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Toksokaroz (toksokara) – symptoms, diagnosis and treatment

Features of the disease

Toksokaroz – this disease (helminthiasis), which develops as a result of damage to the body parasite Toksokara. Human invasion occurs through contact with sick dogs (toxocar larvae may be in feces, on animal fur), as well as contaminated soil.

There are two types of parasites that cause disease of toxocarosis:
one. Tocsocara canis – distributed by members of the canine family.
2 Toxosara mystax (cati) – develops in the body of animals of the cat family.

Toxocara is an atypical helminth for the human body, despite the fact that it is very similar to ascaris. Contact with a person threatens the parasite with death, as there are no optimal conditions for the development of a full-fledged larva and the continuation of the life cycle. Therefore, the disease cannot be transmitted from one person to another. Nevertheless, in the CIS countries, particularly in Russia, about 40-50% of children are infected with toxocarosis. Adults also suffer from this disease, but children are more likely because of their close contact with stray animals, games in contaminated sand and soil, and poor hygiene during walks.

Toxocar larvae: how the infection occurs

Animals can transmit toksokar larvae to each other in several ways:
one. Direct – through the environment.
2 Intrauterine – infection of offspring from a sick mother.
3 Transmammary – when feeding offspring with milk.

People get infected:

  • In contact with the coat of the sick animal.
  • In case of insufficient washing of fruits and vegetables.
  • By drinking raw polluted water.
  • In case of non-compliance with the rules of hygiene, insufficient and irregular washing of hands.

A person can become infected with toxocariasis at any time of the year, since the parasite’s larvae are extremely resistant to negative environmental factors. Most often, invasion occurs in summer and autumn, at this time there is a peak in the number of eggs in the ground, along with favorable conditions for the development of the larvae (warm, wet weather).

The risk group with a high probability of infection with toxocariasis includes:

  • Veterinarians, dog nursery staff.
  • Children 3-5 years old, who actively play with sand and soil and do not always follow the rules of hygiene.
  • Hunters in close contact with hunting dogs.
  • Vendors of vegetable stores and markets, constantly in contact with unwashed vegetables, the land on which may be contaminated with Toxcar larvae.
  • People who have a land plot or a vegetable garden, are forced to regularly carry out work with the ground, thereby increasing the risk of infection.

Main symptoms

Depending on the clinical manifestations of toxocarosis, it is divided into several forms:

  • eye
  • visceral
  • dermal
  • neurological.

Visceral toxocariasis

Eye toxocarosis

Cutaneous toxocariasis

Neurological toxocariasis

Toxocarosis in adults and children

Diagnostics

A preliminary diagnosis is made by a doctor based on:
one. Anamnesis data (frequent contact with soil and animals, presence of a dog house).
2 The presence of pronounced symptoms of the disease.
3 Eosinophilia.

The final diagnosis can be made if, as a result of a biopsy (most often for this purpose, a liver biopsy is performed) the larvae of parasites are found.

Good results in the diagnosis of toxocarosis show serological studies, the purpose of which is to determine the presence in the blood of antibodies to toxocar antigens. The ELISA method gives very good results, as it is highly sensitive (almost 95%).

Antibody titers from 1: 200 to 1400 suggest that there is an infection with parasites in the body.
If antibody titers are more than 1: 800, then this is evidence of the disease. Similar test results suggest that a person needs specific treatment. Especially strictly the course of treatment should be selected for children. Here an individual approach is important, which will necessarily take into account immunological, clinical and laboratory data.

No larvae or eggs of toxocara can be detected in human feces, since the parasite is not present in the intestine. For this reason, stool analysis is not informative for the diagnosis of toxocariasis. It is also quite difficult to identify the migratory larvae themselves in the body. But the body’s immune response to the presence of the parasite is, and for this reason, the detection of antibodies is the most common method of diagnosis.

If a parasite is affected by a human eye, the disease should be diagnosed in conjunction with an ophthalmologic study, since the amount of eosinophils in the blood may only slightly increase in the blood to occlusion, or it may be normal. As for specific antibodies in the blood, in some cases they are not detected at all, while in the rest they are present only in small quantities.

The results of serological studies conducted to identify toxocariasis are not sufficient grounds for the final determination of the presence or absence of the parasite in the body. Positive results can be caused by the presence in the body of parasites similar to toxocars, and negative ones by a certain localization (of the eye) and a small number of helminths.

Treatment of toxocariasis

The treatment is carried out with the following drugs:

  • Vermox
  • Mintezol
  • Ditrazina citrate
  • Albendazole.

Vermox should be consumed in 100 mg 2 times a day. The course of treatment is 2-4 weeks, and does not depend on the age of the patient. If Vermox is prescribed for an adult, then the amount of the drug used can be increased to 300 mg per day. One of the advantages of this medication is that in the process of its use side effects (diarrhea, pain in the abdomen, nausea) are rare.
Mintezol should be taken on the basis of the calculation of 25–50 mg of the drug per 1 kg of the patient’s body weight per day. The course of such treatment is 5-10 days, without interruption in use. This drug is well absorbed from the gastrointestinal tract and is rapidly excreted by the kidneys. Mintezol gives side effects, which include: headaches, nausea, loss of appetite, fatigue and drowsiness, pain in the abdomen. All these side effects are short-lived, and after discontinuation of the drug, they disappear in a short time. The positive quality of Mintezol is that it does not adversely affect the respiratory organs and the cardiovascular system.

Ditrazina citrate can be administered at the rate of 2–6 mg of the drug per 1 kg of the patient’s body weight per day. The duration of such treatment is 2-4 weeks. The drug has the following side effects: dizziness, headache, nausea. In some rare cases, the use of Ditrazin can cause fever.

Albendazole can be prescribed at the rate of 10 mg of the drug per 1 kg of the patient’s body weight per day. The duration of such treatment is 10-20 days. Albendazole has the following side effects: nausea, dizziness and headaches, abdominal pain, diarrhea. These side effects are usually rarely observed, and immediately disappear after drug withdrawal.

Albendazole and thiabendazole show a good result in the treatment of ocular and visceral toxosis. However, we should not forget that these drugs have a teratogenic effect, so that they can not be appointed during pregnancy, in all trimesters.

All the side effects that can be detected in a patient undergoing treatment with the use of the above drugs can be the result of both the toxic effect of the drug on the body and the reaction of the organism itself to the death of the parasites.

The prognosis for treatment of toxocariasis is favorable, but it should not be delayed, since invasion of vital organs with the toxocars can cause a fatal outcome.

Prevention of toxocariasis

Considering that nowadays cases of toxocarosis are increasingly registered, a number of measures should be taken to prevent this disease. First of all, you need to pay attention to the wide distribution of stray dogs in the cities. You also need to carefully monitor the health of pets, regularly de-worming them, show the vet for a general examination, etc. It is important to follow the rules of personal hygiene, special attention should be paid to thorough washing of hands after contact with soil or animals. It is also good to wash vegetables and fruits before eating them.

A necessary measure to reduce the number of toxocariasis diseases is sanitary education, during which the population should be informed about possible ways of infection with toxocarosis and ways to avoid invasion.

Tokocarosis: infection, preventive measures – video

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