Sunday, December 02, 2007

Toxocariasis of CNS simulating ADEM

Marx et al. Toxocariasis of the CNS Simulating ADEM. Neurolgy 2007; 69: 806-807. General notes about the disease: there are two forms, visceral larval migrans (systemic) and disease focused on optic nerves. The hosts are dogs and ADin which adults live in intestine. Humans ingest embryonated eggs fromsoil (geophagia, pica) or through exposure to dirty hands, raw vegetables, larva from undercooked giblets. Case was a 2 year old girl with fever and cough, leukocytosiswith MRI of brain and spinal cord extensively involved mimicking ADEM.

Diagnosis is made by high titers of T. canis with ELISA or Western blot, eosinophils in blood or CSF, demonstration of intrathecal synthesis of anti T Canis antibodies and close contact with dogs. Clinicalnormalization with treatment supports the diagnossi.

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