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Toxocara canis myelitis: Clinical features, Magnetic Resonance Imaging (MRI) findings, and treatment outcome in 17 patients

Show simple item record Jabbour R.A. Kanj S.S. Sawaya R.A. Awar G.N. Hourani M.H. Atweh S.F.
dc.contributor.editor Sep-2011 2017-10-05T15:41:28Z 2017-10-05T15:41:28Z 2011
dc.identifier 10.1097/MD.0b013e31822f63fb
dc.identifier.issn 00257974
dc.description.abstract Toxocara myelitis is a rare disease. Few cases have been reported in the literature. Patients present with myelopathy, occasional eosinophilia in blood and cerebrospinal fluid (CSF), with abnormal signals on magnetic resonance imaging (MRI). In the current study we report 17 cases of isolated Toxocara myelitis from a single tertiary referral center in Lebanon, with description of the clinical presentation, laboratory data, MRI findings, and response to antihelminthic treatment. Clinical and laboratory data were collected for 17 patients who presented with evidence of spinal cord disease. The clinical presentation included sensory, motor, and autonomic dysfunction, predominantly in the lower extremities. Patients exhibited a subacute or chronic course; this was either slowly progressive or remitting-relapsing with mild to moderate disability. The patients underwent extensive blood and CSF workup as well as MRI of the spinal cord and brain. Only 2 patients had a high eosinophil count in the CSF, although blood eosinophilia was seen in 6 patients. All patients tested positive for Toxocara canis antibodies in the blood and CSF. MRI of the spinal cord revealed a single characteristic lesion in the spinal cord with fusiform enlargement that was isointense on T1-weighted images and hyperintense on T2-weighted images. Nodular enhancement was seen after gadolinium injection. Treatment with albendazole, with or without steroids, resulted in marked neurologic improvement and normalization of the MRI in all patients.The finding of a single inflammatory MRI lesion in the spinal cord with positive Toxocara canis serology in the blood and CSF in cases of subacute or chronic myelitis suggests the diagnosis of Toxocara myelitis, irrespective of the presence of eosinophilia. Antihelminthic treatment is associated with a good outcome. © 2011 by Lippincott Williams and Wilkins.
dc.format.extent Pages: (337-343)
dc.language English
dc.publisher PHILADELPHIA
dc.relation.ispartof Publication Name: Medicine; Publication Year: 2011; Volume: 90; no. 5; Pages: (337-343);
dc.source Scopus
dc.title Toxocara canis myelitis: Clinical features, Magnetic Resonance Imaging (MRI) findings, and treatment outcome in 17 patients
dc.type Article
dc.contributor.affiliation Jabbour, R.A., Neurology Division, University of Balamand, St George Hospital University Medical Center, PO Box 166378, Ashrafieh Beirut 1100 2807, Lebanon
dc.contributor.affiliation Kanj, S.S., Infectious Diseases Division, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Sawaya, R.A., Neurology Division, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Awar, G.N., Infectious Diseases Division, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Hourani, M.H., Radiology Department, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Atweh, S.F., Neurology Division, American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.authorAddress Jabbour, R.A.; Neurology Division, University of Balamand, St George Hospital University Medical Center, PO Box 166378, Ashrafieh Beirut 1100 2807, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Neurology;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Neurology
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Jabbour, RA
dc.contributor.authorInitials Kanj, SS
dc.contributor.authorInitials Sawaya, RA
dc.contributor.authorInitials Awar, GN
dc.contributor.authorInitials Hourani, MH
dc.contributor.authorInitials Atweh, SF
dc.contributor.authorReprintAddress Jabbour, RA (reprint author), Univ Balamand, St George Hosp, Univ Med Ctr, POB 166378, Ashrafieh Beirut 11002807, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited ADAMS RD, 1997, PRINCIPLES NEUROLOGY, P1237; BRAIN L, 1964, LANCET, V20, P1355; Courtade H., 1995, Bulletin de la Societe Francaise de Parasitologie, V13, P37; DESAVIGNY DH, 1979, J CLIN PATHOL, V32, P284, DOI 10.1136-jcp.32.3.284; Despommier D, 2003, CLIN MICROBIOL REV, V16, P265, DOI 10.1128-CMR.16.2.265-272.2003; Duprez TPJ, 1996, NEURORADIOLOGY, V38, P792; Eberhardt O, 2005, CLIN NEUROL NEUROSUR, V107, P432, DOI 10.1016-j.clineuro.2004.10.003; Finsterer Josef, 2007, Revista do Instituto de Medicina Tropical de Sao Paulo, V49, P279, DOI 10.1590-S0036-46652007000500002; FISHMAN RA, 