Materiały źródłowe

• #1 Therapy and Prevention for Human Toxocariasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8875715/

  For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

• #2 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Treatment is with albendazole or mebendazole. Corticosteroids may be added for severe symptoms or eye involvement. […] Asymptomatic patients and patients with mild visceral larva migrans (VLM) symptoms do not require anthelmintic therapy because infection is usually self-limited. […] For patients with moderate to severe symptoms, albendazole or mebendazole is used, but the optimal duration of therapy has not been determined. […] Corticosteroids are indicated for patients with severe symptoms to reduce inflammation. […] Ophthalmologic expertise is essential in the care of ocular larva migrans (OLM). Corticosteroids, both local and oral, are indicated to reduce inflammation within the eye. […] The role of anthelmintic therapy is uncertain. Albendazole used with corticosteroids may reduce recurrences, but comparative data are not available on the optimal dose and duration of therapy, and there is no evidence that albendazole improves visual outcome.

• #3 Toxocariasis: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/23401-toxocariasis

  How is toxocariasis treated? You typically dont need treatment for toxocariasis if you dont have symptoms. The infection usually goes away on its own. If the infection is causing severe symptoms, dont try any home remedies for intestinal parasites. Instead, make a call to your healthcare provider. They may recommend an antiparasitic drug such as albendazole or mebendazole. These medications will kill the worms. […] Treatment guidelines for ocular toxocariasis may include measures to prevent permanent eye damage. Your healthcare provider may suggest the use of a corticosteroid. They may refer you to an eye specialist for treatment. You may need surgery to remove the worms or treat any problems with your vision.

• #4 Toxocariasis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/toxocariasis.html

  A child with mild symptoms might not need treatment because the infection will go away on its own when the larvae die. […] Kids with symptoms that affect the lungs, eye, or other important organs may be treated with anti-parasite drugs that will kill the larvae. […] Doctors sometimes also give steroids to ease inflammation in the damaged organs. They also might refer a child to a specialist (like an ophthalmologist if the eye is involved).

• #5 Clinical Care of Toxocariasis | Parasites – Toxocariasis | CDC

  https://www.cdc.gov/toxocariasis/hcp/clinical-care/index.html

  Treat visceral toxocariasis with antiparasitic drugs. […] Treatment of ocular toxocariasis usually consists of measures to prevent eye damage. […] Treatment of visceral toxocariasis include the antiparasitic drugs albendazole or mebendazole. […] Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. […] In addition to antiparasitic therapy, symptomatic therapy including steroid treatment to control inflammation may be indicated. […] For ocular toxocariasis, the goal of treatment is to minimize damage to the eye. […] Systemic antiparasitic treatment with albendazole or mebendazole at the same doses as for visceral disease may be beneficial for active disease. […] Control of inflammation in the eye by use of topical or systemic steroids may be indicated. […] Prescribe albendazole only if the potential benefits to the woman justify the potential risks to the fetus. […] Prescribe mebendazole only if the potential benefits to the woman justify the potential risks to the fetus.

• #6 Clinical Care of Toxocariasis | Parasites – Toxocariasis | CDC

  https://www.cdc.gov/toxocariasis/hcp/clinical-care/index.html

  Treat visceral toxocariasis with antiparasitic drugs. […] Treatment of ocular toxocariasis usually consists of measures to prevent eye damage. […] Treatment of visceral toxocariasis include the antiparasitic drugs albendazole or mebendazole. […] Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. […] In addition to antiparasitic therapy, symptomatic therapy including steroid treatment to control inflammation may be indicated. […] For ocular toxocariasis, the goal of treatment is to minimize damage to the eye. […] Systemic antiparasitic treatment with albendazole or mebendazole at the same doses as for visceral disease may be beneficial for active disease. […] Control of inflammation in the eye by use of topical or systemic steroids may be indicated. […] Prescribe albendazole only if the potential benefits to the woman justify the potential risks to the fetus. […] Prescribe mebendazole only if the potential benefits to the woman justify the potential risks to the fetus.

• #7 Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC153144/

  Albendazole is the treatment of choice for toxocariasis. Patients receiving a 5-day treatment course of albendazole (10 mg/kg of body weight/day in two divided doses) improved relative to patients who received treatment with the older anthelminthic drug thiabendazole. A dose of 400 mg of albendazole twice a day for 5 days is the currently recommended therapy. Because the other commonly used benzimidazole, mebendazole, is poorly absorbed outside the gastrointestinal tract, this agent is a second-line treatment, although some success has been reported in patients who ingest 1 g or more for a 21-day course. Symptomatic treatment, including administration of corticosteroids, has been helpful for suppressing the intense allergic manifestations of the infection. OLM is treated by surgery (vitrectomy), anthelminthic chemotherapy, and/or corticosteroids.

• #8 Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC153144/

  Albendazole is the treatment of choice for toxocariasis. Patients receiving a 5-day treatment course of albendazole (10 mg/kg of body weight/day in two divided doses) improved relative to patients who received treatment with the older anthelminthic drug thiabendazole. A dose of 400 mg of albendazole twice a day for 5 days is the currently recommended therapy. Because the other commonly used benzimidazole, mebendazole, is poorly absorbed outside the gastrointestinal tract, this agent is a second-line treatment, although some success has been reported in patients who ingest 1 g or more for a 21-day course. Symptomatic treatment, including administration of corticosteroids, has been helpful for suppressing the intense allergic manifestations of the infection. OLM is treated by surgery (vitrectomy), anthelminthic chemotherapy, and/or corticosteroids.

• #9 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  ABZ appears to be the drug of choice due to its quasi-worldwide availability, low price, seemingly acceptable efficacy and lack of major adverse reactions. We recommend 10–15 mg/kg b/w daily for 14 days. A higher daily dose and an excessively prolonged course might cause severe and sometimes irreversible adverse reactions (agranulocytosis, aplasia or hepatotoxicity), such as those reported in the treatment of echinococcoses with benzimidazoles, and nonadherence to therapy. However, the heterogeneity of studies on ABZ makes our recommendation open to discussion, and the optimal dose and duration of the drug course remains to be established. […] The role of anthelmintic treatment in compartmentalized toxocariasis, OT and NT, remains to be clarified. Regarding OT, experimental studies have demonstrated the harmful role of viable Toxocara spp. larvae, thus suggesting that drug-induced parasite death would reduce local inflammation. Unfortunately, the great majority of published small series or anecdotal reports about anthelmintic therapy for OT referred to the concomitant use of anthelmintics and corticosteroids. The same consideration applies to NT. Review articles about NT and OT did not answer this question. Consequently, a meta-analysis investigating the efficacy of reported drug regimens (anthelmintics alone, corticosteroids alone, or both) for NT and OT is urgently needed.

• #10 Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC153144/

  Albendazole is the treatment of choice for toxocariasis. Patients receiving a 5-day treatment course of albendazole (10 mg/kg of body weight/day in two divided doses) improved relative to patients who received treatment with the older anthelminthic drug thiabendazole. A dose of 400 mg of albendazole twice a day for 5 days is the currently recommended therapy. Because the other commonly used benzimidazole, mebendazole, is poorly absorbed outside the gastrointestinal tract, this agent is a second-line treatment, although some success has been reported in patients who ingest 1 g or more for a 21-day course. Symptomatic treatment, including administration of corticosteroids, has been helpful for suppressing the intense allergic manifestations of the infection. OLM is treated by surgery (vitrectomy), anthelminthic chemotherapy, and/or corticosteroids.

