Toxocariasis in Adult
Toxocariasis occurs most commonly in children due to their poor hygiene and play habits. Two general clinical subcategories exist: ocular and visceral. Visceral infection is mainly seen in children younger than 6 years of age. Ocular manifestations are mainly seen in children 6 years and older.
The range of clinical manifestations is wide. Most patients are asymptomatic. Others may present with generalized pruritus and/or urticaria but without localizing signs or symptoms. Still others may present with wheezing, fever, abdominal pain, and hepatomegaly.
In ocular toxocariasis, patients will present with unilateral visual impairment and/or strabismus. Blindness may occur. Rarely, T. canis larvae can cause eosinophilic meningitis.
Risk factors include exposure to dogs / cats (particularly puppies or kittens), pica (ingestion of non-nutritive substances), lower socioeconomic status, and intellectual disability (institutionalized).
B83.0 – Visceral larva migrans
87121004 – Visceral larva migrans syndrome
- Unlike toxocariasis, Baylisascaris procyonis infection (raccoon parasite) often involves the central nervous system.
- Schistosomiasis is associated with freshwater exposure in tropical areas, and the patient may present with lower extremity pruritic papules during parasite penetration.
- Liver fluke infections (Opisthorchis, Clonorchis) usually are associated with ingestion of raw fish and usually do not present with skin findings.
- Echinococcosis usually does not present with skin findings and has characteristic liver or lung findings on ultrasound or CT scan.
- Urticarial vasculitis
- Contact dermatitis (irritant, allergic)
- Pruritus without rash
- Atopic dermatitis
- Willan's itch
- Drug eruption