Is it possible to treat toxocariasis if 1,800. Antibodies to toxocara - decoding of indicators

Toxocarosis is a type of helminthiasis, the causative agent of which is Toxocar.

This helminth belongs to the type of roundworms and belongs to the genus Toxocara. This type of worm lives mainly in the body of animals (dogs, cats, great cattle), so the development of toxocariasis in humans is rare.

But if infection, nevertheless, occurs, then the larva cannot develop inside the human body - it dies almost immediately. For this reason, toxocariasis is not transmitted from one person to another. You can get infected only through contact with animals, and most often small children are susceptible to the disease.

Pathogen

The causative agent of toxocariasis can be:

canine roundworms, or Toxocara canis;
feline toxocara, or Toxocara cati;
toxocara cows, buffaloes, or Toxocara vitulorum.

Most cases of human infection with toxocariasis are associated with canine toxocariasis. This variety of helminths has a yellowish color, and can reach from 4 to 10 cm (males) or 6-18 cm (females). They have a curved tail end and a mouth opening with 3 lips. At the head end are the so-called "lateral wings", which are actually swellings of the cuticle. It is by its size that differential diagnosis is carried out.

The eggs of this species of helminths have a light or dark brown hue. They have a round shape and a size ranging from 65-75 microns. Despite the fact that they are larger than roundworm eggs, nevertheless, their structure is almost the same. Inside the mature Toxocara egg there is a larva, which is quite active and mobile. If the egg is not ripe, then inside it contains a rounded blastomere. Sexually mature individuals live mainly in the stomach of young dogs or other representatives of the fauna. Their life cycle lasts 4-6 months.

A sexually mature female lays up to 200 thousand eggs per day. 1 g of animal feces contains up to 15,000 eggs, so you can imagine how many of them are in the ground. After the eggs fall into the soil, they begin to ripen. This process takes from 5 days to 1 month. Ripe eggs are able to remain viable in the soil from several months to several years.

Methods of infection with toxocariasis

Like most types of helminthiasis, toxocariasis occurs due to poor hygiene. If, after contact with infected animals or contaminated soil, a person neglects elementary hand washing, then when touching the food they eat, Toxocar eggs get into it, after which they enter the human body. This route of transmission is called the fecal-oral route.

Certain conditions are necessary for the penetration of Toxocar into the human body. These include:

consumption of contaminated products and water;
contacts with dust where toxocar eggs are located;
neglect of hygiene rules;
contact with the hair of infected animals;
use of various household items.

Sometimes toxocariasis can be contracted by eating the meat of infected animals. A vertical (placental) route of infection is also possible, when the pathology is transmitted from mother to unborn child through the placenta, and lactation - through breast milk.

The development of the disease in humans occurs after the toxocar larvae begin to move throughout the body. They can settle in:

liver;
lungs;
a heart;
eyes;
the brain;
skeletal muscles;
pancreas.

Classification and symptoms of the disease

Toxocariasis has 3 forms:

manifest with a pronounced clinical picture;
erased when vague nonspecific symptoms appear;
latent, when the disease does not manifest itself in any way.

The severity of the course of the disease directly depends on the age category of the patient:

children under 12 years of age suffer from a manifest form of pathology of moderate or severe severity;
in adults, the symptoms are erased, fuzzy.

If the disease lasts for 3 months, after which it disappears, it is called acute. With a longer course, we are talking about the chronicity of the pathological process with periods of exacerbation and remission.

Forms of toxocariasis, depending on the clinical manifestations, are as follows:

visceral, when various internal organs are involved in the pathological process;
eye;
skin;
neurological.

Epidermal rash, which in its appearance resembles mosquito bites. Rashes can be ring-shaped and have different localization. The nature of the rash is also different: from minor discomfort to unbearable itching.
- a very dangerous pathological condition, accompanied by compression of the larynx. In extremely severe cases, there is a narrowing of the laryngeal lumen (stenosis) or even the development of anaphylactic shock. With Quincke's edema, the patient feels a sharp attack of suffocation and lack of air, inhalation and exhalation is much more difficult. Due to a lack of oxygen, the nasolabial triangle is blue first, and then all the skin. In the absence of qualified medical assistance, Quincke's edema almost always ends in the death of a person.
, the main symptom of which is a strong dry cough with the release of a small amount of light mucus. The disease is accompanied by attacks of poison (suffocation) caused by a sudden narrowing of the lumen of the bronchi (bronchospasm). Treatment is symptomatic, aimed at relieving an asthma attack and liquefying sputum. It is extremely difficult to cure asthma completely - it can only be "outgrown" or transferred to a phase of long-term remission.

In the acute form or during the period of exacerbation of chronic toxocariasis, the patient develops subfebrile or febrile fever, general weakness, increased sweating, loss of appetite. Symptoms such as body aches and muscle pain, which are constant companions of high temperature, practically do not occur.

With an exacerbation of toxocariasis, an increase in lymph nodes occurs - lymphadenopathy. Despite this, they remain mobile and painless.

Visceral shape

In almost 90% of cases, toxocariasis affects the internal organs, so the symptoms of the disease directly depend on which of them was involved in the pathological process. But the clinical picture of intoxication of the body and allergies does not disappear anywhere. When toxocar larvae penetrate the liver, other organs of the gastrointestinal tract are also affected.

After that, the larvae penetrate into the bile ducts and pancreatic ducts, then into the small intestine and duodenum. Because of this, there is a violation of the outflow of bile and juice from the pancreas, as a result of which the intestinal wall is injured. This process is accompanied by:

flatulence;
stabbing pains in the right hypochondrium;
bitterness in the mouth;
violation of the stool, when constipation is replaced by diarrhea;
bouts of nausea after eating;
pain in the abdomen;
drastic weight loss.

