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http://dx.doi.org/10.3904/kjm.2012.82.4.435

Clinical Evaluation of Toxocariasis Presenting as a Liver Abscess  

Joo, Dong-Wook (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Kim, Byung-Seok (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Ha, Kyung-Ho (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Park, Kyoung-Chan (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Ryu, Jung-Il (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Lee, Chang-Hyeong (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
Publication Information
The Korean Journal of Medicine / v.82, no.4, 2012 , pp. 435-440 More about this Journal
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.
Keywords
Toxocariasis; Liver Abscess;
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