / diagnosis
  • Larva Migrans, Visceral* / drug therapy
  • Liver / parasitology
  • Liver / pathology
  • Liver Abscess / diagnosis
  • Liver Abscess / drug therapy
  • Liver Abscess / parasitology
  • Male
  • Tomography, X-Ray Computed*
  • Toxocara canis* / isolation & purification
  • Toxocariasis / diagnosis
  • Toxocariasis / drug therapy
  • Ultrasonography
  • Young Adult

Substances

  • Albendazole
  • Antibodies, Helminth
  • Immunoglobulin E
  • Anthelmintics