Toxocara can disrupt the integrity of the intestinal walls, which leads to constant blood loss. Although it is small, but with systematic bleeding, anemia develops. Anemia is accompanied by weakness, headaches and dizziness, blanching of the skin, trembling in the limbs, tinnitus. In severe pathology, short-term syncope (fainting) is possible.

When the respiratory system is affected, the following symptoms occur:

persistent unproductive cough with no or minimal sputum;
dyspnea;
lengthening and difficulty of exhalation;
bouts of suffocation.

If the symptoms are ignored, toxocariasis leads to the development of bronchial asthma. Sometimes the disease can cause pneumonia, pulmonary edema.

In severe cases, the larvae penetrate the heart and settle on its valves, which causes the development of endocarditis. Clinical manifestations of the pathological process are:

constant weakness;
blue fingers and nasolabial triangle;
with damage to the left half of the heart, the patient develops cough and shortness of breath, especially in the supine position;
the formation of symmetrical edema of the tissues of the legs; when the right side of the heart is affected, the abdomen also swells.

Ocular form (ophthalmotoxocariasis)

The ophthalmic form of toxocariasis is much less common than the visceral form. As in most cases, the cause of the development of pathology is a weak immune system, which is unable to prevent larvae from entering the eyes. As a rule, the disease affects only one visual organ. When larvae enter it, granulomas form in the lens or retina.

Ocular toxocariasis leads to the development of a chronic inflammatory process. On its soil, keratitis (inflammation of the cornea), endophthalmitis (purulent inflammation of the eye membranes), retinal detachment or optic nerve neuritis often develop. In severe cases, complete blindness may develop.

neurological form

When the larvae of toxocara are damaged in the brain, a neurological form of toxocariasis develops. In this case, the shell and tissues of the GM are affected, as well as the central nervous system. A person begins to experience difficulties with thinking, recognizing objects, and motor skills.

The clinical picture of the neurological form of toxocariasis consists of the following symptoms:

convulsions similar to an attack;
syncope;
disturbances of consciousness;
gait changes;
imbalance;
photophobia;
intolerance to loud sounds;
a sharp reaction to touch;
intense throbbing or pressing headache;
nausea with bouts of vomiting;
muscle hypotonia (up to complete cessation of both functioning and absolute immobilization);
causeless aggression, affective states;
inability to deal with stressful situations on their own.

In rare cases, the development of combined toxocariasis is possible, when a person suffers from several forms of pathology at once. However, science has isolated cases of such a deviation.

Skin form

The cutaneous form of toxocariasis is characterized by the development of an allergic reaction, accompanied by epidermal rashes of varying intensity and localization. A person has severe skin itching, hyperemia and swelling.

Symptoms may start in one place, then move to another part of the body. This is due to the peculiarity of the movement of larvae through the body.

Diagnostics

A preliminary diagnosis is made by a doctor based on several factors. They are:

collection of anamnesis;
the presence of pronounced symptoms of pathology;
eosinophilia.

However, the final diagnosis is made only on the basis of the results of the biopsy. If toxocara larvae are found in the biopsy, treatment can begin.

If an ophthalmic form of the disease is suspected, an obligatory examination of the eyes by an oculist is carried out. In this case, it is impossible to rely on eosinophilia, since the increase in the level of eosinophils in the blood with this type of toxocariasis is insignificant. The same applies to immunological tests.

It should also be taken into account that the results of serological studies and a pronounced clinical picture may not always indicate the presence of toxocars in the body. Positive test results may well indicate the development of other types of helminthiasis, and negative ones indicate a different localization of toxocara and a small number of them.

How to treat toxocariasis?

There is no specific treatment regimen for toxocariasis, but it is also impossible to let the situation take its course. Infectionists often prescribe the following medications:

- an anthelmintic agent, the active substance of which is mebendazole. The dosage is 100 mg twice a day for a course of 2 to 4 weeks. The drug is safe, but in rare cases, side effects may occur in the form of nausea and cephalalgia.
Mintezol is a drug based on thiabendazole, the dosage of which is calculated according to the scheme of 50 mg per kg of body weight once a day. Used to treat toxocariasis for 5-10 days. The drug can cause side effects, but they pass quite quickly.
Ditrazine citrate, the active substance of which is diethylcarbamazine. The course of treatment is from 14 to 28 days, 4 or 6 mg per 1 kg of body weight per day. The dose is calculated individually. The drug can cause pronounced symptoms of side effects and overdose. They manifest themselves through the occurrence of fever, bouts of nausea, cephalalgia, vertigo.
- an antihelminthic drug, the active substance of which is albendazole. Assign 10 mg per kilogram of weight 1 time per day in a course of 10-20 days. Rarely, the patient has side effects in the form of stool disorders, nausea, headache. The drug has a teratogenic effect, so its appointment during pregnancy is not practiced.

Complementary therapies include:

etiotropic;
pathogenetic;
symptomatic.

Let's briefly consider each therapeutic approach separately.

Etiotropic therapy

Etiotropic therapy involves the use of drugs aimed at eliminating the cause of the disease. That is, for the complete destruction of Toxocara larvae. Often used drugs:

Mebendazole is an anthelmintic drug approved for use in adults and children over 2 years of age.
Albendazole is another antihelminthic used to treat various types of helminthiasis. The medicine is prescribed for children from 1 year of age and adult patients.

