Visceral larva migrans with cardiac manifestation: a case report and literature review

Toxocariasis is a roundworm infection that may be associated with serious cardiac manifestations. We report one case and review another 12 cases in the literature. A 74-year-old man, presented with clinical features of myopericarditis. Eosinophil count was 20,000/mm(3). The ELISA and Western Blot were positive for Toxocara canis. The patient was treated with corticosteroids and antiparasite treatment. The outcome was rapidly favorable. In the other 12 cases, the cardiac manifestations were often severe: six myocarditis, three tamponades and three Loeffler's endocarditis have been published. Four therapeutic strategies have been reported: symptomatic treatment alone was associated with worse progressive; antiparasite treatment alone or companied with corticosteroids and corticosteroids alone had good results. The toxocariasis should be investigated systematically in case of eosinophilic cardiomyopathy. The treatment strategy is still controversial.