IN SOME CASES, toxocariasis can cause organ damage and blindness. Because its symptoms mimic many other ailments, identifying toxocariasis tests your assessment skills. Roundworms from the intestines of dogs, possibly cats, and wild animals cause toxocariasis in humans. Learn to identify this infection before it causes serious damage.
Transmission and detection
Almost all puppies are infected with roundworms. Dogs excrete the parasites' eggs in feces, contaminating soil, sandboxes, or even their own fur. People, especially children, can become infected by accidentally ingesting contaminated dirt or sticking contaminated fingers in their mouths. Undercooked game meat is another source of infection.
Once ingested, the eggs hatch into larvae in the small intestine and burrow through body tissue, particularly the heart, lungs, brain, eyes, and muscles, leaving behind inflammation and necrosis. Ocular larva migrans (OLM) involves the eye and can lead to blindness. Visceral larva migrans (VLM), which is more common, involves other tissue. Fortunately, people don't transmit either infection because eggs or larvae aren't expelled in body secretions.
Clinical signs and symptoms vary with the degree of infestation, individual immune response, and the larvae's migration. Some patients are asymptomatic. Those with VLM may have unexplained fever, headache, wheezing, abdominal and leg pain, a creeping poison ivy-like rash, seizures, and Ever enlargement, Signs of OLM include red conjunctiva, impaired vision, and poor eye coordination.
To investigate the possibility of toxocariasis, ask the patient (or his parents) if he has regular contact with dogs or soil. Also, determine if he has a history of eating dirt or other nonfood substances.
Clinicians often diagnose toxocariasis by excluding more common diseases. But the most reliable test is an enzyme-linked immunosorbent assay titer for the Toxocara antigen. Treatment and prevention
Because larvae can live in the body for 10 years or more and no treatment is available to kill them, clinicians treat toxocariasis symptoms with drugs such as albendazole, diethylcarbamazine, and corticosteroids. Infected people aren't tracked consistently, so their prognosis is uncertain.
Help your patients prevent infection by explaining how toxocariasis is transmitted and giving them the following advice:
* Wash hands thoroughly and regularly, especially after contact with soil, sand, or animals.
* Avoid hand-to-mouth contact.
* Deworm dogs 3 weeks after birth and then at least every 2 years, even if stool samples are negative.
* Train pets to defecate on asphalt or another surface that won't contaminate the soil.
* Put wrapped pet feces in the trash.
* Lay plastic on the ground before installing a child's play area.
* Cover sandboxes when not in use so pets don't defecate in them.
BY SALLY CALDWELL-BLATZ RN, BA
Grand Rapids, Ohio
JANICE CHU RN CNS MSN
Clinical Instructor
Mercy College of Nursing, Toledo, Ohio
Copyright Springhouse Corporation Jan 2000
Provided by ProQuest Information and Learning Company. All rights Reserved
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