Pathogenetic therapy

Pathogenetic treatment is aimed at restoring the normal functioning of the body, which was disturbed by the disease. At the same time, drugs are also used that stop pathological processes and prevent their possible complications. For this purpose, apply:

Such treatment is aimed at eliminating the symptoms associated with toxocariasis: high fever, nausea, vomiting, etc.

Antipyretics bring down the heat and relieve muscle pain: Nurofen, Paracetamol.
Antispasmodics stop vomiting and improve the functioning of the gastrointestinal tract: Papaverine,.
Antiemetics: Cerucal,.
Antihistamines, stopping the manifestations of an allergic reaction: Cetrin, Loratadin, Fenkarol, Tavegil, etc.

Treatment of toxocariasis has its own criteria for effectiveness, which are:

removal of the clinical picture of toxocariasis - both specific and non-specific symptoms;
decrease in the level of eosinophils;
decrease in the level of antigens to toxocariasis to 1:8000 or less.

The duration and number of therapeutic courses depends on the positive dynamics of treatment. In most cases, toxocariasis is quite successfully treated, but in extremely rare and severe cases, death is possible.

Consequences and the myth of the effectiveness of self-treatment

Basically, the disease does not cause serious complications, but in the absence of adequate treatment, it may develop:

tissue injuries of varying severity;
secondary inflammatory processes;
hemorrhages;
tissue necrosis.

With the defeat of the larvae of toxocar eyes, the development of one-sided blindness is possible. In addition, with a long absence of therapy, the formation of granulomas in the tissues of various internal organs is possible.

As for the effectiveness of folk remedies used for toxocariasis, such therapy can only temporarily eliminate the symptoms of the disease. It is impossible to cure it completely without the use of anthelmintic drugs, therefore, alternative medicine methods can only be used in combination with pharmacy drugs.

Prevention

To avoid the development of toxocariasis, which requires a long and exhausting treatment, it is necessary to direct all efforts to the adoption of preventive measures. For this you should:

carefully observe hand hygiene, especially after visiting the restroom and contact with animals;
teach children hygiene from early childhood;
carry out regular preventive procedures aimed at preventing helminthiasis in pets;
thoroughly wash fruits and vegetables, you can use laundry soap;
ensure that meat products undergo complete heat treatment.

It is important to follow these rules for people who are at risk of contracting toxocariasis. Such persons are:

small children who love to play with sand and soil;
owners of pets, in particular dogs and cats;
summer residents and gardeners;
veterinarians.

If the first symptoms of toxocariasis occur, you should immediately consult a doctor and undergo the necessary studies. By refusing self-treatment, a person can be completely sure that he will not harm his own health, and this is the most important thing in the treatment of not only helminthiases, but also any other, even the mildest, diseases.

Other helminths may not give themselves away for a long time. For example, with toxocariasis, complaints are vague, and the usual analysis of feces is not informative. An analysis for antibodies to Tosocaram will help.

What is toxocariasis?

Toxocariasis is caused by helminths belonging to the group of nematodes. The disease caused by toxocar larvae leads to the appearance of bronchitis, feverish conditions, and pneumonia in humans. Larval toxocariasis is found in people all over the world.

There are several types of toxocariasis. Imaginal (intestinal) is quite rare, the larval form of the disease is more often diagnosed. In this case, they talk about visceral or.

From eggs in the intestines of a person, larvae appear. They are able to penetrate through the walls of the intestine into the blood and through the vessels to reach any organs or tissues. There they are encapsulated and retain their biological activity for a long time.

As for the larvae of cat Toxocara, after migration through the body, they again reach the intestine in the adult stage, which leads to the imaginal form of the disease.

Toxocara are quite prolific. The female is able to lay about 200 thousand eggs per day. Eggs enter the external environment, where they are picked up by a person. Most often, children of preschool age face toxocariasis. They play on the ground, in the sandbox, and animals run nearby, some of which are probably infected with toxocars. After playing, children are in no hurry to wash their hands, but pull food into their mouths. This is how infection occurs.

Read more about the causes of infection of children with toxocariasis in the article

Damage to the brain by toxocar larvae leads to impaired performance. The person suffers from headaches. The worst thing is that the disease leads to paresis and paralysis.

The intestinal form of toxocariasis (imaginal) is rarely registered. The disease is accompanied by nausea and dizziness. A person is worried about the lack of appetite, pain in the stomach.

The ophthalmic form of toxocariasis causes damage to the posterior surface of the eye. Larvae caught in the eye cause uveitis, chorioretinitis, keratitis. All of these can lead to vision loss. Usually one eye is affected.

Diagnosis of toxocariasis

Toxocara can not be detected by fecal analysis. The larvae are not excreted in the feces, so the disease can go unrecognized for a long time. When taking a blood test, an increased number of eosinophils is detected, while the level of eosinophilia sometimes reaches even 80%. In addition, an increased content of leukocytes is found in the blood.

With the transition of the disease to a chronic state, clinical and laboratory parameters become close to normal. Eosinophilia remains the only stable indicator in the diagnosis of blood.

Very rarely, the diagnosis of toxocariasis is established by examining biopsy material, for example, by biopsy of the liver or lungs. Sometimes the disease is detected during a surgical operation.

A more informative diagnostic method is the method of detecting antibodies to toxocar antigens. The most commonly used method is enzyme immunoassay.

Blood test for antibodies to toxocara

Clinical picture

Doctor of Medical Sciences, Professor Gandelman G. Sh.:

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After infection, class G immunoglobulins can be detected after 1.5-2 months. After 3 months, their concentration in the blood is maximum, then the concentration is stable for a long period.

The IgG antibody test for toxocariasis is considered one of the main ways to detect the disease. It is carried out not only to confirm the diagnosis, but also to monitor the effectiveness of the prescribed treatment.

