A rare case of presumptive pleural toxocariasis

Toxocariasis is a cosmopolitan helminthiasis linked to contamination with Toxocara cati or Toxocara canis . Only six isolated cases of pleural toxocariasis have been reported in the literature. We describe a case of pleurisy with isolated eosinophilia varying between 600 and 1500/mm 3 likely linked...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2023-06, Vol.42 (6), p.781-786
Main Authors: Hirabidian, Mickaël, Thierry, Saelens, Deleplancque, Anne-Sophie, Bergues, Benoît, Loridant, Séverine, Cornu, Marjorie, Sendid, Boualem, Leroy, Jordan
Format: Article
Language:English
Subjects:
Aged
Albendazole
Albendazole - therapeutic use
Animals
Antibodies
Antiparasitic agents
Asthenia
Biomedical and Life Sciences
Biomedicine
Brief Report
Contamination
Diagnosis
Diarrhea
Dyspnea
Enzyme-Linked Immunosorbent Assay
Eosinophilia
Eosinophilia - diagnosis
Eosinophilia - drug therapy
Eosinophils
Helminthiasis
Humans
Immunoblotting
Internal Medicine
Leukocytes (eosinophilic)
Medical Microbiology
Patients
Pleural fluid
Pleurisy
Pleurisy - drug therapy
Respiration
Serology
Toxocara
Toxocariasis
Toxocariasis - diagnosis
Toxocariasis - drug therapy
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Summary:Toxocariasis is a cosmopolitan helminthiasis linked to contamination with Toxocara cati or Toxocara canis . Only six isolated cases of pleural toxocariasis have been reported in the literature. We describe a case of pleurisy with isolated eosinophilia varying between 600 and 1500/mm 3 likely linked o presumptive toxocariasis in a 72-year-old patient. Our patient was admitted to hospital with severe dyspnoea, asthenia and diarrhoea. Imaging studies confirmed right unilateral pleurisy without any parenchymal involvement. Serology of serum and pleural fluid was positive for anti- Toxocara antibodies by ELISA and immunoblotting. Treatment by pleural drainage and anti-parasitic medication with albendazole for 8 days resulted in the resolution of symptoms. A decrease in the levels of polynuclear eosinophils and total IgE confirmed the clinical resolution. The presence of hypereosinophilia in pleural fluid should evoke a diagnosis of pleural toxocariasis. Clinical symptoms and imaging are non-specific, but positive serology for anti- Toxocara antibodies in serum and pleural fluid can confirm the diagnosis.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-023-04595-9