Toxocariasis

Toxocariasis is an infection caused by the roundworms Toxocara canis (from dogs) and Toxocara cati (from cats). People get sick after swallowing the microscopic eggs of these worms. The eggs are passed in dog or cat poop, contaminate soil, sand, vegetables, or hands, and then enter the mouth. Inside a person, the eggs hatch into tiny larvae. Because humans are not the normal host, the larvae do not grow into adult worms. Instead, they wander through the body and can get stuck in different organs. The immune system surrounds them, forming small inflammatory lumps (granulomas). This process can cause fever, cough, tummy pain, rashes, high eosinophils (a type of white cell), and—if the eye is hit—blurred vision or even permanent vision loss. There is no person-to-person spread. You cannot “catch it” by being near someone. The risk is mainly from contaminated soil or food and from poor pet deworming. Children are at higher risk because they often play in dirt and put hands in their mouths.

Toxocariasis is an infection caused by roundworm larvae from dogs or cats. The dog roundworm is Toxocara canis, and the cat roundworm is Toxocara cati. People get sick when they accidentally swallow the microscopic eggs of these worms. The eggs are found in soil, dust, or on unwashed hands, vegetables, or objects that touched animal feces. After a person swallows the eggs, the eggs hatch in the intestine. The tiny larvae then move through the body in the bloodstream. They cannot grow into adult worms in humans, so they wander and get stuck in tissues like the liver, lungs, eyes, or brain. The body reacts to the larvae by creating inflammation and “granulomas,” which are small lumps of immune cells. This reaction can cause fever, cough, belly pain, eye problems, or nervous system problems, depending on where the larvae stop. Many people have no symptoms, but blood tests can show the infection. Children are affected more often because they are more likely to put dirty hands or objects into their mouths and may play in soil or sandboxes contaminated by animal feces.

Types of toxocariasis

1. Visceral larva migrans (VLM)
   This type happens when many larvae move through the body and settle mainly in organs inside the chest and belly, such as the liver and lungs. The immune system fights them, which can cause fever, cough, wheezing like asthma, belly pain, and enlarged liver. Blood tests often show a high count of eosinophils (a type of white blood cell).

2. Ocular toxocariasis (OT)
   This type affects one eye in most cases. A single larva gets into the eye and causes swelling and a lump (granuloma) in the retina or vitreous. The person may notice blurry vision, a white reflection from the pupil, floaters, or an eye that turns inward or outward. It can look similar to other serious eye diseases, so careful eye exams and imaging are important.

3. Neural toxocariasis (NT)
   This is uncommon but serious. Larvae reach the brain or spinal cord. Symptoms can include headaches, seizures, behavior changes, weakness, or other neurological signs. Brain imaging and special blood or spinal fluid tests help support the diagnosis.

4. Covert toxocariasis
   This is a milder form, often in school-age children. Symptoms can be vague, like tiredness, tummy aches, cough, or poor appetite. Eosinophils are usually elevated, and the Toxocara antibody test may be positive.

5. Common (or minor) toxocariasis
   This label is sometimes used for people with mild or scattered symptoms such as intermittent belly pain or cough and a positive blood test but without clear organ involvement. It still needs attention because it shows ongoing exposure.

6. Asymptomatic infection
   Many people have no symptoms at all. They may have a positive blood test and a history suggesting exposure. Even without symptoms, prevention is important to avoid eye or organ complications later.

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Causes

1. Swallowing contaminated soil
   Soil can hold Toxocara eggs from dog or cat feces. Touching soil while playing or gardening and then touching your mouth without washing hands can lead to infection.

2. Unwashed hands
   If hands are dirty after playing outside, cleaning a litter box, or handling pets, the tiny eggs can get into the mouth during eating or nail biting.

3. Eating unwashed vegetables or fruits
   Leafy greens, root vegetables, or fruits that fell on the ground can pick up eggs from soil. Not washing them well can pass eggs into the body.

4. Pica or geophagia (eating soil or clay)
   Some children and adults may eat soil or non-food items. This behavior increases the chance of swallowing eggs.

5. Playing in sandboxes
   Open sandboxes are attractive to cats and dogs. If sand is contaminated with feces, children can ingest eggs while playing.

6. Contact with puppies or kittens not dewormed
   Young animals shed many eggs. Touching their fur, bedding, or areas where they defecate and then touching your mouth can lead to exposure.