What does it mean: the titer of antibodies to toxocar antigens is higher than 1:800? Most likely, we are talking about infection with toxocariasis. But the doctor will additionally consider other signs of the disease, and will also take a look at the eosinophil count in the blood. If eosinophilia exceeds 10%, other signs of infection are present, and the person confirms the likelihood of infection, a diagnosis of toxocariasis is made.

If toxocariasis is suspected, an igg-positive result, as well as an increase in serum repeat titers, indicates a primary infection with toxocara.

Carriage of Toxocar does not always lead to the progression of the disease. Antibody titers from 1:100 to 1:400 can indicate toxocarriage. In this case, eosinophilia in the blood must be present (up to 10%). To confirm the diagnosis, a second study is required, which is carried out no earlier than after 1.5 months.

Preparing to donate blood for analysis

To obtain reliable and informative test results, you should always know what preparation requirements should be followed.

There are no special requirements for testing for toxocariasis.

The day before the test, you should refrain from taking strong drinks.
The food taken by a person the day before the analysis should be light and quickly digestible.
On the day of the test, you should come to the laboratory in the morning (on an empty stomach).
It should be remembered that blood will be taken from a vein, so it is better to go to the hospital with an escort (many people feel bad on the way after donating blood).

Deciphering the analysis

Must be done by a specialist.

Why might the result be false?

A false positive reaction is observed in the following cases:

Diseases of an infectious nature, as well as somatic diseases that cause destructive focal lesions in organs. For example, in oncological diseases, tuberculosis, liver damage, patients very often observed a false positive reaction during the analysis.
Autoimmune diseases also cause false positive responses.
Pregnancy.

Other factors can affect the analysis, so in some cases a false negative result is possible.

Therefore, studies of the body should be carried out comprehensively. It is impossible to make an accurate diagnosis based only on the results of ELISA.

Video from Dr. Malysheva about toxocariasis:

The development cycle of the pathogen is as follows: the released Toxocara eggs enter the soil, where, depending on soil moisture and temperature, they mature in 5-36 days, becoming infectious. The infectivity of eggs remains in the soil for a long time, in compost - for several years.

In humans, the development cycle of the pathogen, its migration is carried out as follows. From the Toxocara eggs that have entered the mouth, then the larvae enter the stomach and small intestine, which penetrate the blood vessels through the mucous membrane and migrate through the portal vein system to the liver, where some of them settle, surrounded by an inflammatory membrane. Some of the larvae through the hepatic vein system pass through the liver filter, enter the right heart and through the pulmonary artery into the lungs. In the lungs, some of the larvae also linger, and some, having passed the filter of the lungs, are brought into various organs through the systemic circulation, settling in them. Toxocara larvae can be localized in various organs and tissues - kidneys, muscles, thyroid gland, brain, etc. In tissues, the larvae remain viable for many years and periodically, under the influence of various factors, resume migration, causing relapses of the disease.

Toxocariasis is a widespread disease, it is registered in many countries.

The main source of infection for humans are dogs, especially puppies. Infection occurs by direct contact with an infected animal whose coat is contaminated with eggs, or by ingestion of earth in which Toxocara eggs were found. Children are especially susceptible to infection while playing in the sand or with a dog. Adults become infected through household contact with infectious animals or in the course of professional activities (veterinarians, dog breeders, public utilities, drivers, diggers, etc.). In humans, infection is also possible when eating raw or poorly thermally processed meat. Cases of infection with toxocariasis are described when eating lamb liver.

Symptoms of toxocariasis are determined by the intensity of infection, the distribution of larvae in organs and tissues, and the characteristics of the human immune response. Manifestations of toxocariasis are not specific and are similar to other helminths.

Toxocariasis usually develops suddenly or, after a short pre-disease, manifests itself as a slight malaise. A temperature appears - low in mild cases and high up to 39 ° C and above, sometimes with chills. There may be skin rashes in the form of urticaria, sometimes Quincke-type edema. In the acute period, there is a pulmonary syndrome of varying severity: from mild phenomena to acute bronchitis, pneumonia, severe asthma attacks. Especially severe pulmonary syndrome occurs in young children. Sometimes there are bouts of pain in the abdomen. There are known cases of thyroid lesions, manifested by symptoms of a tumor. When larvae migrate to the brain: persistent headaches, convulsions, paralysis. In children, the disease is accompanied by weakness, mild excitability, sleep disturbance.

The most characteristic laboratory indicator of toxocariasis is an increased content of eosinophils in the peripheral blood. The relative level of eosinophilia can vary widely, reaching in some cases 70-80% or more. The content of leukocytes increases. In the chronic stage of the disease, acute clinical and laboratory signs subside. The most stable laboratory indicator is the increase in eosinophils.

A diagnostic titer is an antibody titer of 1:400 or more (in ELISA). An antibody titer of 1:400 indicates infection, but not disease. An antibody titer of 1:800 and above indicates a disease of toxocariasis. Practice shows that a direct relationship between the level of antibodies and the severity of clinical manifestations of toxocariasis does not always exist.

Toxocariasis is a widespread and at the same time difficult to detect zoonotic tissue helminthiasis that develops mainly in children of early and preschool age.

Symptoms of toxocariasis

The disease affects mainly children aged 1.5-6 years. For the disease, a long relapsing course is typical, due to the cyclic release of Toxocara larvae from granulomas and the resumption of their spread. Allocate visceral and ocular toxocariasis.

