Usually the patient is a child <= 10 years of age.
Syndromes:
(1) asymptomatic (covert)
(2) idiopathic single symptoms (seizure disorder, asthma, etc.)
(3) visceral larva migrans (VLM)
(4) ocular larva migrans (OLM)
Single symptoms that may be due to toxocariasis:
(1) pediatric seizure disorder
(2) functional gastrointestinal complaints
(3) asthma
(4) prurigo or urticaria
(5) behavioral problem
(6) strabismus
Visceral larva migrans may consist of one or more of the following:
(1) fever
(2) hepatomegaly
(3) bronchospasm (asthma) with cough
(4) splenomegaly
(5) neurologic disorders, including seizures, neuropsychiatric disorders, behavioral problems, or encephalopathy
(6) myocarditis
(7) nephritis (which may be related immune complexes as well as migrating larvae)
(8) irritable bowel or other functional gastrointestinal complaints (cramping, etc.)
(9) pruritis or urticaria
Ocular larva migrans may consist of one or more of the following:
(1) strabismus
(2) unilateral vision impairment (decreased visual acuity) ranging from mild to blindness
(3) retinal granulomas (usually peripheral or in posterior pole)
(4) retinal or macular detachment
(5) diffuse endophthalmitis or papillitis
(6) secondary glaucoma
(7) formation of a choroidal neovascular membrane
Laboratory findings:
(1) eosinophilia, which may be marked
(2) hypergammaglobulinemia
(3) antibodies to Toxocara species (precipitin test, ELISA). Patients with only ocular larva migrans may show lower antibody titers or may show negative serologic tests.
(4) elevated liver function tests in visceral larva migrans
(5) eosinophilic granulomas in a tissue biopsy
