Age / Sex : 51 / M

Spinal visceral larva migrans of Toxocara canis

Discussion

Findings: MR findings

Hyperintensity
on T2WI with swelling in the cervical spinal cord at C2~T2 involving gray and
white matter of spinal cord

Focal patchy
enhancing cord lesion on lateral aspect of C5-6 level and another small
enhancing cord lesion on posterolateral aspect of C4 level

Differential Diagnosis:

Non-tumorous
myelopathy including transverse myelitis, inflammatory myelopathy associated
with systemic vasculitis

Diagnosis:

Toxocariosis
Ab IgG           Positive 2.38       

Total IgE                      > 5000 KU/L       

Spinal
visceral larva migrans of Toxocara canis

Discussion:

Visceral larva migrans (VLM): Zoonotic disease

ü  Migration of second stage larvae of
nematodes thorough tissue of human viscera

ü  Various etiologic agents

Toxocara canis (m/c), Toxocara catis,
Baylisascaris procyonis, Capillaria hepatica, Ascaris summ and some Ancylostoma
species

Toxocara canis

ü  Three disease forms in human

ü  Occult, ocular, and visceral larva
migrans

ü  Common in liver, skin, lungs, and eyes

ü  CNS involvement: extremely rare

Eosinophilic meningitis, encephalitis, seizures,
myelitis or paraparesis

MR findings

ü  Non-specific imaging findings like
non-tumorous myelopathy mimicking transverse myelitis involving cervical or
thoracic spinal cord

ü  High SI on T2WI and minimal or mild
swelling of involved spinal cord

ü  Focal nodular enhancement on posterior
or posterolateral segment of spinal cord

ü  Relatively short segment involvement

ü  Possible migration of the lesion

References:

MRI findings
of spinal visceral larva migrans of Toxocara canis. European Journal of
Radiology 2010;75:236–240

The
epidemiology and public health importance of toxocariasis: A zoonosis of global
importance.

International
Journal for Parasitology 2013;43: 999–1008