• #11 Who Let the Dogs Out? Unmasking the Neglected: A Semi-Systematic Review on the Enduring Impact of Toxocariasis, a Prevalent Zoonotic Infection

  https://www.mdpi.com/1660-4601/20/21/6972

  However, doses of 10 up to 15 mg/kg/day taken orally twice daily have also been reported with sufficient therapeutic rates. […] MBZ is an alternative treatment option, with low extraintestinal absorption and rapid first-pass metabolism as major disadvantages. […] Other anthelmintic agents, such as ivermectin, should be avoided in the treatment of human toxocariasis due to their very low cure rate. […] The diagnosis of OT represents a diagnostic challenge, something that may explain the limited existing data regarding the therapy of OT. […] However, the therapy of OT is based on anthelmintic drugs in combination with corticosteroids or surgical interventions, depending on previous ocular comorbidities and grade of inflammation. […] Unfortunately, due to the rarity of NT, no controlled studies have taken place in this direction. […] The suggested dose of ABZ is 10–15 mg/kg daily, which should be administered until complete resolution of the clinical symptoms and normalization of the MRI, generally over a time period of 21 to 28 days.

• #12 Toxocariasis: Clinical Aspects, Epidemiology, Medical Ecology, and Molecular Aspects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC153144/

  Albendazole is the treatment of choice for toxocariasis. Patients receiving a 5-day treatment course of albendazole (10 mg/kg of body weight/day in two divided doses) improved relative to patients who received treatment with the older anthelminthic drug thiabendazole. A dose of 400 mg of albendazole twice a day for 5 days is the currently recommended therapy. Because the other commonly used benzimidazole, mebendazole, is poorly absorbed outside the gastrointestinal tract, this agent is a second-line treatment, although some success has been reported in patients who ingest 1 g or more for a 21-day course. Symptomatic treatment, including administration of corticosteroids, has been helpful for suppressing the intense allergic manifestations of the infection. OLM is treated by surgery (vitrectomy), anthelminthic chemotherapy, and/or corticosteroids.

• #13 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Treatment is with albendazole or mebendazole. Corticosteroids may be added for severe symptoms or eye involvement. […] Asymptomatic patients and patients with mild visceral larva migrans (VLM) symptoms do not require anthelmintic therapy because infection is usually self-limited. […] For patients with moderate to severe symptoms, albendazole or mebendazole is used, but the optimal duration of therapy has not been determined. […] Corticosteroids are indicated for patients with severe symptoms to reduce inflammation. […] Ophthalmologic expertise is essential in the care of ocular larva migrans (OLM). Corticosteroids, both local and oral, are indicated to reduce inflammation within the eye. […] The role of anthelmintic therapy is uncertain. Albendazole used with corticosteroids may reduce recurrences, but comparative data are not available on the optimal dose and duration of therapy, and there is no evidence that albendazole improves visual outcome.

• #14 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  The mainstay of toxocariasis therapies includes anthelmintics (e.g. albendazole [ABZ], mebendazole [MBZ] and thiabendazole) and anti-inflammatory drugs. These drugs are used to achieve a clinical resolution or to reduce the damage caused by larval migration to various organs, particularly the brain and eyes. ABZ at 400 mg twice a day for five days is the first choice for treatment of VLM patients, but MBZ has been indicated as the second therapeutic option for VLM, due to its lower absorption rate outside the gastrointestinal tract compared to ABZ. Other anthelmintic drugs such as diethylcarbamazine (DEC) and ivermectin have been explored to treat VLM, but ivermectin has uncertain efficacy. In cases with cardiac involvement, regimens involving 800 mg/day for two weeks, 50 mg/(kgday) for 28 days, 600 mg/day for 14 days, or 1000 mg/day for four weeks have been used. Corticosteroids have been used in cases of pulmonary toxocariasis and toxocariasis-associated cardiac diseases.

• #15 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Laser photocoagulation has been used to kill larvae in the retina. Cryosurgery or surgical vitrectomy have been used in some circumstances. […] Most cases of visceral larva migrans are self-limited and do not require treatment, but, if needed, the following can be used: albendazole or mebendazole for moderate to severe symptoms, possibly antihistamines for mild symptoms of itching and rash, and corticosteroids for severe symptoms. […] For ocular larva migrans, systemic and local corticosteroids, sometimes albendazole, and depending on the circumstances laser therapy, cryotherapy, or surgical procedures.

• #16 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Treatment is with albendazole or mebendazole. Corticosteroids may be added for severe symptoms or eye involvement. […] Asymptomatic patients and patients with mild visceral larva migrans (VLM) symptoms do not require anthelmintic therapy because infection is usually self-limited. […] For patients with moderate to severe symptoms, albendazole or mebendazole is used, but the optimal duration of therapy has not been determined. […] Corticosteroids are indicated for patients with severe symptoms to reduce inflammation. […] Ophthalmologic expertise is essential in the care of ocular larva migrans (OLM). Corticosteroids, both local and oral, are indicated to reduce inflammation within the eye. […] The role of anthelmintic therapy is uncertain. Albendazole used with corticosteroids may reduce recurrences, but comparative data are not available on the optimal dose and duration of therapy, and there is no evidence that albendazole improves visual outcome.

• #17 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  ABZ appears to be the drug of choice due to its quasi-worldwide availability, low price, seemingly acceptable efficacy and lack of major adverse reactions. We recommend 10–15 mg/kg b/w daily for 14 days. A higher daily dose and an excessively prolonged course might cause severe and sometimes irreversible adverse reactions (agranulocytosis, aplasia or hepatotoxicity), such as those reported in the treatment of echinococcoses with benzimidazoles, and nonadherence to therapy. However, the heterogeneity of studies on ABZ makes our recommendation open to discussion, and the optimal dose and duration of the drug course remains to be established. […] The role of anthelmintic treatment in compartmentalized toxocariasis, OT and NT, remains to be clarified. Regarding OT, experimental studies have demonstrated the harmful role of viable Toxocara spp. larvae, thus suggesting that drug-induced parasite death would reduce local inflammation. Unfortunately, the great majority of published small series or anecdotal reports about anthelmintic therapy for OT referred to the concomitant use of anthelmintics and corticosteroids. The same consideration applies to NT. Review articles about NT and OT did not answer this question. Consequently, a meta-analysis investigating the efficacy of reported drug regimens (anthelmintics alone, corticosteroids alone, or both) for NT and OT is urgently needed.

• #18 Clinical Care of Toxocariasis | Parasites – Toxocariasis | CDC

  https://www.cdc.gov/toxocariasis/hcp/clinical-care/index.html

  Treat visceral toxocariasis with antiparasitic drugs. […] Treatment of ocular toxocariasis usually consists of measures to prevent eye damage. […] Treatment of visceral toxocariasis include the antiparasitic drugs albendazole or mebendazole. […] Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. […] In addition to antiparasitic therapy, symptomatic therapy including steroid treatment to control inflammation may be indicated. […] For ocular toxocariasis, the goal of treatment is to minimize damage to the eye. […] Systemic antiparasitic treatment with albendazole or mebendazole at the same doses as for visceral disease may be beneficial for active disease. […] Control of inflammation in the eye by use of topical or systemic steroids may be indicated. […] Prescribe albendazole only if the potential benefits to the woman justify the potential risks to the fetus. […] Prescribe mebendazole only if the potential benefits to the woman justify the potential risks to the fetus.

• #19 Toxocariasis – EyeWiki

  https://eyewiki.org/Toxocariasis

  Ocular toxocariasis is a rare infection caused by roundworms, Toxocara canis and Toxocara cati. […] Management includes quieting inflammation, eliminating the offending organism, and repairing vitreoretinal sequelae. […] Topical steroids are typically used to limit inflammation in order to prevent the development of tractional membranes and resulting retinal detachments. Other options include periocular injections and oral corticosteroids at 0.5-1 mg/kg. […] There is some support for the use of albendazole or thiabendazole to eradicate the organism. Albendazole is the preference of some physicians as it has increased blood brain barrier penetration. […] The CDC reports that 25% of patients presenting with new cases of ocular toxocariasis require surgery. Vitrectomy is the most common surgical therapy for ocular toxocariasis.

