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Infection
Published in: Infection 5/2016

01-10-2016 | Review

Neurotoxocariasis: a systematic literature review

Authors: S. Deshayes, J. Bonhomme, Arnaud de La Blanchardière

Published in: Infection | Issue 5/2016

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Abstract

Purpose

Toxocariasis is a widespread zoonosis, which may result in central nervous system injury.

Methods

We conducted a systematic literature review in MEDLINE, SciELO, ScienceDirect and Google Scholar up to April 2015 using a combination of the following search terms: “neurotoxocariasis” or “neurotoxocarosis”, “toxocariasis” or “toxocarosis” and “cerebral” or “neurologic”.

Results

One hundred cases of neurotoxocariasis were identified in literature. The majority of patients were male (58 %), with a median age of 42 years. The predominant clinical pictures were myelitis (60 %), encephalitis (47 %) and/or meningitis (29 %). Fever was inconstant (23 %). The suspected mode of transmission, mentioned in only 49 % of cases, was mainly contact with dogs and/or cats (67 %) and ingestion of contaminated food (31 %). Diagnostic imaging examinations found hypodense lesions in cerebral scanner sequences and hyperintense lesions in cerebral MRI T2-weighted sequences in 65 and 57 % of encephalitis cases respectively, and in 92 % of myelitis cases in medullary MRI T2-weighted sequences. The detection of antibodies against Toxocara spp. was almost constant in blood and cerebrospinal fluid (CSF), 99 and 93 %, respectively. The two most commonly used drugs were corticosteroids (72 %) and/or albendazole (68 %) for a period of at least 3 weeks, which often needed to be repeated. Despite a low mortality rate (6 %), complete remission was observed in only 40 % of cases.

Conclusions

Neurotoxocariasis, a completely preventable zoonosis, could lead to severe sequelae failing prompt diagnosis. A compatible clinical picture, presence of risk factors, blood eosinophilia and high titers of antibodies against Toxocara spp. in CSF should alert physicians.
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Metadata
Title
Neurotoxocariasis: a systematic literature review
Authors
S. Deshayes
J. Bonhomme
Arnaud de La Blanchardière
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 5/2016
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-016-0889-8

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