7. Stray or free-roaming animals in the neighborhood
   Communities with many stray dogs or cats often have more soil contamination, increasing risk for everyone.

8. Poor pet deworming practices
   Not giving regular veterinary deworming treatment to pets lets adult worms survive and shed eggs into the environment.

9. Cleaning up pet feces without proper hygiene
   Picking up feces without gloves or not washing hands right away can transfer eggs to the mouth.

10. Contaminated household dust
    Eggs can stick to dust. Poor ventilation and infrequent cleaning allow dust to build up and be swallowed or inhaled then swallowed.

11. Eating raw or undercooked animal liver or offal
    Larvae can be present in some animal tissues. Eating raw or undercooked liver (for example, cow, pig, chicken) has been linked to human toxocariasis in some regions.

12. Handling raw offal without washing hands
    Preparing raw liver or other organs and then touching your mouth or food can pass larvae if present.

13. Rural or peri-urban living with poor sanitation
    Areas without good waste disposal allow feces to remain in yards, fields, or streets, which raises soil contamination risk.

14. Occupational exposure
    Gardeners, farmers, veterinary staff, animal shelter workers, and sanitation workers can contact contaminated soil or feces more often.

15. Daycare and school playground exposure
    Children share toys and play outdoors. If handwashing is inconsistent, eggs can be passed to mouths easily.

16. Inadequate household cleaning
    Infrequent cleaning of floors and surfaces lets dust and soil particles accumulate, increasing ingestion risk.

17. Travel to high-prevalence areas
    Visiting places with many stray animals or poor sanitation can increase exposure through food, water, or soil.

18. Pet sleeping areas and bedding
    Eggs can stick to pet bedding and nearby floors. Touching these and then eating can allow ingestion.

19. Nail biting or thumb sucking
    These habits move dirt and dust from hands to mouth and raise the chance of swallowing eggs.

20. Using contaminated water for washing produce
    If water used to rinse vegetables is contaminated, eggs can remain on the food and be eaten.

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Symptoms

1. Fever
   The immune system reacts to migrating larvae, and this can raise body temperature to fight what it sees as a foreign invader.

2. Fatigue and malaise
   Inflammation uses energy. People feel tired, weak, or “run down.”

3. Cough and wheeze
   Larvae can irritate the lungs and airways. This can cause coughing, chest tightness, or wheezing that can look like asthma.

4. Shortness of breath
   If the lungs are inflamed, breathing can feel harder, especially with activity.

5. Abdominal pain
   The gut and liver can get inflamed. People feel cramps, tenderness, or a dull ache under the right ribs where the liver sits.

6. Enlarged liver (hepatomegaly)
   The liver swells due to inflammation and granulomas, which a doctor may feel on exam.

7. Poor appetite and weight loss
   Illness reduces appetite. Long-lasting inflammation can lead to slow weight gain in children.

8. Skin rash or hives
   The immune system releases chemicals that can make itchy, raised patches on the skin.

9. Lymph node swelling
   Glands in the neck, armpits, or groin can enlarge as they filter immune cells.

10. Eye symptoms: blurry vision
    A larva in the eye can disturb the retina or cause a lump that blurs central or peripheral vision, usually in one eye.

11. Eye floaters or spots
    Inflammatory cells in the gel of the eye can cast shadows that people see as floaters or dark spots.

12. Strabismus (eye misalignment)
    If one eye sees poorly, it may drift inward or outward, and parents may notice a “lazy eye.”

13. Leukocoria (white pupil reflex)
    A white reflex can show when light reflects off a retinal granuloma or scar.

14. Headache or seizures (neural involvement)
    If the brain is inflamed, people can have headaches, seizures, or behavior changes.

15. General aches and muscle pains
    Inflammation can cause diffuse, hard-to-locate pains in muscles and joints.

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Diagnostic tests

A) Physical Exam

1. General exam with vital signs
   The clinician checks temperature, heart rate, breathing rate, and blood pressure. Fever supports an active inflammatory process. The doctor also looks for tired appearance, pallor, or signs of poor nutrition.

2. Skin and lymph node exam
   The clinician looks for rashes or hives and gently feels lymph nodes in the neck, armpits, and groin. Enlarged, soft nodes can support a recent immune response.