• #20 Toxocariasis – EyeWiki

  https://eyewiki.org/Toxocariasis

  Ocular toxocariasis is a rare infection caused by roundworms, Toxocara canis and Toxocara cati. […] Management includes quieting inflammation, eliminating the offending organism, and repairing vitreoretinal sequelae. […] Topical steroids are typically used to limit inflammation in order to prevent the development of tractional membranes and resulting retinal detachments. Other options include periocular injections and oral corticosteroids at 0.5-1 mg/kg. […] There is some support for the use of albendazole or thiabendazole to eradicate the organism. Albendazole is the preference of some physicians as it has increased blood brain barrier penetration. […] The CDC reports that 25% of patients presenting with new cases of ocular toxocariasis require surgery. Vitrectomy is the most common surgical therapy for ocular toxocariasis.

• #21 Ocular Toxocariasis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/140071

  Ocular toxocariasis can present with or without active inflammation. In cases with anterior chamber cells/flare and vitritis, the inflammation must be controlled with topical and systemic corticosteroids. This helps in reducing anterior chamber reaction, vitreous haze, and vitreous membranes. Topical cycloplegic mydriatic prevents posterior synechia formation and seclusio pupillae. Increased intraocular pressure can be controlled with topical antiglaucoma medications. The role of systemic anthelmintic drugs such as albendazole and thiabendazole is unclear. It is not proven to kill intraocular Toxocara. Though some cases have been described in the literature showing favorable results in combination with oral corticosteroids. In one study, treatment resulted in an improved vision in all patients. There were no recurrences of uveitis during the study period of 13.8 months. In adults, the dose of albendazole was 800 mg orally twice a day for two weeks with prednisolone at 1.5mg/kg tapered over three months. The children received 200 mg orally twice a day for two weeks with prednisolone at 1mg/kg. Sometimes, the larva is seen migrating in the subretinal space. It can then be destroyed with laser photocoagulation over and around it. The laser can be done with a neodymium-doped yttrium aluminum garnet (Nd: YAG) frequency-doubled 532 nm green laser. The laser power can be in the range of 250 to 300 mW and 100 to 150 ms duration. The reaction should produce a white burn over the retina. Secondary complications like choroidal neovascularization can be treated with intravitreal anti-vascular endothelium growth factor agents. Some patients present late without active inflammation. There is a peripheral focal granuloma with a vitreal fold radiating from it to the posterior pole. There can be accompanying tractional retinal detachment and a cataract. In such cases, surgery is indicated. Lens aspiration with intraocular lens implantation is preferred for the cataract. Pars plana vitrectomy is done for vitreous opacification and membranes. It also relieves the traction bands and allows retinal reattachment. Epiretinal membrane over the macula and disc can be peeled off. With such maneuvers, vision improves or remains stable in 85% of cases. Sometimes a retinal tear occurs secondary to the traction from a peripheral granuloma. A scleral buckle can be placed to relieve the retinal traction and improve visual acuity. The most important step in the management of toxocariasis is prevention. Good hygiene should be maintained in children. They should be prohibited from coming in close contact with dogs and cats. They should not play with contaminated soil and not walk bare feet outside. Meat should be properly cooked before consuming it. The puppies and dogs should be given anthelmintic drugs. Their litter should be disposed of in plastic bags. Educating the parents and child about clean and hygienic habits is essential.

• #22 Detection and Treatment Of Ocular Toxocariasis

  https://www.reviewofophthalmology.com/article/detection-and-treatment-of-ocular-toxocariasis

  The decision to start therapy depends on the stage of infection. Quiescent clinical presentations with no active inflammation require no anti-inflammatory or anti-helminthic treatment. For those rare patients who present with eye involvement in the setting of visceral larva migrans, systemic treatment with one of the benzimidazole derivatives (albendazole, thiabendazole and mebendazole) in conjunction with local and/or systemic corticosteroids as indicated is most effective. While no comparative trials are available, albendazole’s better tolerance and general availability in most countries make it the anti-helminthic drug of choice in most settings. […] Corticosteroids can be administered topically, periocularly, intraocularly or systemically, depending on the location and severity of inflammation. A cycloplegic/mydriatic is often indicated when anterior chamber inflammation is present to minimize the risk of posterior synechiae formation and should be selected and dosed based on the severity of the inflammation. Pars plana vitrectomy should be considered in selected patients to remove inflammatory tissues, relieve vitreomacular traction, and repair retinal detachment. Attempts have also been made to surgically remove live larva from the subretinal space. Alternatively, a motile larva can be destroyed using laser photocoagulation.

• #23 Ocular Toxocariasis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/140071

  Ocular toxocariasis can present with or without active inflammation. In cases with anterior chamber cells/flare and vitritis, the inflammation must be controlled with topical and systemic corticosteroids. This helps in reducing anterior chamber reaction, vitreous haze, and vitreous membranes. Topical cycloplegic mydriatic prevents posterior synechia formation and seclusio pupillae. Increased intraocular pressure can be controlled with topical antiglaucoma medications. The role of systemic anthelmintic drugs such as albendazole and thiabendazole is unclear. It is not proven to kill intraocular Toxocara. Though some cases have been described in the literature showing favorable results in combination with oral corticosteroids. In one study, treatment resulted in an improved vision in all patients. There were no recurrences of uveitis during the study period of 13.8 months. In adults, the dose of albendazole was 800 mg orally twice a day for two weeks with prednisolone at 1.5mg/kg tapered over three months. The children received 200 mg orally twice a day for two weeks with prednisolone at 1mg/kg. Sometimes, the larva is seen migrating in the subretinal space. It can then be destroyed with laser photocoagulation over and around it. The laser can be done with a neodymium-doped yttrium aluminum garnet (Nd: YAG) frequency-doubled 532 nm green laser. The laser power can be in the range of 250 to 300 mW and 100 to 150 ms duration. The reaction should produce a white burn over the retina. Secondary complications like choroidal neovascularization can be treated with intravitreal anti-vascular endothelium growth factor agents. Some patients present late without active inflammation. There is a peripheral focal granuloma with a vitreal fold radiating from it to the posterior pole. There can be accompanying tractional retinal detachment and a cataract. In such cases, surgery is indicated. Lens aspiration with intraocular lens implantation is preferred for the cataract. Pars plana vitrectomy is done for vitreous opacification and membranes. It also relieves the traction bands and allows retinal reattachment. Epiretinal membrane over the macula and disc can be peeled off. With such maneuvers, vision improves or remains stable in 85% of cases. Sometimes a retinal tear occurs secondary to the traction from a peripheral granuloma. A scleral buckle can be placed to relieve the retinal traction and improve visual acuity. The most important step in the management of toxocariasis is prevention. Good hygiene should be maintained in children. They should be prohibited from coming in close contact with dogs and cats. They should not play with contaminated soil and not walk bare feet outside. Meat should be properly cooked before consuming it. The puppies and dogs should be given anthelmintic drugs. Their litter should be disposed of in plastic bags. Educating the parents and child about clean and hygienic habits is essential.

• #24 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  Very few anthelmintics are available for the treatment of human helminthiases, and most of them have a veterinary origin. This situation is encountered in human toxocariasis, for which current therapeutic regimens only rely upon four licensed drugs. […] The treatment of OT with anthelmintics represents a special situation. First, controversy concerning the safety of anthelmintic use for therapy of this compartmentalized form of toxocariasis has occurred for years and still persists. Some ophthalmologists have claimed that larval lysis will boost inflammation in the parasitized eye. Nonetheless, this pending issue has been answered by two experimental studies in mice and in primates. The results demonstrated that only viable T. canis larvae releasing TES Ag locally were responsible for ocular involvement. Whether anthelmintics would penetrate into the eye or permeate the blood–brain barrier is another question of crucial importance.

