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Space Occupying Lesion in the Liver Caused by Hepatic Visceral Larva Migrans: A Case Report

Title
Space Occupying Lesion in the Liver Caused by Hepatic Visceral Larva Migrans: A Case Report
Author
박훈기
Keywords
CLINICAL EXPRESSION; TOXOCARIASIS; ALBENDAZOLE; DIAGNOSIS; ABSCESS
Issue Date
2018-12
Publisher
AMER SOC TROP MED & HYGIENE
Citation
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, v. 99, no. 6, page. 1602-1605
Abstract
Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presenting preprandial malaise and epigastric discomfort in a 58-year-old woman drinking raw roe deer blood. The imaging studies of the abdomen showed a 74-mm hepatic mass featuring hepatic VLM. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Despite anthelmintic treatment, the patient complained of newly developed cough and skin rash with severe eosinophilia. Hepatic lesion increased in size. The patient underwent an open left lobectomy of the liver. After the surgery, the patient was free of symptoms such as preprandial malaise, epigastric discomfort, cough, and skin rash. Laboratory test showed a normal eosinophilic count at postoperative 1 month, 6 months, 1 year, and 4 years. The initial optical density value of 2.55 of anti-T. canis IgG in ELISA was found to be negative (0.684) at postoperative 21 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting severe eosinophilia and a variety of symptoms which reflect high worm burdens. Symptom remission, eosinophilia remission, and complete radiological resolution of lesions can be complete with surgery.
URI
http://www.ajtmh.org/content/journals/10.4269/ajtmh.18-0199http://repository.hanyang.ac.kr/handle/20.500.11754/121107
ISSN
0002-9637; 1476-1645
DOI
10.4269/ajtmh.18-0199
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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