3. Chest and lung exam
   Listening with a stethoscope can reveal wheezes or crackles. These sounds suggest airway or lung inflammation, which can occur when larvae pass through the lungs.

4. Abdominal exam
   The clinician feels for an enlarged liver or tenderness. A firm, enlarged liver edge under the right rib cage supports visceral involvement.

B) Manual Tests (bedside and office tools)

5. Visual acuity testing
   Reading letters or symbols on a chart measures how clearly each eye sees. Reduced vision in one eye can be a clue to ocular toxocariasis.

6. Cover–uncover test for strabismus
   Covering one eye and then the other shows whether the eyes are aligned. A drifting eye can point to vision loss from a retinal granuloma.

7. Amsler grid
   Looking at a simple grid checks for wavy or missing lines. Distorted or missing spots suggest a retinal problem near the center of vision.

8. Slit-lamp and indirect ophthalmoscopy
   These office-based eye exams use lights and lenses to look at the front and back of the eye. The examiner may see vitreous cells (inflammation), a white granuloma, traction, or scarring suggestive of ocular toxocariasis.

C) Lab & Pathological Tests

9. Complete blood count (CBC) with differential
   This blood test counts all blood cells. A high eosinophil count supports a parasitic infection. Eosinophilia is common in VLM and covert disease but may be absent in isolated eye disease.

10. Total IgE level
    IgE is an antibody that rises with allergic and parasitic conditions. A high total IgE level supports the diagnosis when combined with other findings.

11. Toxocara excretory–secretory (TES) IgG ELISA
    This is the main blood test for toxocariasis. It looks for antibodies that recognize Toxocara proteins. A positive result supports exposure or infection, especially if the titer is high and the clinical picture fits.

12. Confirmatory immunoblot (Western blot)
    This test can confirm that the antibodies are truly directed at Toxocara antigens. It is helpful when the ELISA is borderline or when cross-reactions with other parasites are possible.

13. Liver function tests (LFTs)
    Blood tests like ALT, AST, and alkaline phosphatase can be mildly elevated if the liver is inflamed by migrating larvae or granulomas.

14. Tissue biopsy (selected cases)
    Very rarely, if a lump in the liver, eye, or other tissue is unclear, a doctor may test a tiny piece under the microscope. A granuloma with parasite remnants supports the diagnosis. In the eye, biopsy is uncommon and used only when necessary.

(Note about stool tests: Toxocara larvae do not mature in humans, so human stool tests usually do not show Toxocara eggs. Stool tests may be used to look for other worms if mixed infections are suspected.)

D) Electrodiagnostic Tests

15. Electroretinography (ERG)
    This test measures how the retina responds to flashes of light. In ocular toxocariasis, ERG can show reduced function if the retina is inflamed, detached in areas, or scarred by a granuloma.

16. Visual evoked potential (VEP)
    This test measures how quickly signals travel from the eye to the brain. Delayed or reduced signals can appear when the macula or optic pathways are affected by inflammation or scarring.

E) Imaging Tests

17. Ocular B-scan ultrasound
    This is a simple, painless scan of the eye using sound waves. It helps when the view to the retina is cloudy. It can show a solid-looking mass (granuloma), vitreous membranes, or traction that suggests ocular toxocariasis.

18. Optical coherence tomography (OCT)
    OCT is like an ultrasound that uses light. It makes very detailed cross-section pictures of the retina. In ocular toxocariasis, OCT can show a dome-shaped granuloma, layers of retinal swelling, or pulling (traction) on the macula.

19. Fundus photography (± fluorescein angiography or OCT-angiography)
    Taking photos of the retina documents the lesion. Angiography can show leakage or abnormal vessels around the granuloma. These images help with diagnosis and follow-up.

20. Abdominal ultrasound
    This scan looks at the liver and other abdominal organs. It can show an enlarged liver or scattered small lesions compatible with inflammatory granulomas in visceral disease.

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Non-pharmacological treatments (therapies and other measures)

These steps support recovery, reduce complications, and cut ongoing exposure. They do not kill the parasite by themselves; medicines do that. But they make treatment safer and more effective.

1. Exposure elimination at home: Immediately start strict handwashing before eating and after outdoor play or pet handling. Keep nails short. Purpose: stop swallowing new eggs. Mechanism: removes eggs from skin and under nails.