• #25 Clinical Features and Course of Ocular Toxocariasis in Adults | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002938

  To investigate the clinical features, clinical course of granuloma, serologic findings, treatment outcome, and probable infection sources in adult patients with ocular toxocariasis (OT). […] Treatment with albendazole (400 mg twice a day for 2 weeks) and corticosteroids (oral prednisolone; 0.51 mg/kg/day) resulted in comparable outcomes to patients on corticosteroid monotherapy; however, the 6-month recurrence rate in patients treated with combined therapy (17.4%) was significantly lower than that in patients treated with corticosteroid monotherapy (54.5%, P=0.045). […] Combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence. […] We suggest that combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence.

• #26 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Treatment is with albendazole or mebendazole. Corticosteroids may be added for severe symptoms or eye involvement. […] Asymptomatic patients and patients with mild visceral larva migrans (VLM) symptoms do not require anthelmintic therapy because infection is usually self-limited. […] For patients with moderate to severe symptoms, albendazole or mebendazole is used, but the optimal duration of therapy has not been determined. […] Corticosteroids are indicated for patients with severe symptoms to reduce inflammation. […] Ophthalmologic expertise is essential in the care of ocular larva migrans (OLM). Corticosteroids, both local and oral, are indicated to reduce inflammation within the eye. […] The role of anthelmintic therapy is uncertain. Albendazole used with corticosteroids may reduce recurrences, but comparative data are not available on the optimal dose and duration of therapy, and there is no evidence that albendazole improves visual outcome.

• #27 Toxocariasis – EyeWiki

  https://eyewiki.org/Toxocariasis

  Ocular toxocariasis is a rare infection caused by roundworms, Toxocara canis and Toxocara cati. […] Management includes quieting inflammation, eliminating the offending organism, and repairing vitreoretinal sequelae. […] Topical steroids are typically used to limit inflammation in order to prevent the development of tractional membranes and resulting retinal detachments. Other options include periocular injections and oral corticosteroids at 0.5-1 mg/kg. […] There is some support for the use of albendazole or thiabendazole to eradicate the organism. Albendazole is the preference of some physicians as it has increased blood brain barrier penetration. […] The CDC reports that 25% of patients presenting with new cases of ocular toxocariasis require surgery. Vitrectomy is the most common surgical therapy for ocular toxocariasis.

• #28 Toxocariasis – EyeWiki

  https://eyewiki.org/Toxocariasis

  Ocular toxocariasis is a rare infection caused by roundworms, Toxocara canis and Toxocara cati. […] Management includes quieting inflammation, eliminating the offending organism, and repairing vitreoretinal sequelae. […] Topical steroids are typically used to limit inflammation in order to prevent the development of tractional membranes and resulting retinal detachments. Other options include periocular injections and oral corticosteroids at 0.5-1 mg/kg. […] There is some support for the use of albendazole or thiabendazole to eradicate the organism. Albendazole is the preference of some physicians as it has increased blood brain barrier penetration. […] The CDC reports that 25% of patients presenting with new cases of ocular toxocariasis require surgery. Vitrectomy is the most common surgical therapy for ocular toxocariasis.

• #29 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Laser photocoagulation has been used to kill larvae in the retina. Cryosurgery or surgical vitrectomy have been used in some circumstances. […] Most cases of visceral larva migrans are self-limited and do not require treatment, but, if needed, the following can be used: albendazole or mebendazole for moderate to severe symptoms, possibly antihistamines for mild symptoms of itching and rash, and corticosteroids for severe symptoms. […] For ocular larva migrans, systemic and local corticosteroids, sometimes albendazole, and depending on the circumstances laser therapy, cryotherapy, or surgical procedures.

• #30 Toxocariasis Definition – CorneaCare

  https://mycorneacare.com/glossary/toxocariasis/?srsltid=AfmBOoqlPDBE1byrHjtCsdNhu0u5bp411Ib7Y90DWV3lqPH_ibPSLxCL

  Management includes quieting the inflammation, eliminating the offending organism, and repairing vitreoretinal findings. […] Medical therapy includes topical steroids to limit inflammation and prevent the development of tractional membranes and retinal detachments. Other options include periocular injections and oral corticosteroids at 0.5-1 mg/kg. […] The use of anti-parasitic therapy is unproven in the case of ocular toxocariasis. There is some support for the use of albendazole or thiabendazole to eradicate the organism. […] The CDC reports that approximately 25% of new cases of ocular toxocariasis require surgery. Vitrectomy is the most common surgery performed for ocular toxocariasis. Individuals may need surgery for persistent vitreous opacification, hemorrhage, tractional retinal detachment, and epiretinal membranes.

• #31 Detection and Treatment Of Ocular Toxocariasis

  https://www.reviewofophthalmology.com/article/detection-and-treatment-of-ocular-toxocariasis

  The decision to start therapy depends on the stage of infection. Quiescent clinical presentations with no active inflammation require no anti-inflammatory or anti-helminthic treatment. For those rare patients who present with eye involvement in the setting of visceral larva migrans, systemic treatment with one of the benzimidazole derivatives (albendazole, thiabendazole and mebendazole) in conjunction with local and/or systemic corticosteroids as indicated is most effective. While no comparative trials are available, albendazole’s better tolerance and general availability in most countries make it the anti-helminthic drug of choice in most settings. […] Corticosteroids can be administered topically, periocularly, intraocularly or systemically, depending on the location and severity of inflammation. A cycloplegic/mydriatic is often indicated when anterior chamber inflammation is present to minimize the risk of posterior synechiae formation and should be selected and dosed based on the severity of the inflammation. Pars plana vitrectomy should be considered in selected patients to remove inflammatory tissues, relieve vitreomacular traction, and repair retinal detachment. Attempts have also been made to surgically remove live larva from the subretinal space. Alternatively, a motile larva can be destroyed using laser photocoagulation.

• #32 Ocular toxocariasis: a neglected parasitic disease in Egypt | Bulletin of the National Research Centre | Full Text

  https://bnrc.springeropen.com/articles/10.1186/s42269-019-0185-8

  Ocular toxocariasis can be treated either medically or surgically. […] The goal of medical treatment is to prevent the ocular damage and visual loss. […] Corticosteroids are the mainstay medical treatment for ocular toxocariasis as they have the ability to decrease the release of local mediators of inflammation leading to the suppression of inflammation, induce cell membranes stabilization, and prevent vitreous opacification and tractional retinal detachment. […] Regarding antiparasitic medications, some ophthalmologists recommend anthelmintic using in addition to corticosteroids while the others use these medications only when the response to corticosteroids is inefficient. […] Anthelmintic treatment can be given, especially with the presence of extraocular toxocariasis symptoms. […] Surgical interferences are required in cases with post-inflammatory complications such as vitreous opacification, retinal scars, bands, or detachment and formation of the epiretinal membrane with vitreomacular or optic nerve traction.

• #33 Toxocariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/toxocariasis

  Laser photocoagulation has been used to kill larvae in the retina. Cryosurgery or surgical vitrectomy have been used in some circumstances. […] Most cases of visceral larva migrans are self-limited and do not require treatment, but, if needed, the following can be used: albendazole or mebendazole for moderate to severe symptoms, possibly antihistamines for mild symptoms of itching and rash, and corticosteroids for severe symptoms. […] For ocular larva migrans, systemic and local corticosteroids, sometimes albendazole, and depending on the circumstances laser therapy, cryotherapy, or surgical procedures.

• #34 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/ocular-toxocariasis–europe

  Methods include all variations of vitrectomy (use of SF-6 gas or silicon oil, with or without scleral buckle/lens extraction). […] Perfluorocarbon liquids injection […] Indicated to facilitate removal of epiretinal membranes (ERMs) and the posterior hyaloid in cases of tractional retinal detachment. […] Cryotherapy […] Applied directly at the areas of exudation at the pars plana with a double freeze-thaw technique. […] Endolaser […] Indicated for treatment of ocular granulomas […] Visual acuity recovery is directly related to the anatomical location of the lesions, the degree of retinal detachment, and compromise of the photoreceptors, external limiting membrane, and optic nerve. Vision loss can therefore be variable, from mild to severe. […] Early treatment should be performed to decrease complications and provide better visual outcomes. […] Most cases of ocular toxocariasis have visual acuity of less than 20/40 at presentation. […] As in any pediatric condition that affects one eye, amblyopia treatment is an important component of the overall visual rehabilitation scheme.

