Per Orbital Edema in a Child with Serologically Confirmed Toxocariasis: A Case Report

Abstract

Toxocariasis is a globally distributed zoonotic helminthic infection caused by Toxocara species. Humans are accidental hosts in whom the larvae cannot complete their life cycle; instead, they migrate through various tissues, resulting in a broad spectrum of clinical manifestations. We report the case of a 4-year-old boy from western Iran with a history of close contact with cats and dogs who presented with per orbital edema and swelling of the hands and feet. He was referred to the Diagnostic Laboratory of Helminths, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran in March 2024. Laboratory investigations revealed marked hypereosinophilia, raising suspicion of a parasitic etiology. Serological testing was positive for toxocariasis, while computed tomography (CT) revealed subtle hepatic abnormalities. The patient's clinical manifestations improved following concomitant treatment with albendazole and prednisolone, and the eosinophil count returned to the normal range during follow-up. This case highlights the importance of considering toxocariasis in children presenting with edema, marked hypereosinophilia, and a history of close contact with cats or dogs. However, although the patient was serologically positive for toxocariasis, not all clinical manifestations could be definitively attributed to the infection.