title: Fulminant eosinophilic myocarditis associated with visceral larva migrans caused by Toxocara canis infection.
abstract: A 19-year-old man was transferred to hospital because of myocarditis with cardiogenic shock. Echocardiography showed a left ventricular ejection fraction of 23.8% and an intermediate amount of pericardial effusion. The patient immediately received an intra-aortic balloon pump and percutaneous cardiopulmonary support. Right ventricular endomyocardial biopsy was performed in the acute phase and showed extensive eosinophilic inflammatory cell infiltration, severe interstitial edema and moderate myocardial necrosis. High-dose corticosteroids were administered. Because the patient's antibody titer against Toxocara canis was high and his symptoms had appeared after eating raw deer meat, the diagnosis was fulminant eosinophilic myocarditis caused by a hypersensitivity reaction to visceral larval migrans. After starting high-dose corticosteroids, the ejection fraction dramatically improved, the eosinophilia decreased and the patient made a full recovery.
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama, Japan.
authors.forename: Kenki
authors.initials: K
authors.lastname: Enko
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Keiko O
authors.initials: KO
authors.lastname: Ohgo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagase
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kei
authors.initials: K
authors.lastname: Ohta
authors.forename: Shingo
authors.initials: S
authors.lastname: Ichiba
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ujike
authors.forename: Yukifumi
authors.initials: Y
authors.lastname: Nawa
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Maruyama
authors.forename: Tohru
authors.initials: T
authors.lastname: Ohe
authors.forename: Kengo F
authors.initials: KF
authors.lastname: Kusano
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D006801:Humans; D007816:Larva Migrans, Visceral / Q000175:diagnosis* / Q000469:parasitology*; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology*; D017166:Toxocara canis; D014120:Toxocariasis / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones