Some patients with cutaneous larva migrans have no symptoms. Others, however, will notice a puffy, red area at the site where the larvae have burrowed into the skin. This symptom appears within hours of the penetration. When the larvae start to move beneath the skin, red lines appear. The lines become extremely itchy, and sometimes blisters appear. After the larvac have entered the bloodstream and reached the lungs, they can cause additional symptoms, including pneumonia, coughing, and anemia.

How Is Toxocariasis Diagnosed and Treated?

To diagnose visceral larva migrans, a doctor will typically order a blood test to determine whether the patient has a higher than normal number of certain white blood cells, called eosinophils (e-o-SIN-o-filz), which is a sign of this syndrome. In some cases, the doctor may also request that the blood be examined with a test called ELISA, which stands for enzyme-linked immunosorbent assay. ELISA is a very sensitive technique that can scan for signs of the body's own, very specific immune response (its defense system) to the larvae. In addition, the doctor will look for or ask the patient about other symptoms, including lung or eye problems. Visceral larva migrans often goes away on its own. When  doctors feel treatment is necessary, they frequently prescribe the drug albendazole, which kills the larvae. If a patient is having severe, infection-related heart, nervous-system, or lung problems, the doctor may prescribe hormones known as glucocorticoids that reduce inflammation in these organs.

To diagnose cutaneous larva migrans, a doctor will look for the characteristic red lines, which the patient will typically report as extremely itchy. Doctors can also take a very close look at the red lines with a microscope using a technique called epiluminescence (ch-pih-loom-in-ES-sens) to verify that the lines were made by the larvae. Cutaneous larva migrans usually goes away on its own without treatment. Sometimes, however, doctors will prescribe albendazole or ivermectin to help climinate the larvae.

How Can Toxocariasis Be Prevented?

As with other infections, good hygiene and frequent hand-washing are essential. Important safety measures include the following:

* Keeping children from playing in areas that may be contaminated by cat or dog feces, such as the damp area under a porch

* Teaching children not to put their hands and toys in their mouths after playing with cats and dogs

* Keeping pets away from sandboxes, which should be covered when not in use

* Prohibiting pets from public areas, such as beaches and parks, where people are likely to come into contact with sand or dirt

* Having a veterinarian periodically check pets for parasites, and if parasites are present, treat the pets

* Keeping an especially close watch on children who are known to eat dirt

* Teaching children to wash their hands thoroughly after playing outside, after playing with pets, and before cating

* Washing raw vegetables before cating them

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