Ocular toxocariasis caused by toxocara canis in an adult woman. Case report

Abstract

Introduction: Toxocariasis is a zoonosis caused by the Toxocara canis and Toxocara cati nematodes larvae. These are intestinal parasites found in canids and felids, respectively. Case presentation: This paper presents the case of a 22-year-old woman from Caquetá, with a three-month history of vision loss in her left eye, eye pain, diplopia, photophobia and bilateral red eye. Retinal detachment in the left eye was diagnosed by ultrasound. The ophthalmology service made a differential diagnosis of retinoblastoma and pars planitis. Symptomatic management was initiated with oral and topical corticosteroids, obtaining symptom improvement, although loss of visual acuity persisted. Discussion: Coexistence and cohabitation of the patient with pets (dogs and cats) was an important factor to consider ocular toxocariasis. Complete blood count revealed mild leukocytosis and lymphocytosis without eosinophilia. Antibodies against Toxoplasma gondii and Taenia solium cysticercus were negative, as well as the VDRL. The ELISA test for Toxocara canis was positive, with IgG titers of 1:64 (positive ≥1:32, specificity >90%). Management with ophthalmic and systemic corticosteroids, albendazole and vitrectomy was initiated. The vitreous band was released by means of surgery, making the diplopia disappear, although residual peripheral granuloma persisted and will be operated by ophthalmology. Conclusions: Knowledge on ocular toxocariasis is important for physicians because it might be mistaken with retinoblastoma, a malignant neoplasm that may require enucleation of the eye.

Keywords

• Larva Migrans
• Toxocara canis
• Neglected Diseases
• Diagnosis
• Colombia