• #35 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/ocular-toxocariasis–europe

  Methods include all variations of vitrectomy (use of SF-6 gas or silicon oil, with or without scleral buckle/lens extraction). […] Perfluorocarbon liquids injection […] Indicated to facilitate removal of epiretinal membranes (ERMs) and the posterior hyaloid in cases of tractional retinal detachment. […] Cryotherapy […] Applied directly at the areas of exudation at the pars plana with a double freeze-thaw technique. […] Endolaser […] Indicated for treatment of ocular granulomas […] Visual acuity recovery is directly related to the anatomical location of the lesions, the degree of retinal detachment, and compromise of the photoreceptors, external limiting membrane, and optic nerve. Vision loss can therefore be variable, from mild to severe. […] Early treatment should be performed to decrease complications and provide better visual outcomes. […] Most cases of ocular toxocariasis have visual acuity of less than 20/40 at presentation. […] As in any pediatric condition that affects one eye, amblyopia treatment is an important component of the overall visual rehabilitation scheme.

• #36 Ocular toxocariasis: a neglected parasitic disease in Egypt | Bulletin of the National Research Centre | Full Text

  https://bnrc.springeropen.com/articles/10.1186/s42269-019-0185-8

  Ocular toxocariasis can be treated either medically or surgically. […] The goal of medical treatment is to prevent the ocular damage and visual loss. […] Corticosteroids are the mainstay medical treatment for ocular toxocariasis as they have the ability to decrease the release of local mediators of inflammation leading to the suppression of inflammation, induce cell membranes stabilization, and prevent vitreous opacification and tractional retinal detachment. […] Regarding antiparasitic medications, some ophthalmologists recommend anthelmintic using in addition to corticosteroids while the others use these medications only when the response to corticosteroids is inefficient. […] Anthelmintic treatment can be given, especially with the presence of extraocular toxocariasis symptoms. […] Surgical interferences are required in cases with post-inflammatory complications such as vitreous opacification, retinal scars, bands, or detachment and formation of the epiretinal membrane with vitreomacular or optic nerve traction.

• #37 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/ocular-toxocariasis–europe

  Methods include all variations of vitrectomy (use of SF-6 gas or silicon oil, with or without scleral buckle/lens extraction). […] Perfluorocarbon liquids injection […] Indicated to facilitate removal of epiretinal membranes (ERMs) and the posterior hyaloid in cases of tractional retinal detachment. […] Cryotherapy […] Applied directly at the areas of exudation at the pars plana with a double freeze-thaw technique. […] Endolaser […] Indicated for treatment of ocular granulomas […] Visual acuity recovery is directly related to the anatomical location of the lesions, the degree of retinal detachment, and compromise of the photoreceptors, external limiting membrane, and optic nerve. Vision loss can therefore be variable, from mild to severe. […] Early treatment should be performed to decrease complications and provide better visual outcomes. […] Most cases of ocular toxocariasis have visual acuity of less than 20/40 at presentation. […] As in any pediatric condition that affects one eye, amblyopia treatment is an important component of the overall visual rehabilitation scheme.

• #38 EPIDEMIOLOGY

  https://www.aao.org/education/topic-detail/ocular-toxocariasis–europe

  Methods include all variations of vitrectomy (use of SF-6 gas or silicon oil, with or without scleral buckle/lens extraction). […] Perfluorocarbon liquids injection […] Indicated to facilitate removal of epiretinal membranes (ERMs) and the posterior hyaloid in cases of tractional retinal detachment. […] Cryotherapy […] Applied directly at the areas of exudation at the pars plana with a double freeze-thaw technique. […] Endolaser […] Indicated for treatment of ocular granulomas […] Visual acuity recovery is directly related to the anatomical location of the lesions, the degree of retinal detachment, and compromise of the photoreceptors, external limiting membrane, and optic nerve. Vision loss can therefore be variable, from mild to severe. […] Early treatment should be performed to decrease complications and provide better visual outcomes. […] Most cases of ocular toxocariasis have visual acuity of less than 20/40 at presentation. […] As in any pediatric condition that affects one eye, amblyopia treatment is an important component of the overall visual rehabilitation scheme.

• #39 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #40 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #41 Who Let the Dogs Out? Unmasking the Neglected: A Semi-Systematic Review on the Enduring Impact of Toxocariasis, a Prevalent Zoonotic Infection

  https://www.mdpi.com/1660-4601/20/21/6972

  However, doses of 10 up to 15 mg/kg/day taken orally twice daily have also been reported with sufficient therapeutic rates. […] MBZ is an alternative treatment option, with low extraintestinal absorption and rapid first-pass metabolism as major disadvantages. […] Other anthelmintic agents, such as ivermectin, should be avoided in the treatment of human toxocariasis due to their very low cure rate. […] The diagnosis of OT represents a diagnostic challenge, something that may explain the limited existing data regarding the therapy of OT. […] However, the therapy of OT is based on anthelmintic drugs in combination with corticosteroids or surgical interventions, depending on previous ocular comorbidities and grade of inflammation. […] Unfortunately, due to the rarity of NT, no controlled studies have taken place in this direction. […] The suggested dose of ABZ is 10–15 mg/kg daily, which should be administered until complete resolution of the clinical symptoms and normalization of the MRI, generally over a time period of 21 to 28 days.

• #42 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #43 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #44 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #45 Toxocariasis: a silent threat with a progressive public health impact | Infectious Diseases of Poverty | Full Text

  https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0437-0

  Despite the lack of an optimal treatment for OT, some patients can be treated successfully with anthelmintic drugs or surgically, depending on the severity of intraocular inflammation and retinal comorbidities. Current standard treatment for OT with active intraocular inflammation includes systemic corticosteroid in combination with ABZ. Periocular or systemic steroids can limit the inflammation, fibrosis, or cicatrization in eyes with active vitritis. Surgery is advised for treatment of structural complications. Cryotherapy can be used to treat granulomas, with the administration of steroids following the procedure. […] Combinations of corticosteroids with DEC, MBZ, orthiabendazole have been used for the treatment of NT. Although NT may resolve from treatment using ABZ, MBZ, thiabendazole and DEC, ABZ used for at least three weeks, which often needed to be repeated is the preferable choice because it can penetrate the CSF with a minimal toxicity. Corticosteroids can be used for reducing inflammation and controlling hypersensitivity reactions caused by degenerated larvae following the treatment of NT. Encouraging results have been reported recently where a long-term administration of ABZ (10-15 mg/[kgday]) for four weeks or eight weeks resulted in recovery rate of 78.9 and 81.3%, respectively. Monitoring of side effects post-treatment is recommended especially in patients who might be at a high risk of treatment complications, including people with allergies, pregnant or lactating women, children weighing less than 15 kg, older patients, and those concurrently taking other medicines.

• #46 Clinical Care of Toxocariasis | Parasites – Toxocariasis | CDC

  https://www.cdc.gov/toxocariasis/hcp/clinical-care/index.html

  Treat visceral toxocariasis with antiparasitic drugs. […] Treatment of ocular toxocariasis usually consists of measures to prevent eye damage. […] Treatment of visceral toxocariasis include the antiparasitic drugs albendazole or mebendazole. […] Treatment of ocular toxocariasis is more difficult and usually consists of measures to prevent progressive damage to the eye. […] In addition to antiparasitic therapy, symptomatic therapy including steroid treatment to control inflammation may be indicated. […] For ocular toxocariasis, the goal of treatment is to minimize damage to the eye. […] Systemic antiparasitic treatment with albendazole or mebendazole at the same doses as for visceral disease may be beneficial for active disease. […] Control of inflammation in the eye by use of topical or systemic steroids may be indicated. […] Prescribe albendazole only if the potential benefits to the woman justify the potential risks to the fetus. […] Prescribe mebendazole only if the potential benefits to the woman justify the potential risks to the fetus.

