J Korean Med Sci.  2009 Feb;24(1):40-45. 10.3346/jkms.2009.24.1.40.

Impact of Toxocariasis in Patients with Unexplained Patchy Pulmonary Infiltrate in Korea

• Yoon YS
• Lee CH
• Kang YA
• Kwon SY
• Yoon HI
• Lee JH
• Lee CT

• KMID: 1794404
• DOI: http://doi.org/10.3346/jkms.2009.24.1.40

Abstract

Toxocariasis is one of the causes of pulmonary eosinophilic infiltrate that is increasing in Korea. This study was designed to identify the prevalence of toxocara seropositivity in patients with unexplained pulmonary patchy infiltrate and to evaluate associated factors. We evaluated 102 patients with unexplained pulmonary patchy infiltrate on chest computed tomography (CT) scan. As a control set, 116 subjects with normal chest CT were also evaluated. History of allergic disease, drug use, parasitic disease and raw cow liver intake were taken. Blood eosinophil count and total IgE level were measured. Specific serum IgG antibody to Toxocara canis larval antigen and specific IgG antibodies to 4 other parasites were measured by enzymelinked immunosorbent assay (ELISA). In the infiltrate group, 66.7% subjects were toxocara seropositive whereas 22.4% of the control group were seropositive (p< 0.001). In the infiltrate group, patients with a history of eating raw cow liver (odds ratio [OR], 7.8) and patients with eosinophilia (OR, 5.2) had a higher incidence of toxocara seropositivity. Thirty-five percent of toxocara seropositive patients with infiltrate exhibited migrating infiltrate and 48% had decreased infiltrate on the follow- up CT. We recommend that toxocara ELISA should be performed in patients with unexplained pulmonary patchy infiltrate, and that the eating of raw cow liver should be actively discouraged.

Keyword

Toxocariasis; Eosinophilia; Pulmonary Infiltrate; Raw Cow Liver

MeSH Terms

Adult
Aged
Animals
Case-Control Studies
Female
Humans
Immunoglobulin E/blood
Korea
Leukocyte Count
Liver/parasitology
Male
Middle Aged
Pulmonary Eosinophilia/diagnosis/*etiology/immunology
Seroepidemiologic Studies
Tomography, X-Ray Computed
Toxocara/immunology
Toxocariasis/*complications/diagnosis/epidemiology

Figure

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  Fig. 1 High-resolution CT scan findings before treatment and after treatment. The figures on the top (A and B) show multiple ground glass opacities with peripheral halo in both lower lobes before treatment. The figures on the bottom (C and D) show the disappearance of ground glass opacities 3 months after treatment with albendazole. The patient was a 53-yr-old man and ingested raw cow liver frequently.

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