Diagnosis of toxocariasis

In fact, only a post-mortem diagnosis is possible, as a result, serological reactions with a toxocariasis antigen (ELISA, RID, RNGA) are the main ones in the diagnosis of toxocariasis. In enzyme immunoassay, a titer of 1:800 and above indicates the presence of a disease, and a titer of 1:200 and 1:400 indicates toxocariasis and toxocariasis of the eyes. For children with low titers of antitoxocariasis antibodies, dispensary observation is established, and if there is an appropriate clinic, specific therapy is prescribed. X-ray revealed increased lung pattern and volatile eosinophilic infiltrates. In addition to eosinophilia, moderate leukocytosis appears in the blood, ESR increases, hypergammaglobulinemia, a sharp increase in the level of immunoglobulin E. With a long course, anemia develops.

Apply "Mintezol" at the rate of 25-50 mg / kg per day for 5-7 days; "Vermox" 100 mg 2 times a day (2-4 weeks); "Ditrazin" at the rate of 2-6 mg / kg per day (2-4 weeks); "Albendazole" at a dose of 10 mg / kg per day for 5 days. Simultaneously with deworming, the appointment of antihistamines and vitamin preparations is indicated. With a torpid and protracted course of the disease, courses of treatment are carried out again after 3-4 months, up to 4-5 courses. The effect of deworming is judged by the positive dynamics of symptoms, a decrease in the level of eosinophils and specific antibody titers. The prognosis is favorable, but with intensive invasion and penetration of larvae into vital organs, a lethal outcome is not ruled out.

Essential drugs

There are contraindications. Specialist consultation is required.

Mintezol (anthelmintic). Dosage regimen: inside, during or after meals at the rate of 25-50 mg / kg per day for 2 doses. The course of treatment is 5-7 days.

Vermox (anthelmintic). Dosage regimen: inside, with a small amount of water, 100 mg 2 times a day. The course of treatment is 2-4 weeks.

Ditrazine (anthelmintic). Dosage regimen: inside, at the rate of 2-6 mg / kg per day for 3 doses. The course of treatment is 2-4 weeks.

Albendazole (anthelmintic). Dosage regimen: inside, adults and children over 14 years of age weighing more than 60 kg are used in a single dose of 400 mg; with a body weight of less than 60 kg - 200 mg, for children under 14 years of age, the dose is set at the rate of 10 mg / kg; the multiplicity of reception 2 times / day, the duration of therapy is 7-14 days.

online-diagnos.ru

What antibodies are total to Toxocara?

The purpose of a serological study is primarily to diagnose the disease itself, and also to evaluate the treatment being carried out.

But first, about diagnostics. Antibodies to toxocara are usually counted in titers. The norm of the indicator is their complete absence. Other data may indicate infection or past illness. The results of the analyzes themselves are recorded in the following terms:

A positive result is considered when antibodies to toxocar antigens have an indicator of 1:400 or more. If this indicator, for example, is 1:800, then this not only indicates the invasion of helminths, but also that pathological processes are developing inside. If the figure is even higher, then this is a guarantee that a person is infected with another type of helminth.

A titer of 1:400 and below is an indication that there may be larvae in the eyes or that a visceral type of disease occurs. Therefore, if antibodies of the IgG class are present in the human body in the indicated amount, he needs to be observed by specialists so that, in case of manifestation of other symptoms of the disease, adequate treatment is prescribed to him in a timely manner. What does adequate mean? This means that the selection of drugs will be carried out taking into account the symptoms of the disease, examination data and the health status of a particular patient in such a way that the treatment is as effective as possible.

If, according to the results of the study, a figure of less than 1:100 is set, then this indicates that:

There was no infection at all.
The number of IgG class antibodies is negligible.

Do not be afraid even of a positive diagnosis. It may not always be indicative of toxocara invasion.

What factors can affect the result

A false positive reaction can occur when the patient is diagnosed with:

Autoimmune diseases.
antiphospholipid syndrome.
infectious diseases.
Somatic diseases.

False may be indicators for antibodies of the IgG class during pregnancy. Also, antibodies to toxocara may not be detected due to:

Given the possibility that the data may not always be conclusive, the diagnosis is made regardless of whether the result was positive or negative for antibodies in the aggregate:

clinical data.
The results of a complete laboratory examination of a person.

Therefore, if there is the slightest suspicion of infection with toxocara, it is imperative to undergo a re-examination in a few months: the more toxocariasis is started, the more difficult it is to treat it. Moreover, infection can not only affect the well-being of a person, but also threaten his life.

Determination of IgG class antibodies to the causative agent of toxocariasis is the main serological method for diagnosing toxocara invasion.

Anti-Toxocara IgG, Toxocara antibodies, IgG.

General information about the study

The study is being conducted to detect infection with a nematode of the Anisakidae family of the genus Toxocara canis - these are roundworms that cause toxocariasis.

Migrating through the body, the larvae have a different effect on it: they injure blood vessels, causing bleeding and necrosis. Of great importance are the excretory-secretory antigens of the larvae, which have a sensitizing effect on the body.

The main symptoms of T. canis infection are: fever, lymphadenopathy, general malaise, skin rash, gastrointestinal disorders, with massive invasions - pain in the right hypochondrium, enlarged liver and spleen, signs of lung damage. The ocular form of toxocariasis is characterized by damage to one eye in the form of reduced visual acuity, retinal granuloma, uveitis, endophthalmitis, optic neuritis, keratitis, or the presence of migrating larvae in the vitreous body. Although the main manifestations of the disease depend on the affected organs, the most characteristic laboratory finding is peripheral blood eosinophilia.

The diagnosis of "toxocariasis" is made on the basis of the clinical picture, eosinophilia, epidemiological history data and the results of a serological study.