• #47

• #48 Toxocariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.69.2.

  Treatment that includes anthelmintics is advocated for toxocariasis and particularly acute toxocariasis, so as to limit the larvae from reaching the eyes and brain. Specialist consultation is advised. Albendazole and mebendazole are often used. Glucocorticoids (eg, prednisolone) and in some instances ophthalmic surgery are used in more complex infections. […] The first-line drug is oral albendazole 15 mg/kg/d (max 800 mg/d) for 5 to 10 days. […] Albendazole and glucocorticoids administered systemically or topically as well as surgical treatment (vitrectomy and laser photocoagulation). […] In the course of albendazole treatment, monitor eosinophilia and blood aminotransferase levels on a regular basis. Treatment should be discontinued if features of liver damage are observed. Fundoscopy should be periodically performed in case of a further decrease of visual acuity.

• #49 Toxocariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.69.2.

  Treatment that includes anthelmintics is advocated for toxocariasis and particularly acute toxocariasis, so as to limit the larvae from reaching the eyes and brain. Specialist consultation is advised. Albendazole and mebendazole are often used. Glucocorticoids (eg, prednisolone) and in some instances ophthalmic surgery are used in more complex infections. […] The first-line drug is oral albendazole 15 mg/kg/d (max 800 mg/d) for 5 to 10 days. […] Albendazole and glucocorticoids administered systemically or topically as well as surgical treatment (vitrectomy and laser photocoagulation). […] In the course of albendazole treatment, monitor eosinophilia and blood aminotransferase levels on a regular basis. Treatment should be discontinued if features of liver damage are observed. Fundoscopy should be periodically performed in case of a further decrease of visual acuity.

• #50 Toxocariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.69.2.

  Treatment that includes anthelmintics is advocated for toxocariasis and particularly acute toxocariasis, so as to limit the larvae from reaching the eyes and brain. Specialist consultation is advised. Albendazole and mebendazole are often used. Glucocorticoids (eg, prednisolone) and in some instances ophthalmic surgery are used in more complex infections. […] The first-line drug is oral albendazole 15 mg/kg/d (max 800 mg/d) for 5 to 10 days. […] Albendazole and glucocorticoids administered systemically or topically as well as surgical treatment (vitrectomy and laser photocoagulation). […] In the course of albendazole treatment, monitor eosinophilia and blood aminotransferase levels on a regular basis. Treatment should be discontinued if features of liver damage are observed. Fundoscopy should be periodically performed in case of a further decrease of visual acuity.

• #51

  https://link.springer.com/article/10.1007/s00436-011-2772-y

  Evaluation of the efficacy of treatment is not easy due to non-characteristic symptoms; low kinetics of specific anti-Toxocara IgG decrease; however, high IgG titers suggest non-effective treatment of concomitant infection requiring subsequent therapy. […] In conclusion of the above, constant multispecialistic care of patients with T. canis infection, widening of indications for repeated antiparasitic therapy, and introduction of new diagnostic methods for detection of new cases, apart from widespread prophylactic efforts, may become a crucial element in the prevention of consequences and complications of toxocariasis.

• #52

  https://link.springer.com/article/10.1007/s00436-011-2772-y

  Evaluation of the efficacy of treatment is not easy due to non-characteristic symptoms; low kinetics of specific anti-Toxocara IgG decrease; however, high IgG titers suggest non-effective treatment of concomitant infection requiring subsequent therapy. […] In conclusion of the above, constant multispecialistic care of patients with T. canis infection, widening of indications for repeated antiparasitic therapy, and introduction of new diagnostic methods for detection of new cases, apart from widespread prophylactic efforts, may become a crucial element in the prevention of consequences and complications of toxocariasis.

• #53 Ocular Toxocariasis

  https://www.medsci.org/v06p0129.htm

  The best therapy is to prevent infection, eliminating or reducing the contact between children and contaminated environments, periodic treatment of pets, in particular lactating females. […] Once the infection is established, therapy should be guided according to: – visual acuity, – severity of inflammation, – irreversible ocular damage. Generally peripheral granuloma are silent or show minimal inflammatory reaction and do not require therapy. An antielmintic therapy with either tiabendazole or diethylcarbamazepine is not worldwide accepted because of the possibility that larvae death may increase the inflammatory reaction. A steroid umbrella, either administered sistemically or by periocular injections is always advisable to reduce the inflammatory reaction followed by the death of the larva or given alone to control vitreitis and the formation of vitreoretinal tractional membranes. Vitreoretinal surgery is useful and indicated to remove vitreous opacities and epiretinal membranes, to prevent and to treat retinal detachment. Nevertheless in 24-42% of the cases a relapse retinal detachment may occur because of a persistent post-surgical inflammatory reaction. Laser photocoagulation has a limited role and may be used to kill live and mobile larva in the retinal space when visible (under steroid umbrella) and to treat choroidal neovascular membrane.

• #54 Ocular Toxocariasis

  https://www.medsci.org/v06p0129.htm

  The best therapy is to prevent infection, eliminating or reducing the contact between children and contaminated environments, periodic treatment of pets, in particular lactating females. […] Once the infection is established, therapy should be guided according to: – visual acuity, – severity of inflammation, – irreversible ocular damage. Generally peripheral granuloma are silent or show minimal inflammatory reaction and do not require therapy. An antielmintic therapy with either tiabendazole or diethylcarbamazepine is not worldwide accepted because of the possibility that larvae death may increase the inflammatory reaction. A steroid umbrella, either administered sistemically or by periocular injections is always advisable to reduce the inflammatory reaction followed by the death of the larva or given alone to control vitreitis and the formation of vitreoretinal tractional membranes. Vitreoretinal surgery is useful and indicated to remove vitreous opacities and epiretinal membranes, to prevent and to treat retinal detachment. Nevertheless in 24-42% of the cases a relapse retinal detachment may occur because of a persistent post-surgical inflammatory reaction. Laser photocoagulation has a limited role and may be used to kill live and mobile larva in the retinal space when visible (under steroid umbrella) and to treat choroidal neovascular membrane.

• #55 Roundworms in Small Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-small-animals/roundworms-in-small-animals

  Drugs approved for treatment of ascarid infections in cats include emodepside, eprinomectin, fenbendazole, milbemycin, moxidectin, piperazine, pyrantel, and selamectin. […] As in dogs, many drugs only kill adult parasites. […] Thus, when used to treat infected cats, such drugs should be administered twice, 10-14 days apart. […] Fecal examination 10-14 days after the second treatment should be used to confirm the efficacy of treatment. […] For control of T canis, perinatal transmission of infection can be greatly decreased by treating bitches with one of the following: daily doses of fenbendazole (25 mg/kg, PO) from day 40 of gestation to day 2 after whelping, ivermectin (0.3 mg/kg, SC) on days 0, 30, and 60 of gestation, and 10 days after whelping, or ivermectin (0.5 mg/kg, SC) on days 38, 41, 44, and 47 of gestation.

