How does a person become infected?
Adult Toxocara parasitize the intestines of dogs and cats, especially puppies and kittens. With their feces, eggs enter the soil, which mature in sand and soil and remain viable for a long time. The child swallows them with dirty hands, sand, unwashed vegetables and herbs. In the intestine, larvae emerge from the eggs, penetrate through the wall into the blood and spread to the organs. Humans are not a suitable host for this parasite, so the cycle ends, and the larvae remain in tissues for years as foci of inflammation.
- Sand and soil on playgrounds
- Unwashed vegetables, greens, berries
- Contact with puppies and kittens
- Habit of biting nails and putting hands in mouth
- Working with soil without gloves
Forms and symptoms
Manifestations depend on where the larvae ended up and how many there are. In the visceral form, the liver and lungs suffer: a prolonged dry cough, attacks of suffocation, abdominal pain, enlarged liver, and wave-like temperature appear. The cutaneous form causes an itchy rash and hives. Ocular most often occurs in schoolchildren and adolescents, affects one eye and can lead to permanent vision loss. An asymptomatic course is also possible, when the only finding is increased eosinophils in a blood test.
- Visceral form: cough, shortness of breath, abdominal pain
- Skin form: rash, urticaria, itching
- Ocular form: decreased vision in one eye
- Neurological form: headache, seizures
- Hidden form: only changes in blood test
What tests are needed
The main test is the determination of antibodies to Toxocara in the blood. It is assessed along with symptoms and a complete blood count, where elevated eosinophils and sometimes leukocytosis are typical. Total IgE is often elevated. Fecal analysis for helminth eggs in toxocariasis is not informative because the larvae do not develop into adult worms. To assess organ damage, an ultrasound of the abdominal cavity is used, if there is a cough, a chest x-ray is used, and if there are complaints about vision, an examination by an ophthalmologist with examination of the fundus is required.
- Antibodies to Toxocara in the blood
- General blood test with leukemia formula
- Total immunoglobulin E
- Ultrasound of the abdominal organs
- Chest x-ray for cough
- Fundus examination by an ophthalmologist
Treatment
Treatment is carried out with anthelmintic drugs in a course prescribed by the doctor, taking into account age and weight. In case of severe inflammation, damage to the eyes or nervous system, anti-inflammatory drugs are additionally used, sometimes in a hospital. After the course, the state of health, eosinophils and antibody levels are monitored, while the antibodies decrease slowly and in themselves are not considered a reason to repeat the treatment. The eye examination is carried out together with an ophthalmologist. Preventive courses of drugs are not prescribed without a confirmed diagnosis.
- Anthelmintic course as prescribed by a doctor
- Anti-inflammatory therapy for severe forms
- Joint management with an ophthalmologist for the ocular form
- Eosinophil control after treatment
- Treatment of concomitant allergies
Prevention
It is impossible to completely rid urban soil of Toxocara eggs, so prevention is built around hygiene. Teach your child to wash their hands after going outside, in the sandbox, or playing with animals, and always before eating. Rinse greens and vegetables thoroughly with running water. Domestic dogs and cats are regularly dewormed by a veterinarian, and hands are washed after cleaning the animal. Sandboxes should be closed at night, and the beds should be handled with gloves.
- Wash your hands after going outside and touching animals
- Wash vegetables, herbs and berries well
- Regular deworming of pets at the veterinarian
- Keep sandboxes away from animals
- Work with soil with gloves
- Cutting children's nails short