International Journal of Surgery Research

International Journal of Surgery Research


International Journal of Surgery Research
International Journal of Surgery Research
Vol. 4, Issue 1 (2022)

A rare case of visceral larva migrans (VLM)


Saurav Gupta, Gopinath Pai, Jagadish B

Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presented with pre-prandial malaise and epigastric discomfort with pain in right upper quadrant of abdomen in the past 4 month in a 31-year-old male with history of eating rabbit flesh. The ultrasound imaging studies of the abdomen showed a small hypoechoic area measuring 8-13 mm in right lobe of liver (segment VII). His CT Abdomen revealed well defined hypodense peripherally enhancing lesion in segment VII of liver -likely infective granuloma. His blood picture showed severe eosinophilia. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Patient underwent CT guided biopsy which showed liver abscess with eosinophilic infiltrate favouring the possibility of parasitic infestation suggestive of visceral larva migrans and toxocariasis. Patient underwent anthelmintics treatment, the patient complained of newly developed skin rash with eosinophilia. Hepatic lesion was same in size. After the treatment, the patient was free of symptoms such as pre-prandial malaise, epigastric discomfort, pain in right upper quadrant, and skin rash. Laboratory test showed a normal eosinophilic count at 1 month, 6 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting with severe eosinophilia and a variety of symptoms which reflect high worm burdens. Remission of symptoms and eosinophilia and complete radiological resolution of lesions can be complete with treatment.
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How to cite this article:
Saurav Gupta, Gopinath Pai, Jagadish B. A rare case of visceral larva migrans (VLM). International Journal of Surgery Research, Volume 4, Issue 1, 2022, Pages 28-32
International Journal of Surgery Research