2. Pet care & deworming (with a veterinarian): Ensure dogs and cats follow a regular deworming schedule and receive fecal exams. Purpose: reduce shedding of eggs into the environment. Mechanism: clears intestinal adult worms in pets.

3. Litter box & yard hygiene: Scoop daily, seal in bags, dispose properly. Cover sandboxes when not in use. Purpose: limit soil contamination. Mechanism: removes eggs before they mature.

4. Food safety at home: Wash raw vegetables and fruits well, peel when possible, avoid cross-contamination, and cook meat/organs thoroughly (especially liver). Purpose: remove or kill eggs. Mechanism: mechanical cleaning and heat inactivation.

5. Clean play areas: Rake or replace contaminated soil where children play; prefer clean sand in sandpits and keep pets out. Purpose: prevent hand-to-mouth egg transfer.

6. Household education: Teach children “no dirt in mouth,” avoid pica (eating soil), and always wash hands after play. Purpose: behavior change to curb re-exposure.

7. Rest and graded return to activity: During fever or wheeze, rest; resume activity slowly as symptoms settle. Purpose: allow the immune system to control inflammation. Mechanism: reduces physiologic stress.

8. Hydration: Drink adequate water to support fever recovery and general metabolism. Purpose: symptom comfort and organ support.

9. Nutrition for healing: Choose a balanced diet with adequate protein, iron, vitamins, and minerals. Purpose: support immune function and tissue repair.

10. Skin comfort for itch/rash: Use cool compresses and bland emollients to soothe itching. Purpose: reduce scratching, which can break skin and invite infection.

11. Breathing support for wheeze (non-drug): Practice pursed-lip breathing, keep the room air clean, avoid smoke and strong fumes. Purpose: ease breathlessness.

12. Fever comfort measures: Light clothing, lukewarm sponging if uncomfortable, and room at a comfortable temperature. Purpose: improve well-being while the cause is treated.

13. Small, frequent meals for abdominal pain/nausea: Gentle foods (e.g., rice, bananas, toast) can calm the gut. Purpose: reduce GI distress.

14. Eye protection strategies: If vision is affected, avoid rubbing the eye, use protective glasses, and limit strenuous activity until cleared by an ophthalmologist. Purpose: reduce risk of retinal complications.

15. Low-vision aids if needed: For persistent eye damage, consider magnifiers, contrast tools, orientation training. Purpose: maximize remaining vision function.

16. Psychological support: Vision loss or prolonged illness can cause anxiety. Reassurance, counseling, and family support help coping. Purpose: mental health and adherence to care.

17. Follow-up planning: Keep scheduled lab checks, especially if taking antiparasitic drugs or steroids. Purpose: monitor response and side effects.

18. Allergy/asthma hygiene: If cough/wheeze mimics asthma, remove dust and smoke, clean bedding, and consider HEPA filtration. Purpose: decrease airway irritation while inflammation subsides.

19. Public health awareness: Inform caregivers/teachers about sandbox covers and pet waste rules at schools and parks. Purpose: community-level exposure reduction.

20. Safety with medicines: When treatment begins, take exactly as prescribed, avoid alcohol with certain drugs, and report symptoms like yellow eyes (liver issues) or worsening vision. Purpose: reduce adverse events.

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10 drug treatments (evidence-based)

Always follow a clinician’s prescription. Doses below are typical references for otherwise healthy patients; exact regimens vary by age, weight, severity, organ involvement, and local guidelines.

1. Albendazole (first-line anti-helminthic)

   • Class: Benzimidazole anthelmintic.

   • Usual dose: Adults: 400 mg twice daily for 5–14 days (often 5–7 days for mild VLM; longer courses may be used for severe disease). Children: 10–15 mg/kg/day divided twice daily (max 400 mg BID).

   • Purpose: Kills migrating larvae.

   • Mechanism: Blocks microtubules in the parasite, disrupting glucose uptake and energy.

   • Common side effects: Nausea, abdominal pain, headache; transient liver enzyme elevations—hence periodic LFT checks in longer courses.

2. Mebendazole (alternative)

   • Class: Benzimidazole.

   • Dose: 100–200 mg twice daily for 5–14 days (some use up to 3 weeks in severe cases).

   • Purpose/Mechanism: As above.

   • Side effects: GI upset, rare liver enzyme rises; avoid in early pregnancy unless benefits outweigh risks.

