Diagnostic Findings [Last Modified: ]
[Toxocara canis] [Toxocara cati] [Toxocara leonina]
Causal Agent Life Cycle Geographic Distribution Clinical Features Laboratory Diagnosis Treatment

Antibody Detection
Antibody detection tests are the only means of confirmation of a clinical diagnosis of visceral larva migrans (VLM), ocular larva migrans (OLM), and covert toxocariasis (CT), the most common clinical syndromes associated with Toxocara infections.  The currently recommended serologic test for toxocariasis is enzyme immunoassay (EIA) with larval stage antigens extracted from embryonated eggs or released in vitro by cultured infective larvae.  The latter, Toxocara excretory-secretory (TES) antigens, are preferable to larval extracts because they are convenient to produce and because an absorption-purification step is not required for obtaining maximum specificity.  Evaluation of the true sensitivity and specificity of serologic tests for toxocariasis in human populations is not possible because of the lack of parasitologic methods to detect Toxocara parasites.  These inherent problems result in underestimations of sensitivity and specificity.  Evaluation of the Toxocara EIA in groups of patients with presumptive diagnoses of VLM or OLM indicated sensitivity of 78% and 73%, respectively, at a titer of >1:32.  When the cutoff titer for OLM cases was lowered to 1:8, sensitivity was increased to 90%.  Further confirmation of the specificity of the serologic diagnosis of OLM can be obtained by testing aqueous or vitreous humor samples for antibodies.  Specificity has been reported to be >90% at a titer of >1:32.  When interpreting the serologic findings, clinicians must be aware that a measurable titer does not necessarily indicate current clinical Toxocara canis infection.  In most human populations, a small number of those tested have positive EIA titers that apparently reflect the prevalence of asymptomatic toxocariasis.  In the United States, 2.8% (cutoff titer 1:32) of nearly 9,000 persons tested showed such positive reactions, but the percentage but varied significantly according to age, race, and socioeconomic status.


Smith HV. Antibody reactivity in human toxocariasis. In: Lewis JW, Maizels RM, editors. Toxocara and toxocariasis: clinical, epidemiological, and molecular perspectives. London, UK: Institute of Biology and the British Society for Parasitology; 1993. p. 91-109.


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