The study is carried out in order to detect infection with a nematode of the family Anisakidae, the genus Toxocara canis , which causes toxocariasis. It is recommended to examine people belonging to risk groups: veterinarians, livestock breeders, dog handlers, children with signs of fever of unknown origin and with blood eosinophilia.

When a person comes into contact with Toxocara canis, their immune system reacts by producing IgM and IgG antibodies.

Immunoglobulins class G to Toxocara in detectable amounts appear in the blood after 6-8 weeks from the moment of infection. Their concentration increases and after 2-3 months reaches a maximum, remaining at a certain level for a long time. The degree of increase in the level of antibodies in the blood is closely related to the severity of the disease.

When the patient is in a high-risk group (livestock breeders, dog handlers, farmers, veterinarians).

A positive test result for Toxocara canis IgG antibodies in a previously seronegative patient, as well as a significant increase in titers in paired sera taken at intervals, confirms a primary infection.

Repeated studies of the level of antibodies in the patient's blood make it possible to evaluate the ongoing treatment - its effectiveness is evidenced by a decrease in the level of antibodies.

no infection,
ocular toxocariasis (due to a weak immune response),
current or past toxocariasis,
The basis for the prevention of toxocariasis is personal hygiene: washing hands after contact with soil or animals. Do not eat poorly processed foods that may contain Toxocara canis eggs.
Dog owners need to timely examine their pets and, if necessary, deworm them.

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Toxocarosis (Latin)- helminthiasis, characterized by fever, bronchitis, pneumonia, hepatosplenomegaly, eosinophilia. Larval toxocariasis is registered in many countries of the world.

Toxocara- a helminth that affects mainly representatives of the canine and feline families. The size of sexually mature helminths ranges from 4 to 18 cm. At the head end there are characteristic 3 lips. A distinctive feature of toxocara is also the swelling of the cuticle, which form lateral wings 2.3-0.3 mm in size. Mature invasive toxocara eggs with a thick, dense, finely tuberous shell contain a live larva.

The average life expectancy is about 4 months. A female toxocara can lay more than 200,000 eggs per day. The maturation period of eggs depends on the ambient temperature and humidity. The optimal temperature for egg development is 24-30 °C, the relative humidity of the soil is above 20%. Under these conditions, the larva in the egg develops in 5-8 days. The lower temperature threshold for the development of Toxocara eggs is + (10-13) °C, at a temperature of +37 °C the eggs die after 5 days, and at +55 °C - within 7 minutes. The death of eggs begins at temperatures below -15 ° C. In the soil, eggs remain viable and invasive for a long time (several years). The spread of toxocariasis among animals occurs through the following transmission mechanisms:

Infection with eggs from the environment.

Infection of the fetus with larvae through the placenta (thus, puppies are born already with toxocariasis).

Ingestion of live larvae by puppies with the milk of a lactating dog.

Infection via reservoir hosts (a study conducted in Japan in 1990 showed that cockroaches eat a significant number of toxocar eggs, with up to 25% excreted by them in a viable state).

The season of human infection seems to be in the summer-autumn period, when the number of eggs in the soil and contact with it are maximum. In the small intestine, larvae emerge from the eggs, which penetrate the bloodstream through the mucous membrane, then enter the liver and heart, from where, migrating, they reach the point where the diameter of the vessel does not let them through (the diameter of the larva is 0.02 mm), and here they leave the bloodstream. channel. Toxocar larvae settle in the liver, lungs, heart, kidneys, pancreas, brain, eyes and other organs and tissues. Here they remain viable for a long time (months, years). the larvae that have settled in the tissues remain in a "dormant" state, and then, under the influence of some factors, they become active and continue to migrate. Over time, some of the larvae are encapsulated and gradually destroyed inside the capsule.

Among animals, the mechanism of transmission of the pathogen is:

Direct (infection with eggs from the environment),

Intrauterine (infection of the fetus with larvae through the placenta),

Transmammary (transmission of larvae with milk).

For people The main prerequisites for the transmission of the causative agent of toxocariasis is soil contamination with toxocara eggs and contact with it. Other transmission factors can be:

contaminated food,

The season of human infection continues throughout the year, but the maximum number of infections occurs in the summer-autumn period, when the number of eggs in the soil and contact with it are maximum, and the temperature and soil moisture are favorable for their development.

Risk groups for infection with toxocariasis:

Children 3-5 years old, intensively in contact with soil, sand;

Veterinarians and dog kennel workers;

Sellers of vegetable shops;

Owners of personal plots, vegetable gardens;

IgG class antibodies to Toxocara, class G immunoglobulins to Toxocara antigens.

Enzyme immunoassay (ELISA).

What biomaterial can be used for research?

How to properly prepare for research?

Do not smoke for 30 minutes before donating blood.

Toxocara larvae, which have passed through the lungs, spread through the systemic circulation throughout the body, settling in various organs. The helminth larvae that got into the tissues of the organs do not undergo further normal development and eventually die there, encapsulating and forming granulomas.

Toxocariasis can occur in various forms, often asymptomatically. Clinically, 2 forms are distinguished: visceral syndrome - "wandering larva syndrome" - and ocular toxocariasis.

In immunocompromised patients with massive toxocara invasion, severe complications are possible.

What is research used for?

There are several methods that can be used to test for toxocariasis. One of them allows you to determine the antibodies of the pathogen in the blood.

False-positive test results are possible in individuals with systemic lymphoproliferative diseases and immunodeficiency. False-negative and questionable test results can be observed in individuals with eye damage as a result of weak antigenic exposure.

The Toxocara IgG antibody test is the main method for detecting toxocariasis in humans and is used to confirm the diagnosis.

