(Visceral Larva Migrans, Ocular Larva Migrans)

The severity of symptoms depends on the number of larvae ingested and the degree of allergic response. Most people who are infected lightly are asymptomatic. Visceral larva migrans typically occurs in children 1 to 4 years of age with a history of pica but can occur in older children and adults. Characteristic manifestations include fever, leukocytosis, eosinophilia, hypergammaglobulinemia, and hepatomegaly. Other manifestations include malaise, anemia, cough, and in rare instances, pneumonia, myocarditis, and encephalitis. When ocular invasion (endophthalmitis or retinal granulomas) occurs (usually in older children or adolescents), other evidence of infection usually is lacking, suggesting that the visceral and ocular manifestations are distinct syndromes. Atypical manifestations include hemorrhagic rash and seizures. In some cases, so-called covert toxocariasis may manifest only as asymptomatic eosinophilia or pulmonary wheezing.