Toxocarcous hepatitis

Toksokaroz is a widespread disease, it is registered in many countries.

Pathogens (Toxocara canis larvae and Toxocara Musa larvae) are found mainly in children under 10 years of age. A person becomes infected by swallowing eggs with toxocar. Adult individuals live in the intestines of cats and dogs, from which they are released into the environment with feces. The average life expectancy of sexually mature individuals is 4 months, while the female T. Canis lays more than 200 thousand eggs per day.

The main source of human infection is dogs. Infection occurs by direct contact with an infected animal whose wool is contaminated with eggs, or when it enters the mouth of the land where the toxocar eggs were. It is possible to infect humans by eating raw or poorly heat-treated meat. Cockroaches eat a significant amount of toxocare eggs and isolate them in a viable state.

Pathomorphology of Toxocarid Hepatitis

From the eggs swallowed by the person, caught in the mouth, then into the stomach and small intestine, migrating larvae emerge, which through the mucous membrane penetrate into the blood vessels and through the portal vein system enter the liver where some of them settle and are surrounded by an inflammatory envelope. In the liver tissue, larvae cause an inflammatory granulomatous reaction, characterized by the presence of a large number of eosinophils, mononuclear cells and necrosis.

Toksokary in the liver can survive up to 10 years, thanks to the isolation of the masking substance by the larva, capable of protecting the parasite from the aggression of eosinophils and host antibodies by a complex reaction, which prevents their contact with the epicuticle of the larva.

Symptoms of Toxocarid Hepatitis

Toksokaroz manifestations are of little importance Toksokaroz usually develops sharply. There is a temperature - low in light cases or high - up to 39 ^o C and higher, sometimes with chills. Often, fever is recurrent for several weeks and even months, with body temperature more often subfebrile, less often - febrile. There may be skin rashes in the form of urticaria, sometimes swelling of the type Quincke. The defeat of the liver in the form of toxo-carcinogenic hepatitis is observed in 65-87% of patients. The disease manifests itself feverish condition, lung damage, hepatomegaly, eosinophilia, hypergammaglobulinemia. When biochemical blood test is often observed a moderate increase in bilirubin and a slight increase in the activity of liver enzymes.

With intensive invasion, severe granulomatous lesions of the liver develop, which can become chronic in case of repeated infections.

Diagnosis of toxo-carious hepatitis

The diagnosis is confirmed by the detection of an egg parasite antigen in the blood serum by ELISA. Usually, ELISA is used with the secretory-excretory antigen of second-age toxocar larvae. Currently, Russia is producing a commercial diagnostic. The antibody titer is estimated to be 1: 400 and higher (in ELISA). The antibody titer of 1: 400 indicates an invasion, but not a disease. The titer of antibodies 1: 800 and higher indicates a disease with toxocarosis. In liver biopsies, larvae of toxocar can be detected

[1], [2], [3]

Treatment of toxo-carious hepatitis

To treat toxocarcosis hepatitis diethylcarbamazine is used. However, this drug is effective against migratory larvae and is not effective enough for tissue forms found in liver granulomas.

Prevention of toxo-carcinogenic hepatitis

Strict adherence to hygiene measures is necessary, children are not allowed to enter the dogs' walking areas, periodic de-worming of cats and dogs.