In what cases is an analysis prescribed?

If there are signs of damage to the liver, lungs and / or fever of unknown origin against the background of eosinophilia in the blood, indicating a possible invasion by nematodes.
With a sudden decrease in vision affecting one eye.
According to epidemiological indications (contact with dogs, earth - especially in children).
If the person is known to have consumed insufficiently processed foods that may have been contaminated with T. canis.

Diagnostic titer: 1:100.

For blood tests for toxocariasis IgG antibodies, which the body produces to fight infection, a positive result indicates that the patient is infected with Toxocara canis. However, a negative result does not always mean that the patient does not have toxocariasis.

A negative result of this test may indicate the absence of infection or too early a period when an immune response has not developed.

Reasons for a negative result:

too early infection, when the immune response has not developed.

Reasons for a positive result:

latent toxocariasis.
Diagnosis of catoxocariasis is difficult. This is due to the fact that toxocara do not reach a sexually mature state in the human body, therefore it is impossible to detect adults or their eggs in stool samples or duodenal contents, as with other helminthiases.
Be sure to take into account the epidemiological history: contact with dogs, land, eating insufficiently processed foods.
The disease is not transmitted from person to person.
Screening for helminthiases (Opistorchis IgG, Toxocara IgG, Trichinella IgG, Echinococcus IgG)

Who orders the study?

Infectionist, therapist, pediatrician, gastroenterologist, allergist, ophthalmologist.

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Toxocariasis is a widespread and at the same time difficult to detect zoonotic tissue helminthiasis that develops mainly in children of early and preschool age.

The causative agent of toxocariasis is the larvae of ascaris in dogs Toxocara canis and possibly cats Toxocara mystax. Sexually mature helminth of light brown color (female 6-18 cm long, male 4-10 cm), having a curved or cone-shaped tail end and wide lateral wings in the head part, which serves as their distinguishing feature from roundworms. Helminths that have reached puberty usually live in the small intestine and stomach of dogs, cats, foxes, arctic foxes, which serve as obligate hosts.

A person becomes infected mainly in the spring, swallowing the eggs contained in the soil through dirty hands, unwashed vegetables, fruits, berries, and water. The predominant defeat of children is due to frequent contacts in everyday life with dogs and cats, especially with puppies and kittens, poorly developed personal hygiene skills and a predisposition to geophagy.

The larvae are mainly localized in the liver and lungs; less often in the heart, kidneys, pancreas, brain, eyes. In these organs, they remain viable for ten years. Over time, a certain number of larvae are encapsulated and destroyed in the same place. In the human body, adults are not formed, so infested people become reservoir hosts.

Symptoms of toxocariasis

Visceral is formed by infection with a large number of larvae and flows with manifest general allergic symptoms: recurrent, predominantly subfebrile temperature, urticarial itchy rashes, polylymphadenopathy, lung injury syndrome, liver enlargement and hypereosinophilia, which is the most stable sign of toxocariasis (up to 95%!). Organ pathology is determined by the topic of localization of Toxocara larvae (granulomas) or their redistribution in the process of migration in the child's body.

When a child is infected with a minimum number of larvae (more often than one), ocular toxocariasis develops. Pathological changes are unilateral and manifested by the formation of solitary granulomas and chronic endophthalmitis with exudation. Possible periorbital edema, keratitis, iridocyclitis, uveitis, optic neuritis up to complete loss of vision. With this form, there are no visceral lesions, eosinophilia is unexpressed.

Diagnosis of toxocariasis

Treatment of toxocariasis

Essential drugs

There are contraindications. Specialist consultation is required.

Mintezol (anthelmintic). Dosage regimen: inside, during or after meals at the rate of 25-50 mg / kg per day for 2 doses. The course of treatment is 5-7 days.
(anthelmintic). Dosage regimen: inside, with a small amount of water, 100 mg 2 times a day. The course of treatment is 2-4 weeks.
Ditrazine (anthelmintic). Dosage regimen: inside, at the rate of 2-6 mg / kg per day for 3 doses. The course of treatment is 2-4 weeks.
Albendazole (anthelmintic). Dosage regimen: inside, adults and children over 14 years of age weighing more than 60 kg are used in a single dose of 400 mg; with a body weight of less than 60 kg - 200 mg, for children under 14 years of age, the dose is set at the rate of 10 mg / kg; the multiplicity of reception 2 times / day, the duration of therapy is 7-14 days.

A little about the pathogen: the main helminth that causes toxocariasis is Toxocara Canis, a nematode whose differential host is a dog.

Once in the human body, Toxocara eggs enter the intestines, where the larvae hatch. They gnaw through the intestinal mucosa and are carried by blood flow to all organs.

In some cases, if a person has strong immunity, the larvae do not take root and die. But if the body is weakened, then the helminths begin their detrimental effect.

Treatment of toxocariasis

Anthelmintic drugs

The use of drugs with such an action is good to use against mature toxocars that live in the intestines.

Anthelmintic drugs:

Dietylcarbamazine - 2-6 mg per 1 kg of body weight, taken within a month.
Carbendacim - 10 mg per 1 kg of body weight, the daily dose is divided into three doses, taken for two weeks.

The following drugs may be used:

Albendazole is an anthelmintic drug used against all classes of worms, including the causative agent of toxocariasis. It is prescribed at a dosage of 10 mg per 10 kg of body weight for two weeks.
Mebendazole - It is prescribed at a dosage of 200-300 mg 3 times a day for a month.

There is only one side effect of the drugs: nausea, vomiting, severe dizziness. This is due to the strong toxic properties of the active substances.

