Toxocariasis: diagnosis

The intravital parasitologic diagnosis of toxocarias is extremely rare and only in the study of biopsy material, when it is possible to detect and verify larvae of toxocar in tissues. Diagnosis of toxocarias is based on epidemiological history, clinical symptoms. Consider the presence of persistent long-term eosinophilia, although with eye toxocariasis it is not always found. Indication of the maintenance in the family of a dog or on close contact with dogs, on geophagy indicates a relatively high risk of infection by toxocarosis.

Immunological diagnostics of toxocarosis is aimed at determining the content of specific IgGs for T. Cams antigen in the serum by ELISA. Which has a high sensitivity and sufficient specificity for visceral localization of the larvae - 93.7 and 89.3%, respectively, but is not sufficiently informative for eye damage. The antibody titer of 1: 400 indicates an invasion, but not a disease; about the disease with toxocarosis says a titer of 1: 800 and above. In patients with chronic form with severe pulmonary syndrome, the level of specific antibodies is usually elevated moderately (1: 800 or 1: 1600). However, in this group of patients, the specific serum level of specific anti-altitude IgE antibodies is regularly detected. To confirm the results of ELISA, immunoblotting can be used. There is not always a correlation between the level of antibodies and the severity of the clinical manifestations of toxocariasis, as well as between the level of antibodies and the blood serum psseozinophilia. In connection with the cyclic course of the invasion with relapses and remissions, significant fluctuations in clinical, hematological and immunological indices in the same patient are possible in the dynamics. In a clinical study, patients with toxocarosis are recommended to include a biochemical blood test, an X-ray examination of the lungs, according to indications - bronchoscopy, bronchography. ECG, ultrasound of the abdominal cavity.

Indications for hospitalization

Treatment of toxicosis of patients with severe form and children under 3 years old is performed in a hospital. Patients with toxocariasis are not religious and do not need isolation.

Differential diagnosis of toxocariasis

Differential diagnostics of toxocarosis is carried out with the early stage of helminthiases peculiar to man (ascariasis, strongyloidosis, schistosomiasis, opisthorchiasis). Bronchial asthma, as well as with numerous diseases that are accompanied by eosinophilia in the peripheral blood (Loeffler syndrome, tropical eosinophilia, chronic nonspecific polyarthritis in children, lymphogranulomatosis, cancer, drug sensitization, near-wall fibroplastic myocarditis, etc.). Ocular toxocarosis must be differentiated from retinoblastoma and chorioretinitis tubercular, cytomegalovirus and other etiology. There are no reliable methods for diagnosing eye toxocariasis. In many cases, the diagnosis is made only with histological examination. For diagnostic purposes, ultrasound and CT scans are used. Sometimes the diagnosis of "toxocarosis" can be made only on the basis of the effect of the course of antiparasitic treatment. The diagnosis and treatment of patients with ocular toxo-narcosis is decided jointly by the ophthalmologist and the infectious disease doctor.

[1], [2], [3], [4]