Toxocariasis — DTM&H MCQ

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EasyHelminthic infectionsToxocariasisDTM&H

A 4-year-old child with pica has fever, wheeze, hepatomegaly and marked eosinophilia. The family has puppies and soil exposure is frequent. What is the most appropriate investigation?

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Correct answer: B — Toxocara serology

Toxocara serology is the single best answer because humans do not harbour adult Toxocara worms, so stool egg detection is not useful. Stool ova microscopy is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that pica, puppies and eosinophilia point to visceral larva migrans.

Reference: Manson's Tropical Diseases; WHO neglected tropical diseases guidance; CDC DPDx