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Visceral larva migrans

Definition

Visceral larva migrans (VLM) is a human infection with certain parasites found in the intestines of dogs and cats.

Alternative Names

Parasite infection - visceral larva migrans; VLM; Toxocariasis; Ocular larva migrans; Larva migrans visceralis 

Causes

VLM is caused by roundworms (parasites) that are found in the intestines of dogs and cats.

Eggs produced by these worms are in the feces of the infected animals. The feces mix with soil. Humans can get sick if they accidentally eat soil that has the eggs in it. This can happen by eating fruit or vegetables that were in contact with infected soil and were not washed thoroughly before eating. People can also become infected by eating raw liver from a chicken, lamb, or cow.

Young children with pica are at high risk of getting VLM. Pica is a disorder involving eating inedible things such as dirt and paint. Most infections in the United States occur in children who play in areas, such as sandboxes, which contain soil contaminated by dog or cat feces.

After the worm eggs are swallowed, they break open in the intestine. The worms travel throughout the body to various organs, such as the lungs, liver, and eyes. They may also travel to the brain and heart.

Symptoms

Mild infections may not cause symptoms.

Serious infections may cause these symptoms:

  • Abdominal pain
  • Cough, wheezing
  • Fever
  • Irritability
  • Itchy skin (hives)
  • Shortness of breath

If the eyes are infected, loss of vision and crossed eyes can occur.

Exams and Tests

Usually, people with VLM seek medical care if they have cough, fever, wheezing, and other symptoms. They may also have a swollen liver since it’s the organ most affected.

The health care provider will perform a physical exam and ask about the symptoms. If VLM is suspected tests that may be done include:

Treatment

This infection usually goes away on its own and may not require treatment. Some people need to take anti-parasitic drugs.

Outlook (Prognosis)

Severe infections involving the brain or heart can result in death, but this is rare.

Possible Complications

These complications may occur from the infection:

  • Blindness
  • Worsened eyesight
  • Encephalitis (infection of the brain)
  • Heart rhythm problems
  • Difficulty breathing

When to Contact a Medical Professional

Contact your provider if you develop any of these symptoms:

  • Cough
  • Difficulty breathing
  • Eye problems
  • Fever
  • Rash

A full medical exam is needed to rule out VLM. Many conditions cause similar symptoms.

Prevention

Prevention includes deworming dogs and cats and preventing them from defecating in public areas. Children should be kept away from areas where dogs and cats may defecate.

It is very important to wash your hands thoroughly after touching soil or after touching cats or dogs. Teach your children to wash their hands thoroughly after being outdoors or after touching cats or dogs.

DO NOT eat raw liver from a chicken, lamb, or cow.

References

Hotez PJ. Parasitic nematode infections. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 225.

Kim K, Weiss LM, Tanowitz HB. Parasitic infections. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 39.

Nash TE. Visceral larvae migrans and other uncommon helminth infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 292.

Review Date:11/14/2016
Reviewed By:Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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