Pulmonary lesions in visceral toxocariasis in children in the phthisiatric practice (clinical case)





toxocariasis, children, tuberculosis


Background. The clinical and radiological picture of pulmonary tuberculosis has many common features with a large number of diseases. Therefore, differential diagnosis is very important when detecting tuberculosis. The purpose of the work: on the example of a clinical case to present the complexity of the differential diagnosis between pulmonary lesion in visceral toxocariasis and tuberculosis in children. Results. The child was diagnosed with an infiltrate in the third segment of the left lung with lesions of the intrathoracic lymph nodes, which is characteristic of the primary tuberculosis. The volatility of the infiltrate was not determined. All general blood test hadn’t shown an increase in eosinophils and white blood cells. According to the literature data, the appearance of persistent and prolonged eosinophilia with the development of eosinophilic leukemoid reactions of the blood, an increase in the level of leukocytes are the main and one of the constant manifestations of toxocariasis. The child was diagnosed with moderate hepatomegaly, which is cha­racteristic for both diseases. The patient was registered at a pediatric tuberculosis clinic due to a shift in tuberculin tests. At the time of hospitalization, there were not reasons to suspect visceral toxocariasis. Due to the examination data, first of all the absence of bacterial excretion and negative tuberculin tests, and the pre­sence in the child’s house of the dogs and cats, it was decided to recommend the consultation of the infectionist to exclude any parasitic disease. At the end, the correct diagnosis was established in this child at time and the necessary treatment was prescribed. Conclusions. This clinical case demonstrates the difficulties of differential diagnosis of visceral toxocariasis in lung lesion and tuberculosis. First of all, this is due to the asymptomatic clinical picture of toxocariasis, the diagnosis of which was established by X-ray data, blood test for IgG antibodies to Toxocara and epidemiological history. Given the fact that toxocariasis includes a large spectrum of masks of various diseases, and children who are infected by Toxocara do not have specific clinical symptoms, doctors should remember to prescribe the additional examination for the presence of parasitic diseases, including toxocariasis, especially if pets live in the child’s home.


Sorokman TV, Perkas I. Features of toxocariasis course in children. Aktual'naâ Infektologiâ. 2018;6(4):195-199. doi:10.22141/2312-413x.6.4.2018.142473. (in Ukrainian).

Chen J, Liu Q, Liu GH, et al. Toxocariasis: a silent threat with a progressive public health impact. Infect Dis Poverty. 2018 Jun 13;7(1):59. doi:10.1186/s40249-018-0437-0.

Daré LO, Bruand PE, Gérard D, et al. Associations of mental disorders and neurotropic parasitic diseases: a meta-analysis in developing and emerging countries. BMC Public Health. 2019 Dec 5;19(1):1645. doi:10.1186/s12889-019-7933-4.

Lembryk IS, Matejko GB, Andrusyshyn LI. Toxocariasis in children: prevalence, clinical features, diagnosis, treatment. Dytiachyi likar. 2013;(22):44-46. (in Ukrainian).

Yershova IB, Mochalova HO, Lokhmatova IA, Manashova MH, Petrenko OV. Nonspecific manifestations of helminthiasis in children. Zdorov'e rebenka. 2015;(68):45-49. doi:10.22141/2224-0551.8.68.2015.75154. (in Ukrainian).

Dralova AA, Usachova OV, Silina EA, Konakova OV. The modern view on the problem of toxocariasis infestations in children (literature review). Sovremennaya Pediatriya. 2017;(83):53-61. doi:10.15574/SP.2017.83.53. (in Ukrainian).

Chokan VI, Zakharchuk OI, Krivchanska MI. Toxocariasis: clinical and laboratory manifestations and anti-epidemic prophylaxis measures. Young Scientist. 2018;(61):159-164. (in Ukrainian).

Bayekeeva KT, Umeshova LA, Sadykova AM, Utaganov BK. Toxocariasis in practice phisician. Vestnik KazNMU. 2017;(1):118-121. (in Russian).

Usachova OV, Dralova OA. Analysis of the peculiarities of the toxocariasis epidemic process in the Zaporizhzhia region in 2007-2009. Zaporozhye Medical Journal. 2012;(71):62-65. (in Ukrainian).

Faz-López B, Mayoral-Reyes H, Hernández-Pando R, et al. A Dual Role for Macrophages in Modulating Lung Tissue Damage/Repair during L2 Toxocara canis Infection. Pathogens. 2019 Dec 2;8(4):280. doi:10.3390/pathogens8040280.

Woodhall DM, Fiore AE. Toxocariasis: a review for pediatricians. J Pediatric Infect Dis Soc. 2014 Jun;3(2):154-159. doi:10.1093/jpids/pit066.

Moisieieva NV, Kapustianska AA, Vakhnenko AV, Rumyantseva MO, Kulyk LG. Toxocariasis: modern aspects of issue. Actual Problems of the Modern Medicine: Bulletin of Ukrainian Medical Stomatological Academy. 2017;(60):272-277. (in Ukrainian).

Cheepsattayakorn A, Cheepsattayakorn R. Parasitic pneumonia and lung involvement. Biomed Res Int. 2014;2014:874021. doi:10.1155/2014/874021.

Zakharchuk AI. Toxocariasis in infants (clinical laboratory and serological examination). Young Scientist. 2014;(61):329-336. (in Russian).

Lee KH, Kim TJ, Lee KW. Pulmonary Toxocariasis: Initial and Follow-Up CT Findings in 63 Patients. AJR Am J Roentgenol. 2015 Jun;204(6):1203-1211. doi:10.2214/AJR.14.13700.

Park BM, Jeong SO, Park HS, et al. Differences in the clinical and radiological characteristics of lung-involved toxocariasis between toxocariasis with eosinophilia and those without eosinophilia. J Thorac Dis. 2014 Dec;6(12):1757-1764. doi:10.3978/j.issn.2072-1439.2014.12.24.

Yukhimenko GG, Maidannyk VG. Toxocariasis in children. International journal of pediatrics, obstetrics and gynecology. 2012;2(1):124-132. (in Ukrainian).

Komarnycka LV, Soroka GP, Pylypyak OV, et al. An еxperience of treatment of toxocarosis in children. Medicine of Ukrainian transport. 2009;(1):76-81. (in Ukrainian).

Ivanova LA, Shevchuk NM, Guk LI. Visceral toxocariasis in adolescents: experience in the treatment using Aldazole (clinical case). Zdorov'e rebenka. 2016;(73):143-146. doi:10.22141/2224-0551.5.73.2016.78318. (in Ukrainian).





Case Report