The raccoon roundworm (Baylisascaris procyonis) can result in larva migrans that can involve the central nervous system and/or eye. Diagnosis often requires a high index of clinical suspicion.
Findings that should suggest the diagnosis of Baylisascaris:
(1) potential exposure in a child or developmentally impaired person to raccoon feces or contaminated soil
(2) encephalitis with CSF eosinophilic pleocytosis
(3) peripheral eosinophilia
(4) deep white matter abnormalities on MRI scan
(5) scarring and/or larval tracks on ophthalmic examination
(6) exclusion of other causes (negative cultures for viruses and bacteria; negative serologic tests for other causes of larva migrans)
More specific tests:
(1) positive antibody titers on CSF or serum (available through CDC)
(2) identification of granulomas with Baylisascaris larvae
(3) larvae on ophthalmic examination
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