Marked hypereosinophilia in a toddler: a case report

Abstract

Background: Human toxocariasis is primarily a soil-transmitted zoonosis, so children with geophagia are at an increased risk of toxocariasis, especially those living in homes with puppies that have not been dewormed.

Case report: A 17-months-old female presented to our department with fever, abdominal distention and marked eosinophilia. Iron deficiency anemia, marked leukocytosis (79,000 cells/mm(3)) accompanied by marked eosinophilia (55,000 cells/mm(3)), and hyper-gammaglobulinemia were noted. On the basis of the strong serological positivity for toxocariasis, marked eosinophilia, and low-density lesions in the liver at computed tomography, a diagnosis of visceral larva migrans syndrome was made.

Conclusion: Visceral larva migrans is usually suspected in a young child with history of geophagia, pets exposure, hepatomegaly, whose complete blood count reveals leukocytosis and marked eosinophilia.

Keywords: geophagia; pets exposure; zoonosis.

Figure 1

Abdominal distention. Hepatosplenomegaly

Figure 2

Hypereosinophilia. Peripheral smear

Figure 3

Computed tomography showing multiple liver low–density lesions

Figure 4

Bone marrow biopsy, with 50% to 60% eosinophils

Figure 5

Normal abdominal size without hepatosplenomegaly after 1 year.

Figure 6

Grandmother's forearm. The subcutaneous migration tracks of the larvae