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  #1  
Old 01-07-2012
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Question Dirt eating boy!

A 4-year-old boy was admitted to the hospital last night with the complaint of “difficulty breathing.” He has no past history of lung infection, no recent travel, and no day-care exposure; he does, however, have an annoying tendency to eat dirt. In the emergency center he was noted to be wheezing and to have hepatomegaly. He is able to talk, relaying his concern about his 6-week-old Chihuahua being left alone at home. Laboratory studies revealed marked eosinophilia (60% eosinophils). Which of the following tests is most likely to produce a specific diagnosis?
a. Tuberculin skin test
b. Histoplasmin test
c. ELISA for Toxocara
d. Silver stain of gastric aspirate
e. Stool examination for ova and parasites
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Old 01-07-2012
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C , Toxocara a worm found in dogs (chihuahua )
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Old 01-07-2012
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Stool examination for ova and parasites
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Old 01-07-2012
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C, Serology for Toxo
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Old 01-07-2012
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elisa for toxocara
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Old 01-07-2012
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E. stool examination
Most probably its Pica due to iron deficiency anemia caused due to parasite infestation(raised eosinophil)
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Old 01-07-2012
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Thumbs Up It is Toxocariasis, ELISA is most specific.

It is Toxocariasis, ELISA is most specific.

4 year old child, i.e. Preschool. Points towards toxocariasis.
He also has a pet dog.
Hepatosplenomegaly is common in toxocariasis. When larva migrates to lungs, it produces cough, wheezing, difficult breathing. (as given in the question).
Toxocariasis also leads to increased eosinophil count. Sometimes as high as 90%.
Pica is another clue. Children end up ingesting eggs along with mud/soil when it is contaminated by dog faeces.
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Old 01-08-2012
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e. Stool examination for ova and parasites
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Old 01-08-2012
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The presentation described is characteristic of visceral larva migrans from infestation with a common parasite of dogs, Toxocara canis. Dirt-eating children ingest the infectious ova. The larvae penetrate the intestine and migrate to visceral sites, such as the liver, lung, and brain, but do not return to the intestine, so the stools do not contain the ova or parasites. The diagnosis can be made by a specific enzyme-linked immunosorbent assay (ELISA) for Toxocara.
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Old 01-08-2012
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Post @Anomali

@Anomali

The reason why we don't see any ova/eggs in stools in because when they're inside humans, larvae cannot mature into adult worms and hence can't produce ova/eggs.
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Old 01-08-2012
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Quote:
Originally Posted by thickasabrick View Post
@Anomali

The reason why we don't see any ova/eggs in stools in because when they're inside humans, larvae cannot mature into adult worms and hence can't produce ova/eggs.
yeah u are true....since humans are not the natural hosts of these worms, they cannot continue their normal life cycle n do not produce ova/cysts!!!!!!1
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