3. Diethylcarbamazine (DEC) (older alternative)

   • Class: Anti-filarial/anthelmintic.

   • Dose: Typically 3–6 mg/kg/day in 3 divided doses for 2–4 weeks.

   • Purpose: Kills larvae and modulates inflammatory reactions.

   • Side effects: Nausea, dizziness; inflammation can briefly worsen as larvae die (Jarisch-Herxheimer-like reaction).

4. Ivermectin (select off-label cases)

   • Class: Macrocyclic lactone.

   • Dose: 200 µg/kg as one dose, sometimes repeated after 1–2 weeks in selected scenarios.

   • Purpose: Alternative when benzimidazoles cannot be used; evidence is more limited than for albendazole.

   • Side effects: Dizziness, mild GI upset.

5. Prednisone / prednisolone (systemic steroid for severe inflammation)

   • Class: Corticosteroid.

   • Dose: 0.5–1 mg/kg/day, short course with gradual taper per response.

   • Purpose: Reduces tissue damage from inflammation, especially in eye, heart, lung, or severe VLM.

   • Mechanism: Suppresses immune over-reaction to trapped larvae.

   • Side effects: Elevated sugar, mood changes, indigestion, infection risk—use the lowest effective dose for the shortest time.

6. Ophthalmic steroids (specialist use)

   • Class: Topical or peri/intra-ocular corticosteroids.

   • Dose: Specialist-determined (e.g., periocular triamcinolone).

   • Purpose: Control eye inflammation in OLM.

   • Risks: Cataract, glaucoma, infection—must be managed by an ophthalmologist.

7. Anti-VEGF injections (selected eye complications)

   • Drug: Intravitreal bevacizumab (dose typically 1.25 mg intravitreal; specialist only).

   • Purpose: Treats abnormal new vessels or macular edema secondary to OLM inflammation.

   • Risks: Rare infection, retinal issues; only by retina specialists.

8. Antihistamines (symptom relief)

   • Drug: Cetirizine 10 mg daily (children per weight-based dosing).

   • Purpose: Reduce itch and allergic-type symptoms while definitive therapy works.

   • Side effects: Drowsiness (less with newer agents).

9. Bronchodilators for wheeze (symptom relief)

   • Drug: Salbutamol/albuterol inhaler as directed.

   • Purpose: Relieves asthma-like tightness that can accompany lung involvement.

   • Note: Use with a spacer and under clinical advice.

10. Gastro-protection if on steroids

• Drug: Proton-pump inhibitor (e.g., omeprazole 20 mg daily) when steroid risk is high.

• Purpose: Reduce stomach irritation/ulcer risk.

• Side effects: Headache; long use only when needed.

Practical point: In uncomplicated, mild cases, a short course of albendazole may be all that is required. Steroids are added when inflammation itself is doing harm (especially in the eye).

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10 dietary, “molecular,” and supportive supplements

There is no supplement that cures toxocariasis. These options support general health while medicines clear the infection. Always check for interactions, pregnancy, and liver conditions.

1. Balanced multivitamin (RDA doses): Helps cover small nutrient gaps during illness; mechanism: supplies essential co-factors for immune cells.

2. Iron (only if deficient, confirmed by tests): Helps correct anemia from chronic inflammation. Too much iron is harmful; test first.

3. Vitamin D3 (e.g., 800–1000 IU/day typical for adults unless otherwise advised): Supports innate and adaptive immunity; avoid excess.

4. Zinc (e.g., 8–11 mg/day adults; short-term up to 20–25 mg/day with clinician guidance): Supports white blood cell function; long-term high doses can cause copper deficiency.

5. Omega-3 fatty acids (fish oil providing ~1 g/day EPA+DHA): May help calm inflammation; watch for bleeding tendency at high doses.

6. Probiotics (such as Lactobacillus/Bifidobacterium): May improve gut comfort during treatment; mechanism: microbiome support.

7. Vitamin A (RDA only; avoid high doses): Important for mucosal immunity and eye health; excess is toxic, especially with liver disease.

