Rubinsky-Elefant G, Hirata C E, Yamamoto J H, Ferreira M U
Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine of São Paulo, Avenida Dr Enéas de Carvalho Aguiar 470, 05403-000, São Paulo, SP, Brazil.
Ann Trop Med Parasitol. 2010 Jan;104(1):3-23. doi: 10.1179/136485910X12607012373957.
Although human toxocariasis ranks among the most common zoonotic infections worldwide, it remains relatively unknown to the public. The causal agents are the nematode parasites Toxocara canis and T. cati, whose definitive hosts are dogs and cats, respectively. When embryonated eggs are accidentally ingested by humans, larvae hatch in the small intestine, penetrate the intestinal wall and migrate, via the bloodstream, to the liver, lungs, muscles, eye and central nervous system. Although most human infections are asymptomatic, two well-defined clinical syndromes are classically recognised: visceral larva migrans (a systemic disease caused by larval migration through major organs) and ocular larva migrans (a disease limited to the eyes and optic nerves). Two less-severe syndromes have recently been described, one mainly in children (covert toxocariasis) and the other mainly in adults (common toxocariasis). Here, the current laboratory diagnosis, epidemiology and main clinical features of both the systemic and ocular forms of human toxocariasis are reviewed. New developments in serological diagnosis are described, the available seroprevalence data are analysed, and the results of relevant clinical studies that have been published over the last decade are explored, to provide an updated overview of this neglected but highly prevalent human infection.
尽管人体弓蛔虫病是全球最常见的人畜共患感染之一，但公众对其仍相对陌生。病原体是线虫寄生虫犬弓首蛔虫和猫弓首蛔虫，其终末宿主分别是狗和猫。当人类意外摄入含胚胎的虫卵时，幼虫在小肠内孵化，穿透肠壁并通过血液循环迁移至肝脏、肺、肌肉、眼睛和中枢神经系统。虽然大多数人类感染无症状，但经典地确认有两种明确的临床综合征：内脏幼虫移行症（一种由幼虫通过主要器官迁移引起的全身性疾病）和眼幼虫移行症（一种局限于眼睛和视神经的疾病）。最近描述了两种不太严重的综合征，一种主要见于儿童（隐匿性弓蛔虫病），另一种主要见于成人（普通弓蛔虫病）。在此，对人体弓蛔虫病的全身型和眼型的当前实验室诊断、流行病学及主要临床特征进行综述。描述了血清学诊断的新进展，分析了现有的血清流行率数据，并探讨了过去十年发表的相关临床研究结果，以提供对这种被忽视但高度流行的人类感染的最新概述。