Antiallergic drugs

The drug on herbs, successfully removes the inflammatory process, cleanses the body, neutralizes pathogenic bacteria, viruses and fungi.

Symptoms of toxocariasis

Toxocariasis manifests itself in humans in the following stages:

The ocular form of the disease is considered especially dangerous, since prolonged stay of helminths in the eyeball can lead to one-sided blindness. Tellingly, Toxocara larvae can live in only one eye.

Localized in the choroid, where they form nodules. Often cause optic neuritis, after which it is impossible to transmit impulses to the brain and the eye can no longer function normally.

The ocular form of toxocariasis is very rare and manifests itself when the body's defenses are greatly weakened.

Symptoms:

Keratitis.
Unilateral decrease in visual acuity.
Slight squint.
Ulcers on the vitreous body.

Skin form

The skin form appears during migration. This is due to the fact that the larvae migrate until they "settle" in small capillaries penetrating the parenchymal organs and the epidermis.

Symptoms:

Hives.
Severe itching caused by the movement of the larvae under the skin.
urtric formations.
Eczematous lesions.
Erythema.

To the touch, the foci are dense and painful. They can be localized in all parts of the body.

Treatment should begin immediately! Protect yourself and your loved ones!

Causes

Causes of toxocariasis:

The main sources of the disease are considered to be young animals that receive helminth eggs through the mother's womb. But you can become infected only after the eggs "ripen" in a humid environment.
The disease is especially dangerous in the spring-summer period, when people massively go to nature and spend a lot of time on land work.
Eating raw or damp game meat, pork, beef, chickens.
Eating unwashed fruits and vegetables.
Violation of personal hygiene.

I did not expect such an effect. The body recovered, even the skin became smooth and even, the stool returned to normal. I'm very happy with this result."

Diagnostics

ELISA blood test

Depending on the titers, three degrees of infection are set:

1/200 - no toxocariasis
1/400 - conditional infection. Either the person was ill and cured, or the infection is very small. With this indicator, additional diagnostics are assigned.
1/800 - the disease is confirmed. Can start treatment immediately

General blood analysis

In peripheral blood:

An increase in the content of eosinophils (indicates the development of an allergy, is considered one of the accurate indicators for the presence of Toxocara, regardless of the course).
An increased content of leukocytes indicates the presence of inflammatory processes. characteristic of the acute stage.
ESR acceleration.
Decreased hemoglobin level (characterizes a strong invasion).

Blood chemistry

By biochemical analysis, you can find out about the presence of pathological processes that can cause toxocara.

Indicators:

elevated levels of bilirubin;
increase in the amount of liver enzymes in the blood;
elevated levels of immunoglobulins.

Additional diagnostics

Methods of additional diagnostics:

Puncture of internal organs - a puncture is made in the area of the liver, lungs and spleen and a small piece of the organ is taken for subsequent biopsy. This diagnostic method with one hundred percent probability shows the presence of Toxocara in the body.
X-ray diagnostics of the organs of the chest cavity. The picture shows small dots - Toxocara larvae
Ultrasound of the liver - with this diagnostic method, you can see fine-grained formations on the surface and thickness of the organ
Fundus examination allows the doctor to see retinal detachment when Toxocara larvae are localized in the vascular layer of the eyeball

Treatment of toxocariasis during pregnancy

Toxocar larvae greatly undermine the health of the expectant mother, as well as the fetus.

If identified, the consequences and symptoms can be viewed here.

Treatment is carried out under the strict supervision of specialists.

Appointed:

antitoxic therapy to reduce the content of toxins produced by toxocar larvae;
drugs to boost the immune system.

Treatment with folk remedies

Decoction of ash bark:

1 teaspoon of ash bark.
200 ml of boiling water.
Boil 10 minutes.
Infuse for 1 hour under a towel.
Drink warm immediately after waking up and before going to bed for a teaspoon.

Decoction of elecampane:

1 st. elecampane spoon.
200 ml. boiling water.
Insist overnight and drink a tablespoon every 3 hours.

Decoction of sour:

1 st. a spoonful of sour.
200 ml of boiling water.
Insist 4 hours and drink 4 times a day.

Decoction of tansy:

1 st. a spoonful of tansy.
200 ml of boiling water.
Insist hour.
Drink 4 times a day for a tablespoon.

Recovery Criteria

In addition, the general condition of the patient is assessed. He himself can monitor the state of his health and observe the changes. If chronic pain goes away, health improves, then the treatment is successful.

If the tests and the patient's condition do not improve, the treatment regimen changes.

Can hair fall out from Toxocar?

How long do toxocars die?

With the right approach to treatment, most of the toxocara die within a week due to severe intoxication caused by taking anthelmintic drugs. Some of them may survive, especially those that live on the periphery (eg, under the skin). For their death, the course of treatment is repeated

How long do toxocariasis titers remain in the blood?

Prevention

Since toxocariasis is considered a dangerous disease, its prevention concerns everyone. After all, any disease is much easier to prevent than to cure.

Fundamentals of prevention of toxocariasis:

Maintaining personal hygiene: washing hands every time after contact with pets, ground work, coming from the street, before eating and after using the restroom
Preventive deworming every 3-6 months of all family members (especially for those who often contact other people's pets) and pets, pay special attention to dogs. Show small puppies immediately after purchase to the veterinarian to eliminate possible invasion
Avoid contact with homeless animals, it is also not advisable for pets to communicate with other animals
Good thermal processing of raw meat products
Thorough washing of fruits, vegetables and herbs just before eating
Organize special walking areas for pets, away from playgrounds
Ensure that public utilities replace sand in playgrounds in a timely manner