• #56 Ocular Toxocariasis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/140071

  Ocular toxocariasis can present with or without active inflammation. In cases with anterior chamber cells/flare and vitritis, the inflammation must be controlled with topical and systemic corticosteroids. This helps in reducing anterior chamber reaction, vitreous haze, and vitreous membranes. Topical cycloplegic mydriatic prevents posterior synechia formation and seclusio pupillae. Increased intraocular pressure can be controlled with topical antiglaucoma medications. The role of systemic anthelmintic drugs such as albendazole and thiabendazole is unclear. It is not proven to kill intraocular Toxocara. Though some cases have been described in the literature showing favorable results in combination with oral corticosteroids. In one study, treatment resulted in an improved vision in all patients. There were no recurrences of uveitis during the study period of 13.8 months. In adults, the dose of albendazole was 800 mg orally twice a day for two weeks with prednisolone at 1.5mg/kg tapered over three months. The children received 200 mg orally twice a day for two weeks with prednisolone at 1mg/kg. Sometimes, the larva is seen migrating in the subretinal space. It can then be destroyed with laser photocoagulation over and around it. The laser can be done with a neodymium-doped yttrium aluminum garnet (Nd: YAG) frequency-doubled 532 nm green laser. The laser power can be in the range of 250 to 300 mW and 100 to 150 ms duration. The reaction should produce a white burn over the retina. Secondary complications like choroidal neovascularization can be treated with intravitreal anti-vascular endothelium growth factor agents. Some patients present late without active inflammation. There is a peripheral focal granuloma with a vitreal fold radiating from it to the posterior pole. There can be accompanying tractional retinal detachment and a cataract. In such cases, surgery is indicated. Lens aspiration with intraocular lens implantation is preferred for the cataract. Pars plana vitrectomy is done for vitreous opacification and membranes. It also relieves the traction bands and allows retinal reattachment. Epiretinal membrane over the macula and disc can be peeled off. With such maneuvers, vision improves or remains stable in 85% of cases. Sometimes a retinal tear occurs secondary to the traction from a peripheral granuloma. A scleral buckle can be placed to relieve the retinal traction and improve visual acuity. The most important step in the management of toxocariasis is prevention. Good hygiene should be maintained in children. They should be prohibited from coming in close contact with dogs and cats. They should not play with contaminated soil and not walk bare feet outside. Meat should be properly cooked before consuming it. The puppies and dogs should be given anthelmintic drugs. Their litter should be disposed of in plastic bags. Educating the parents and child about clean and hygienic habits is essential.

• #57 Comprehensive Control of Toxocariasis in Communities | IntechOpen

  https://www.intechopen.com/chapters/1180844

  With the purpose of understanding the complexity of actions aimed at controlling the main zoonotic soil-transmitted helminthiasis in the world, this book chapter is proposed around the comprehensive control of toxocariasis in urban communities. […] Control strategies will be discussed in the various links of its transmission/infection chain, demonstrating that preventive medicine supported by selective strategic deworming in canines and felines within their various age ranges is the fundamental pillar in the fight against this parasitosis. […] The education of communities, from their state, governmental, and social leaders to family core, must be sensitized. Topics on zoonotic soil-transmitted helminthiasis, responsible ownership of dogs and cats, collection of feces and its correct disposal, selective strategic deworming for Toxocara in dogs and cats according to their age.

• #58 Comprehensive Control of Toxocariasis in Communities | IntechOpen

  https://www.intechopen.com/chapters/1180844

  With the purpose of understanding the complexity of actions aimed at controlling the main zoonotic soil-transmitted helminthiasis in the world, this book chapter is proposed around the comprehensive control of toxocariasis in urban communities. […] Control strategies will be discussed in the various links of its transmission/infection chain, demonstrating that preventive medicine supported by selective strategic deworming in canines and felines within their various age ranges is the fundamental pillar in the fight against this parasitosis. […] The education of communities, from their state, governmental, and social leaders to family core, must be sensitized. Topics on zoonotic soil-transmitted helminthiasis, responsible ownership of dogs and cats, collection of feces and its correct disposal, selective strategic deworming for Toxocara in dogs and cats according to their age.

• #59 Comprehensive Control of Toxocariasis in Communities | IntechOpen

  https://www.intechopen.com/chapters/1180844

  The current guidelines of associations, the European Scientific Counsel of Companion Animal Parasites (ESCCAP; www.esccap.org), the Tropical Council for Companion Animal Parasites (TroCCAP; www.troccap.com), and the Companion Animal Parasite Council (CAPC; www.capcvet.org), recommend serial anthelmintic treatment. […] The biggest problem to control within the life cycle of Toxocara refers to avoiding vertical transmission of the parasite, especially in bitches, which can transmit L3 to their offspring in utero and through the milk. […] Being clear regarding the existing antiparasitic drugs protocols for the control of Toxocara spp. in dogs and cats, which must be socialized with responsible owners of cats and dogs. […] Without a doubt, the staging of a vaccine for the prevention and control of Toxocara spp. will be the fundamental pillar of a complete comprehensive plan for toxocariasis. […] In the near future, hopefully immediate, efforts should be made to research more promising antigens for the development of effective and efficient vaccines to control the vertical transmission of T. canis and T. cati.

• #60 Roundworms in Small Animals – Digestive System – Merck Veterinary Manual

  https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-small-animals/roundworms-in-small-animals

  Drugs approved for treatment of ascarid infections in cats include emodepside, eprinomectin, fenbendazole, milbemycin, moxidectin, piperazine, pyrantel, and selamectin. […] As in dogs, many drugs only kill adult parasites. […] Thus, when used to treat infected cats, such drugs should be administered twice, 10-14 days apart. […] Fecal examination 10-14 days after the second treatment should be used to confirm the efficacy of treatment. […] For control of T canis, perinatal transmission of infection can be greatly decreased by treating bitches with one of the following: daily doses of fenbendazole (25 mg/kg, PO) from day 40 of gestation to day 2 after whelping, ivermectin (0.3 mg/kg, SC) on days 0, 30, and 60 of gestation, and 10 days after whelping, or ivermectin (0.5 mg/kg, SC) on days 38, 41, 44, and 47 of gestation.

• #61 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  To date, anthelmintic therapy for human toxocariasis remains rather unsatisfactory. There are few available compounds, and they are out of date. Their efficacy has rarely been assessed in prospective controlled trials. Clearly, anthelmintic treatment of the systemic forms of human toxocariasis should be standardized. A scoring system to quantify clinical severity should be developed by expert consensus so that therapeutic efficacy may be precisely assessed.

• #62 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  To date, anthelmintic therapy for human toxocariasis remains rather unsatisfactory. There are few available compounds, and they are out of date. Their efficacy has rarely been assessed in prospective controlled trials. Clearly, anthelmintic treatment of the systemic forms of human toxocariasis should be standardized. A scoring system to quantify clinical severity should be developed by expert consensus so that therapeutic efficacy may be precisely assessed.

• #63 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  To date, anthelmintic therapy for human toxocariasis remains rather unsatisfactory. There are few available compounds, and they are out of date. Their efficacy has rarely been assessed in prospective controlled trials. Clearly, anthelmintic treatment of the systemic forms of human toxocariasis should be standardized. A scoring system to quantify clinical severity should be developed by expert consensus so that therapeutic efficacy may be precisely assessed.

• #64 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  Therapy and Prevention for Human Toxocariasis […] For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

• #65 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  Therapy and Prevention for Human Toxocariasis […] For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

• #66

  https://jvpp.rovedar.com/index.php/JVPP/article/view/24

  Toxocariasis, caused by Toxocara parasites, is a prevalent parasitic disease affecting millions of people worldwide. Conventional anthelmintic drugs for toxocariasis face challenges such as limited efficacy and potential adverse effects, necessitating exploring alternative therapeutic strategies. Nanotechnology has emerged as a promising approach for the treatment of toxocariasis. […] The current review aimed to provide an overview of toxocariasis and the current challenges in its treatment, such as limited efficacy and potential adverse effects. It emphasized the need for novel therapeutic approaches to overcome these limitations. […] Nanotechnology in targeted therapy is a great strategy to treat toxocariasis. […] In conclusion, nanotechnology holds immense potential in the treatment of toxocariasis. Its unique features, such as targeted drug delivery, enhanced diagnostics, and improved vaccine efficacy, offer promising avenues for more effective and personalized approaches. Addressing evaluation, regulatory approval, cost-effectiveness, and scalability challenges is crucial for successful translation into clinical practice. The advancements in nanotechnology can potentially revolutionize toxocariasis treatment and improve patient outcomes.

