[Toxocariasis. A cosmopolitan parasitic zoonosis].
The infection by Toxocara canis transmitted by dogs (30% of them are infected in our countries) and less frequently by cats lead to larva migrans visceral syndrome with neurological manifestations, ophtalmological affection and various cutaneous manifestations observed in 24% of the extra-ocular infections: chronic urticaria often associated with asthmatic manifestations and chronic rhinitis, angio-oedema or local oedema reaching particularly the eyclid, chronic pruritus associated with lesions due to scratching or to nodular prurigo. An hypereosinophilia is an argument in favour of a progressive infection. High total IgE is an hallmark of visceral infections by parasites and total IgE level is well correlated with the presence of intra-tissular larva. The serological diagnosis is based on the determination of specific IgG by ELISA which appears also to be interesting for the patient's follow up. The western blot method seems to be more specific than the other methods and so is useful to confirm a diagnosis. The treatment given as early as possible is based on the use of diethylcarbamazine but also of thiabendazole, albendazole and mebendazole. Prophylaxis of toxocara infection includes the prohibition of dog access to children games areas but also a frequent turn over of the sand in public parks.
Humbert
P
P
Service Dermatologie, CHU Saint-Jacques, Besançon.
Buchet
S
S
Barde
T
T
D000818:Animals; D002415:Cats; D004283:Dog Diseases / Q000453:epidemiology; D004285:Dogs; D005128:Eye Diseases / Q000503:physiopathology; D006801:Humans; D007073:Immunoglobulin E / Q000378:metabolism; D007816:Larva Migrans, Visceral / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D017166:Toxocara canis / Q000472:pathogenicity*; D014120:Toxocariasis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015047:Zoonoses / Q000453:epidemiology*
D007073:Immunoglobulin E