Clinical Evaluation of Toxocariasis Presenting as a Liver Abscess.
- Author:
Dong Wook JOO
1
;
Byung Seok KIM
;
Kyung Ho HA
;
Kyoung Chan PARK
;
Jung Il RYU
;
Chang Hyeong LEE
Author Information
1. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. kbs9225@cu.ac.kr
- Publication Type:Original Article
- Keywords:
Toxocariasis;
Liver Abscess
- MeSH:
Abdomen;
Albendazole;
Colon;
Cough;
Eating;
Eosinophilia;
Eosinophils;
Follow-Up Studies;
Food Habits;
Humans;
Immunoglobulin E;
Immunoglobulins;
Liver;
Liver Abscess;
Liver Abscess, Pyogenic;
Male;
Meat;
Retrospective Studies;
Serologic Tests;
Toxocariasis
- From:Korean Journal of Medicine
2012;82(4):435-440
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Toxocariasis rarely causes a liver abscess. We assessed clinical and laboratory manifestations as well as therapeutic responses in patients with toxocariasis presenting as a liver abscess. METHODS: Fourteen patients with toxocariasis presenting as a liver abscess were analyzed retrospectively. Symptoms, occupational history, dietary habits, contact with pets, allergic disease, peripheral eosinophil count, serum immunoglobulin E (IgE) level, and invasion to other organs were evaluated. After treatment with albendazole, follow-up was conducted with abdominal computed tomography (CT) and the measurement of serum eosinophil and IgE levels. RESULTS: Among 568 patients with a liver abscess, 14 were diagnosed with active toxocariasis. The mean age of the patients was 48 years, and nine (64%) were men. Four (28.6%) patients had pain in the right upper quadrant of the abdomen or epigastric area, one had cough, and the others (64.3%) had no symptom. Pulmonary involvement was noted in five patients and colon involvement in one. Six (42.9%) patients had a recent history of eating raw meat. Initial laboratory findings showed increased eosinophil and IgE levels in all patients. The initial CT showed one or multiple ill-defined, hypodense lesions in the liver. After 1 month of albendazole treatment, eosinophil counts were normalized or had decreased in 13 (93%) patients. On follow-up CT, liver abscesses disappeared within 6 months after therapy in 92% of patients. CONCLUSIONS: Symptoms, laboratory findings, and treatment of a liver abscess caused by toxocariasis differ from those of a pyogenic liver abscess. Early serologic testing may increase diagnostic yield and efficacy of treatment in patients with a liver abscess and peripheral eosinophilia.