1992, CEREBROSPINAL FLUID, P195; GILLEPSIE SH, 1995, MED PARASITOLOGY PRA, P178; GILLESPIE SH, 1987, J APPL BACTERIOL, V63, P473, DOI 10.1111-j.1365-2672.1987.tb02716.x; GLICKMAN L, 1978, AM J TROP MED HYG, V27, P492; GLICKMAN LT, 1981, EPIDEMIOL REV, V3, P230; Goffette S, 2000, EUR J NEUROL, V7, P703, DOI 10.1046-j.1468-1331.2000.00123.x; GOTTSTEIN B, 1984, AM J TROP MED HYG, V33, P1185; JACQUIER P, 1991, J CLIN MICROBIOL, V29, P1831; Kanafani ZA, 2006, PARASITOLOGY, V132, P635, DOI 10.1017-S0031182005009637; KAWAMURA J, 1983, ARCH NEUROL-CHICAGO, V40, P483; KOMIYAMA A, 1995, J NEUROL NEUROSUR PS, V59, P197, DOI 10.1136-jnnp.59.2.197; KUMAR J, 1994, AM J NEURORADIOL, V15, P1918; Lee IH, 2010, EUR J RADIOL, V75, P236, DOI 10.1016-j.ejrad.2009.04.024; Magnaval Jean-Francois, 2001, Korean Journal of Parasitology, V39, P1; NICHOLAS WL, 1986, T ROY SOC TROP MED H, V80, P217, DOI 10.1016-0035-9203(86)90015-5; PAGE AP, 1992, EXP PARASITOL, V75, P72, DOI 10.1016-0014-4894(92)90123-R; Romasanta A, 2003, IMMUNOL INVEST, V32, P131, DOI 10.1081-IMM-120022974; RUSSEGGER L, 1989, LANCET, V12, P398; RUTTINGER P, 1991, J NEUROL NEUROSUR PS, V54, P361, DOI 10.1136-jnnp.54.4.361; SCHMUTZHARD E, 1988, J NEUROL NEUROSUR PS, V51, P80, DOI 10.1136-jnnp.51.1.80; SELLAL F, 1992, REV NEUROL, V148, P53; SPEISER F, 1984, ACTA TROP, V41, P361; STURCHLER D, 1990, J INFECT DIS, V162, P571; Tefferi A, 2005, MAYO CLIN PROC, V80, P75; TYLER KL, 1993, INFECT DIS CENTRAL N, P259; Umehara F, 2006, J NEUROL SCI, V249, P7, DOI 10.1016-j.jns.2006.05.057; VANKNAPEN F, 1983, Z PARASITENKD, V69, P113; VIDAL JE, 2003, AM J TROP MED HYG, V69, P241; Villano M, 1992, J Neurosurg Sci, V36, P67; WANG C, 1983, LANCET, V1, P423; 1984, MMWR MORB MORTAL WKL, V33, P445
dc.description.citedCount 5
dc.description.citedTotWOSCount 3
dc.description.citedWOSCount 3
dc.format.extentCount 7
dc.identifier.coden MEDIA
dc.identifier.pubmedID 21862933
dc.identifier.scopusID 80052456651
dc.publisher.address 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
dc.relation.ispartOfISOAbbr Medicine (Baltimore)
dc.relation.ispartOfIssue 5
dc.relation.ispartofPubTitle Medicine
dc.relation.ispartofPubTitleAbbr Medicine (USA)
dc.relation.ispartOfVolume 90
dc.source.ID WOS:000294466500007
dc.type.publication Journal
dc.subject.otherChemCAS albendazole, 54965-21-8
dc.subject.otherChemCAS diethylcarbamazine, 1642-54-2, 1851-24-7, 90-89-1
dc.subject.otherChemCAS methylprednisolone, 6923-42-8, 83-43-2
dc.subject.otherChemCAS Albendazole, 54965-21-8
dc.subject.otherChemCAS Anthelmintics
dc.subject.otherChemCAS Glucocorticoids
dc.subject.otherIndex albendazole
dc.subject.otherIndex diethylcarbamazine
dc.subject.otherIndex methylprednisolone
dc.subject.otherIndex steroid
dc.subject.otherIndex adult
dc.subject.otherIndex article
dc.subject.otherIndex autonomic dysfunction
dc.subject.otherIndex blood analysis
dc.subject.otherIndex cerebrospinal fluid analysis
dc.subject.otherIndex clinical article
dc.subject.otherIndex clinical feature
dc.subject.otherIndex disease course
dc.subject.otherIndex eosinophil count
dc.subject.otherIndex eosinophilia
dc.subject.otherIndex female
dc.subject.otherIndex human
dc.subject.otherIndex Lebanon
dc.subject.otherIndex male
dc.subject.otherIndex motor dysfunction
dc.subject.otherIndex myelitis
dc.subject.otherIndex nuclear magnetic resonance imaging
dc.subject.otherIndex priority journal
dc.subject.otherIndex sensory dysfunction
dc.subject.otherIndex tertiary health care
dc.subject.otherIndex toxocariasis
dc.subject.otherIndex treatment outcome
dc.subject.otherIndex Adult
dc.subject.otherIndex Albendazole
dc.subject.otherIndex Animals
dc.subject.otherIndex Anthelmintics
dc.subject.otherIndex Diagnosis, Differential
dc.subject.otherIndex Drug Therapy, Combination
dc.subject.otherIndex Female
dc.subject.otherIndex Follow-Up Studies
dc.subject.otherIndex Glucocorticoids
dc.subject.otherIndex Humans
dc.subject.otherIndex Magnetic Resonance Imaging
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Myelitis
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Toxocara canis
dc.subject.otherIndex Treatment Outcome
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus VISCERAL LARVA MIGRANS
dc.subject.otherKeywordPlus EXCRETORY-SECRETORY ANTIGENS
dc.subject.otherKeywordPlus LINKED-IMMUNOSORBENT-ASSAY
dc.subject.otherKeywordPlus DIAGNOSIS
dc.subject.otherKeywordPlus IMMUNODIAGNOSIS
dc.subject.otherKeywordPlus EPIDEMIOLOGY
dc.subject.otherKeywordPlus IMMUNOASSAY
dc.subject.otherKeywordPlus MYELOPATHY
dc.subject.otherKeywordPlus INFECTION
dc.subject.otherKeywordPlus DISEASE
dc.subject.otherWOS Medicine, General and Internal

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