Hepatic visceral larva migrans: evolution of the lesion, diagnosis, and role of high-dose albendazole therapy.

An unusual presentation of hepatic involvement of visceral larva migrans is described. A 45-yr-old male presented with fever, pain in the right upper quadrant, and persistent eosinophilia. Ultrasound initially detected a solitary hypoechoic area in the right lobe of the liver which rapidly progressed to multiple lesions with peripheral hyperechoic lesions. Aspiration from the lesion revealed Charcot-Leyden crystals and sheets of eosinophils. Serology for Toxocara canis was strongly positive. Prolonged and high-dose albendazole therapy, in combination with antibiotics, was required to treat the patient effectively.