Pulmonary Toxocariasis Mimicking Invasive Aspergillosis in a Patient with Ulcerative Colitis

A 45-year-old-male who had underlying ulcerative colitis and presented with fever and dry cough. Initially, the patient was considered to have invasive aspergillosis due to a positive galactomannan assay. He was treated with amphotericin B followed by voriconazole. Nevertheless, the patient deteriorated clinically and radiographically. The lung biopsy revealed eosinophilic pneumonia, and ELISA for Toxocara antigen was positive, leading to a diagnosis of pulmonary toxocariasis. After a 10-day treatment course with albendazole and adjunctive steroids, the patient recovered completely without any sequelae. Pulmonary toxocariasis may be considered in patients with subacute or chronic pneumonia unresponsive to antibiotic agents, particularly in cases with eosinophilia.

[1]  G. Suh,et al.  Toxocariasis as a cause of new pulmonary infiltrates. , 2013, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[2]  M. Darabi,et al.  Epidemiological situation of toxocariasis in Iran: meta-analysis and systematic review. , 2012, Pakistan journal of biological sciences : PJBS.

[3]  Yoshifumi Yamamoto,et al.  Lessons from eight cases of adult pulmonary toxocariasis: Abridged republication , 2011, Respirology.

[4]  Min-Hye Kim,et al.  A Case of Recurrent Toxocariasis Presenting With Urticaria , 2010, Allergy, asthma & immunology research.

[5]  M. Ferreira,et al.  Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms , 2010, Annals of tropical medicine and parasitology.

[6]  M. Yoshikawa Duration of treatment with albendazole for hepatic toxocariasis. , 2009, Nature clinical practice. Gastroenterology & hepatology.

[7]  C. Lee,et al.  Impact of Toxocariasis in Patients with Unexplained Patchy Pulmonary Infiltrate in Korea , 2009, Journal of Korean medical science.

[8]  M. Wechsler Pulmonary eosinophilic syndromes. , 2007, Immunology and allergy clinics of North America.

[9]  T. Walsh,et al.  Histoplasmosis-Associated Cross-Reactivity in the BioRad Platelia Aspergillus Enzyme Immunoassay , 2007, Clinical and Vaccine Immunology.

[10]  I. Surmont,et al.  Gluconate-Containing Intravenous Solutions: Another Cause of False-Positive Galactomannan Assay Reactivity , 2007, Journal of Clinical Microbiology.

[11]  Jung Woong Park,et al.  The Characteristics of Eosinophilc Lung Diseases Cause by Toxocara Canis Larval Infestation , 2007 .

[12]  R. Porcher,et al.  Occurrence and Kinetics of False-Positive Aspergillus Galactomannan Test Results following Treatment with β-Lactam Antibiotics in Patients with Hematological Disorders , 2006, Journal of Clinical Microbiology.

[13]  M. Kami,et al.  False-positive results of Aspergillus enzyme-linked immunosorbent assays for a patient with gastrointestinal graft-versus-host disease taking a nutrient containing soybean protein. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  C. Hung,et al.  Seroepidemiology of Toxocara canis infection among mountain aboriginal schoolchildren living in contaminated districts in eastern Taiwan , 2004, Tropical medicine & international health : TM & IH.

[15]  D. Despommier,et al.  Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects , 2003, Clinical Microbiology Reviews.

[16]  Y. Kong,et al.  A seroepidemiological survey for toxocariasis in apparently healthy residents in Gangwon-do, Korea. , 2002, The Korean journal of parasitology.

[17]  Y. Inoue,et al.  Chronic eosinophilic pneumonia due to visceral larva migrans. , 2002, Internal medicine.

[18]  Z. Pawłowski Toxocariasis in humans: clinical expression and treatment dilemma , 2001, Journal of Helminthology.

[19]  L. Glickman,et al.  Highlights of human toxocariasis. , 2001, The Korean journal of parasitology.

[20]  R. Boom,et al.  Detection of Aspergillus galactomannan antigen in foods and antibiotics , 1997, Mycoses.

[21]  B. Gottstein,et al.  Thiabendazole vs. albendazole in treatment of toxocariasis: a clinical trial. , 1989, Annals of tropical medicine and parasitology.

[22]  H. Johannessen [Pulmonary eosinophilia]. , 1974, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.