8. Vitamin C (250–500 mg/day, short term): Antioxidant support; high doses can cause GI upset.

9. Protein-rich foods/supplemental protein if intake is low: Supports tissue repair and immune proteins.

10. Fiber (whole grains, fruits, vegetables): Supports gut function, especially if constipated from reduced activity.

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“Hard immunity booster / regenerative / stem cell drugs” — important safety note

There are no approved “stem cell drugs,” regenerative medicines, or so-called “hard immunity boosters” for toxocariasis in humans. Using unproven immune or stem-cell products can be dangerous, interact with real treatments, and delay effective care. What actually works and is evidence-based is:

1. Albendazole/mebendazole to kill the larvae.

2. Short, supervised steroids when severe inflammation threatens organs (especially the eye).

3. Supportive care, nutrition, and strict exposure prevention (see above).

4. Veterinary deworming of pets to stop re-exposure at its source.

If you came here looking for “immune boosters,” use the supplement list above only as supportive care, and always alongside the prescribed antiparasitic treatment. Avoid clinics or websites advertising stem-cell fixes for parasites.

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5 surgeries and procedures (why, and how)

These are specialist eye procedures used mainly for OLM (eye involvement). Surgery does not kill larvae; it treats the damage caused.

1. Pars plana vitrectomy (PPV):

   • What: A retina surgeon removes cloudy or scarred vitreous gel and inflammatory debris.

   • Why: To clear vision, treat traction on the retina, and manage complications like retinal detachment.

   • How it helps: Restores the visual axis and allows treatment (laser, medications) directly to the retina.

2. Laser photocoagulation of retinal granuloma or suspected larva track:

   • What: Focused laser spots applied to an active lesion.

   • Why: To stabilize the lesion and reduce risk of further retinal damage.

   • Note: Exact use is individualized by the retina specialist.

3. Cryotherapy (freezing) to peripheral retinal lesions:

   • What: Cold probe applied externally to seal/treat inflamed peripheral lesions.

   • Why: Alternative to laser when the lesion is far peripheral or media is hazy.

4. Retinal detachment repair (PPV ± scleral buckle):

   • What: Surgical re-attachment using internal or external support.

   • Why: OLM inflammation can cause membranes that pull the retina off; repair is vision-saving.

5. Cataract surgery (when indicated):

   • What: Removal of a cloudy lens.

   • Why: Long inflammation or steroid use may cause cataract; surgery restores clarity once the eye is quiet.

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10 preventions you can start today

1. Deworm pets on a vet-approved schedule; do stool checks.

2. Pick up pet poop daily; keep it out of sandboxes and gardens.

3. Cover sandboxes and keep pets out of children’s play areas.

4. Teach handwashing before eating and after outdoor play/pet contact.

5. Trim nails to reduce dirt under nails.

6. Wash produce well; peel when possible.

7. Cook meat and especially liver thoroughly; avoid raw/undercooked dishes.

8. Prevent pica (eating soil) in children; seek help if present.

9. Keep shoes on in areas with pet traffic to avoid tracking soil indoors.

10. Community action: Parks and schools should enforce pet waste rules and maintain clean play surfaces.

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When to see a doctor urgently

• Eye symptoms in one eye: sudden blurred vision, floaters, white pupil, eye pain, or a new squint. Eye damage can be permanent without prompt care.

• Breathing problems: wheeze, chest tightness, or shortness of breath.

• Persistent fever, unexplained weight loss, or severe abdominal pain.

• Very high eosinophil counts on a blood test with compatible symptoms.

• Signs of liver trouble: yellow eyes/skin, dark urine, right-upper-belly pain—especially if taking albendazole longer than a few days.

• Worsening symptoms despite treatment or new neurologic symptoms (seizure, weakness, severe headache).

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What to eat and what to avoid (simple, practical)

• Eat:

  • Well-washed fruits and vegetables; peel when practical.

  • Well-cooked meats and organs (no pink or bloody center).

  • Protein-rich foods (eggs, fish, pulses) to aid repair.

  • Whole grains and fiber for gut comfort.

  • Fluids (water, broths) to stay hydrated.

• Avoid:

  • Raw or undercooked meat or liver.

  • Unwashed produce (especially leafy greens from unknown sources).

  • Street foods exposed to dust/soil without proper washing/cooking.

  • Alcohol if you are on a longer course of albendazole or other medicines affecting the liver.

  • Mega-doses of vitamins unless specifically advised—more is not always better.

