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Visceral larva migrans associated with earthworm and gecko ingestion: a case report

Tao Yu1, Li-Na Zhao1, Miao-Jing Fan2, Huan Wu3 and Qi-Kui Chen1*

Author Affiliations

1 Department of Gastroenterology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, People’s Republic of China

2 Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, People’s Republic of China

3 Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou, 510120, People’s Republic of China

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Journal of Medical Case Reports 2012, 6:210  doi:10.1186/1752-1947-6-210

Published: 18 July 2012

Abstract

Introduction

Visceral larva migrans is a syndrome caused by an infection with larval helminths, which may result in partial or general pathological changes in host tissues. Due to the difficulty in finding the causative parasites, the diagnosis of visceral larva migrans is generally based on compatible clinical signs, epidemic history, marked eosinophilia and pathological examination, especially positive serological test results and the disappearance of symptoms after specific treatment.

Case presentation

We report here the case of a 21-year-old Chinese man who, having ingested living earthworms and geckos at a witch’s suggestion, presented with fatigue and wordlessness lasting for one year along with elevated transaminase levels for one month. Clinical examination showed eosinophilia, elevated transaminase levels, nodular lesions in his liver and typical pathological characteristics of hepatic visceral larva migrans. After four courses of anthelmintic therapy, our patient presented with sustaining improvement of clinical manifestations and normalization of laboratory data.

Conclusions

Because of the difficulty in making a definite diagnosis, anthelmintic therapy should be performed in patients with a suspected diagnosis of visceral larva migrans based on their epidemic history and presence of typical manifestations, especially when the serological test results are negative. Furthermore, patients with severe parasite infection may require multiple anthelmintic therapies in order to eliminate the parasites.