• #67 Great Morinda Fruit Potential to Cure Toxocariasis – Universitas Gadjah Mada

  https://ugm.ac.id/en/news/11245-great-morinda-fruit-potential-to-cure-toxocariasis/

  Toxocariasis is an infection often found in developing countries. […] Treatment is usually done with synthetic drugs, such as Albendazole, but its use may cause digestive problems such as nausea, vomiting, diarrhea and allergies. […] They found a way able to cure toxocariasis by using great morinda. […] As a matter of fact, the fruit has benefits, including to be used as toxocariasis medicine due to its antihelminthics compound, said Rosa on Monday (22/2) at Faculty of Veterinary Science. […] The test showed that the fruit extract may decrease the growth of eggs of toxocara cati parasitic worms. […] The optimal result is gained through the 100% of extract concentrate. […] Rosa added the use of great morinda for treating toxocariasis is safe to human beings, even pregnant mothers, as it is natural. […] Some antihelminthics in the market are harmful to pregnant mothers and foetus, but this great morinda extract is safe, she said. […] Various researches are still required to make the extract better, including to get the right dosage for human, she concluded.

• #68 Comprehensive Control of Toxocariasis in Communities | IntechOpen

  https://www.intechopen.com/chapters/1180844

  The current guidelines of associations, the European Scientific Counsel of Companion Animal Parasites (ESCCAP; www.esccap.org), the Tropical Council for Companion Animal Parasites (TroCCAP; www.troccap.com), and the Companion Animal Parasite Council (CAPC; www.capcvet.org), recommend serial anthelmintic treatment. […] The biggest problem to control within the life cycle of Toxocara refers to avoiding vertical transmission of the parasite, especially in bitches, which can transmit L3 to their offspring in utero and through the milk. […] Being clear regarding the existing antiparasitic drugs protocols for the control of Toxocara spp. in dogs and cats, which must be socialized with responsible owners of cats and dogs. […] Without a doubt, the staging of a vaccine for the prevention and control of Toxocara spp. will be the fundamental pillar of a complete comprehensive plan for toxocariasis. […] In the near future, hopefully immediate, efforts should be made to research more promising antigens for the development of effective and efficient vaccines to control the vertical transmission of T. canis and T. cati.

• #69 Therapy and Prevention for Human Toxocariasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8875715/

  For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

• #70 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  ABZ appears to be the drug of choice due to its quasi-worldwide availability, low price, seemingly acceptable efficacy and lack of major adverse reactions. We recommend 10–15 mg/kg b/w daily for 14 days. A higher daily dose and an excessively prolonged course might cause severe and sometimes irreversible adverse reactions (agranulocytosis, aplasia or hepatotoxicity), such as those reported in the treatment of echinococcoses with benzimidazoles, and nonadherence to therapy. However, the heterogeneity of studies on ABZ makes our recommendation open to discussion, and the optimal dose and duration of the drug course remains to be established. […] The role of anthelmintic treatment in compartmentalized toxocariasis, OT and NT, remains to be clarified. Regarding OT, experimental studies have demonstrated the harmful role of viable Toxocara spp. larvae, thus suggesting that drug-induced parasite death would reduce local inflammation. Unfortunately, the great majority of published small series or anecdotal reports about anthelmintic therapy for OT referred to the concomitant use of anthelmintics and corticosteroids. The same consideration applies to NT. Review articles about NT and OT did not answer this question. Consequently, a meta-analysis investigating the efficacy of reported drug regimens (anthelmintics alone, corticosteroids alone, or both) for NT and OT is urgently needed.

• #71 Therapy and Prevention for Human Toxocariasis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8875715/

  The few prospective controlled or observational trials that have been performed to evaluate therapy for toxocariasis have occasionally reported inconsistent dosages and suboptimal durations. The provided information is therefore somewhat questionable. Nonetheless, ABZ appears to be the drug of choice due to its quasi-worldwide availability, low price, seemingly acceptable efficacy and lack of major adverse reactions. We recommend 10-15 mg/kg b/w daily for 14 days. A higher daily dose and an excessively prolonged course might cause severe and sometimes irreversible adverse reactions (agranulocytosis, aplasia or hepatotoxicity), such as those reported in the treatment of echinococcoses with benzimidazoles, and nonadherence to therapy. However, the heterogeneity of studies on ABZ makes our recommendation open to discussion, and the optimal dose and duration of the drug course remains to be established.

• #72 Therapy and Prevention for Human Toxocariasis

  https://www.mdpi.com/2076-2607/10/2/241

  ABZ appears to be the drug of choice due to its quasi-worldwide availability, low price, seemingly acceptable efficacy and lack of major adverse reactions. We recommend 10–15 mg/kg b/w daily for 14 days. A higher daily dose and an excessively prolonged course might cause severe and sometimes irreversible adverse reactions (agranulocytosis, aplasia or hepatotoxicity), such as those reported in the treatment of echinococcoses with benzimidazoles, and nonadherence to therapy. However, the heterogeneity of studies on ABZ makes our recommendation open to discussion, and the optimal dose and duration of the drug course remains to be established. […] The role of anthelmintic treatment in compartmentalized toxocariasis, OT and NT, remains to be clarified. Regarding OT, experimental studies have demonstrated the harmful role of viable Toxocara spp. larvae, thus suggesting that drug-induced parasite death would reduce local inflammation. Unfortunately, the great majority of published small series or anecdotal reports about anthelmintic therapy for OT referred to the concomitant use of anthelmintics and corticosteroids. The same consideration applies to NT. Review articles about NT and OT did not answer this question. Consequently, a meta-analysis investigating the efficacy of reported drug regimens (anthelmintics alone, corticosteroids alone, or both) for NT and OT is urgently needed.

• #73 Ocular toxocariasis: a neglected parasitic disease in Egypt | Bulletin of the National Research Centre | Full Text

  https://bnrc.springeropen.com/articles/10.1186/s42269-019-0185-8

  Ocular toxocariasis can be treated either medically or surgically. […] The goal of medical treatment is to prevent the ocular damage and visual loss. […] Corticosteroids are the mainstay medical treatment for ocular toxocariasis as they have the ability to decrease the release of local mediators of inflammation leading to the suppression of inflammation, induce cell membranes stabilization, and prevent vitreous opacification and tractional retinal detachment. […] Regarding antiparasitic medications, some ophthalmologists recommend anthelmintic using in addition to corticosteroids while the others use these medications only when the response to corticosteroids is inefficient. […] Anthelmintic treatment can be given, especially with the presence of extraocular toxocariasis symptoms. […] Surgical interferences are required in cases with post-inflammatory complications such as vitreous opacification, retinal scars, bands, or detachment and formation of the epiretinal membrane with vitreomacular or optic nerve traction.

• #74 Clinical Features and Course of Ocular Toxocariasis in Adults | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002938

  To investigate the clinical features, clinical course of granuloma, serologic findings, treatment outcome, and probable infection sources in adult patients with ocular toxocariasis (OT). […] Treatment with albendazole (400 mg twice a day for 2 weeks) and corticosteroids (oral prednisolone; 0.51 mg/kg/day) resulted in comparable outcomes to patients on corticosteroid monotherapy; however, the 6-month recurrence rate in patients treated with combined therapy (17.4%) was significantly lower than that in patients treated with corticosteroid monotherapy (54.5%, P=0.045). […] Combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence. […] We suggest that combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence.

• #75

  https://link.springer.com/article/10.1007/s00436-011-2772-y

  Evaluation of the efficacy of treatment is not easy due to non-characteristic symptoms; low kinetics of specific anti-Toxocara IgG decrease; however, high IgG titers suggest non-effective treatment of concomitant infection requiring subsequent therapy. […] In conclusion of the above, constant multispecialistic care of patients with T. canis infection, widening of indications for repeated antiparasitic therapy, and introduction of new diagnostic methods for detection of new cases, apart from widespread prophylactic efforts, may become a crucial element in the prevention of consequences and complications of toxocariasis.

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