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20 diagnostic tests explained simply

A. Physical examination (what the doctor looks for)

1. General check: fever, weight, fatigue—tells how unwell you are.

2. Skin exam: rashes or itchy spots suggest allergic-type inflammation.

3. Lung exam: wheeze or crackles can reflect larval-triggered airway inflammation.

4. Abdominal exam: enlarged, tender liver is common in VLM.

5. Eye exam basics: visual acuity, pupil response, eye alignment—screens for OLM clues.

B. “Manual” clinical tests and office procedures

6. Ophthalmoscopy (dilated fundus exam): The specialist looks inside the eye for granulomas, vitreous strands, or retinal traction.

7. Slit-lamp biomicroscopy: Microscopic view of the front and back of the eye for inflammation signs.

8. Spirometry (if wheeze): Measures airflow; distinguishes asthma-like patterns due to inflammation.

9. Abdominal ultrasound palpation guidance: The clinician correlates tender areas with imaging findings.

10. Peak expiratory flow monitoring: Simple home or office tool to track airway status while treating lung involvement.

C. Laboratory and pathological tests

11. Complete blood count (CBC): Often shows eosinophilia; helps track response to therapy.

12. Serum IgE: Frequently elevated in parasitic infections; supportive but not specific.

13. Toxocara serology (ELISA for Toxocara IgG): The key blood test—a positive test with compatible symptoms supports the diagnosis.

14. Liver enzymes (ALT/AST/ALP): Baseline and during therapy (especially with longer albendazole).

15. Stool exam (for humans): Usually negative in toxocariasis and not helpful for diagnosis (worms do not mature in humans).

16. Pathology (rare): Biopsy of a granuloma (e.g., liver) may show eosinophil-rich inflammation; larvae are seldom seen.

D. Electrodiagnostic tests (eye and nerve)

17. Electroretinogram (ERG): Assesses retinal function when the view is hazy.

18. Visual evoked potential (VEP): Measures the brain’s response to visual signals; helpful if optic pathway involvement is suspected.

E. Imaging tests

19. Abdominal ultrasound / CT / MRI: Shows granulomas or lesions in liver/spleen; monitors response.

20. Ocular imaging (OCT, B-scan ultrasound, fundus photos): Maps retinal granulomas, vitreous membranes, or detachment; guides surgery.

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15 frequently asked questions (clear answers)

1. Can I catch toxocariasis from another person?
   No. It comes from swallowing dog/cat roundworm eggs from contaminated environments, not from other people.

2. Do I get worms in my stool?
   No. In humans, larvae do not grow into adult worms, so you do not pass Toxocara eggs.

3. Is one eye usually affected in OLM?
   Yes, one eye is typical. Vision symptoms in one eye need urgent specialist care.

4. Can albendazole cure me?
   In most cases, yes, especially when given early and at the right dose and duration. Severe inflammation may also need steroids.

5. Will my eosinophils go down right away?
   They usually fall gradually after treatment. Your doctor may recheck blood tests over weeks.

6. Can eye damage be reversed?
   It depends on the location and severity. Some vision can be restored with medicines, laser, or surgery, but damage can also be permanent. Early care is crucial.

7. Should everyone in the family take deworming medicine “just in case”?
   No. Humans are not the normal host, and routine “preventive” treatment is not advised. Testing and treatment are based on symptoms and exam. Pets, however, should be dewormed.

8. Is this the same as toxoplasmosis?
   No. Toxoplasmosis is a different parasite (Toxoplasma gondii), with different risks and treatments.

9. Can pregnant people take treatment?
   Management is individualized. Some antiparasitic drugs are avoided in the first trimester. See an obstetrician and infectious diseases specialist.

10. How long does recovery take?
    Many improve within days to weeks after treatment; eye cases and severe VLM may need longer.

11. Can my child go to school?
    Yes, once feeling well. Emphasize handwashing and avoid sand/dirt play until your doctor says exposure risks are controlled.

12. What if my pet looks healthy?
    Pets can carry worms without symptoms. Regular vet deworming and stool checks are still necessary.

13. Why are my liver tests checked on treatment?
    Drugs like albendazole can temporarily raise liver enzymes, especially if used longer. Monitoring keeps you safe.

14. Can supplements replace medicine?
    No. Supplements do not kill larvae. They can only support recovery alongside prescribed drugs.

15. How do I stop this from happening again?
    Deworm pets, pick up poop, wash hands, cover sandboxes, wash produce, and cook meat well. These steps break the cycle.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 28, 2025.