Treatment of Toxocariasis

Clinical Forms and Diagnosis

The clinical spectrum of toxocariasis includes several presentations, such as visceral larva migrans (VLM), which presents with fever, eosinophilia, wheeze, cough, abdominal pain, and hepatosplenomegaly, according to the Journal of Infection guidelines 1, 3
Ocular toxocariasis presents with visual changes, retinal granuloma, or uveitis, with eosinophilia being less common in isolated ocular disease, as recommended by the Journal of Infection 1
Neurotoxocariasis can present with myelitis, encephalitis, or meningitis, as stated in the Journal of Infection guidelines 1
Diagnosis is primarily through serology, with marked peripheral eosinophilia typically present in visceral forms, according to the Journal of Infection 1, 4

The first-line treatment for VLM is albendazole 400 mg twice daily for 5 days, as recommended by the Journal of Infection 1, 2

Ocular toxocariasis requires a combination approach with albendazole 400 mg twice daily for 2 weeks and corticosteroids, as stated in the Journal of Infection guidelines 1, 2, 3
Joint management with ophthalmology is essential, and prednisolone 40-60 mg once daily may be used in severe disease, according to the Journal of Infection 2, 3

Treatment for neurotoxocariasis includes albendazole for 3-4 weeks, with corticosteroids added in cases with significant inflammation, as recommended by the Journal of Infection 1

In cases with marked inflammation or edema on imaging, corticosteroids should be added to prevent inflammatory reactions to dying parasites, as stated in the Journal of Infection guidelines 1
Corticosteroids must be used with caution if there is potential co-infection with Strongyloides due to risk of hyperinfection, according to the Journal of Infection 2, 3

Ocular toxocariasis may occur without systemic eosinophilia, making diagnosis challenging, as noted in the Journal of Infection guidelines 1