Toxocara Infection is not Associated with Viral or Bacterial Central Nervous System Infection in Children

Abstract

Background: Helminth infections with larvae that migrate through the tissues have been considered risk factors for CNS infections. Objectives: The present work was designed to investigate the prevalence of anti-Toxocara antibodies in the serum and/or in the cerebrospinal fluid (CSF) of children with infectious meningitis or meningoencephalitis and of a control group, without meningitis, admitted at the Children's Hospital NS Glória, Vitória, ES, Brazil. Patients and Methods: After adsorption with Ascaris lumbricoides antigen, serum and/or cerebrospinal fluid of 381 inpatients (201 with meningitis and 180 without meningitis) were submitted to an ELISA IgG, for anti-Toxocara antibodies using secretion/excretion antigens of third stage larvae of T. canis. Results: No significant differences between the meningitis and the control groups were observed in the frequencies of positive tests for anti-Toxocara antibodies in the serum or CSF (respectively for the meningitis and control group: 33/103 or 32 % and 52/152 or 34.2 % for the serum, p = 0.821; 48/184 or 26.1 % and 23/121 or 19.0 % for the CSF; p = 0.196. Conclusion: The results demonstrated that Toxocara infection, evaluated by detection of anti-Toxocara antibodies in serum or CSF, is not associated with viral or bacterial meningitis or meningoencephalitis in children in our country.

Visceral larva migrans - meningitis - toxocariasis - toxocara infection - meningoencephalitis

References

• 1 Beautyman W, Woolf A L. Review of a case previously reported as showing an ascarid larva in the brain.  J Pathol Bacteriol. 1966;  91 271-273
• 2 Beaver P C. Larva migrans.  Exp Parasitol. 1956;  5 587-621
• 3 Bentwich Z, Kalinkovich A, Weisman Z, Borkov G, Beyers N, Beyers N. Can eradication of helminthic infections change the face of AIDS and tuberculosis?.  Immunol Today. 1999;  20 485-487
• 4 Borkow Gadi, Leng Q, Weisman Z, Stein M, Galai N, Kalinkovich A, Bentwich Z. Chronic immune activation associated with intestinal helminth infections results in impaired signal transduction and anergy.  J Clin Invest. 2000;  106 1053-1060
• 5 Carvalho-Filho E. Strongyloidiasis.  Clin Gastroenterol. 1978;  7 179-200
• 6 Cooper P J, Espinel I, Paredes W, Guderian R H, Nutman T B. Impaired tetanus-specific cellular and humoral responses following tetanus vaccination in human onchocerciasis: a possible role for interleukin-10.  J Infect Dis. 1998;  178 1133-1138
• 7 De Brito T, Chieffi P P, Peres B A, Santos R P, Gayotto L CC, Vianna M R, Porta G, Alves V AF. Immunohistochemical detection of Toxocaral antigens in human biopsies.  Int J Surg Pathol. 1994;  2 117-124
• 8 De Savigny D H, Voller A, Woodruff A W. Toxocariasis: serological diagnosis by enzyme immunoassay.  J Clin Pathol. 1979;  32 282-288
• 9 Diniz L M, Zandonade E, Dietze R, Pereira F E, Ribeiro-Rodrigues R. Short report: do intestinal nematodes increase the risk for multibacillary leprosy?.  Am J Trop Med Hyg. 2001;  65 852-854
• 10 Elias D, Wolday D, Akuffo H, Petros B, Bronner U, Britton S. Effect of deworming on human T cell responses to mycobacterial antigens in helminth-exposed individuals before and after bacille Calmette-Guerin (BCG) vaccination.  Clin Exp Immunol. 2001;  123 219-225
• 11 Fishman R A. Cerebrospinal Fluid in Diseases of the Nervous System. 2nd ed. Philadelphia; WB Saunders Co 1992: 197-212
• 12 Glickman L, Schantz P, Dombroske R, Cypess R. Evaluation of serodiagnostic tests for visceral Larva Migrans.  Am J Trop Med Hyg. 1978;  27 492-498
• 13 Gupta A K, Pavri K M. Alteration in immune response of mice with dual infection of Toxocara canis and Japanese encephalitis virus.  Trans R Soc Trop Med Hyg. 1987;  81 835-840
• 14 Hayes K S, Bancroft A J, Grencis R K. Immune-mediated regulation of chronic intestinal nematode infection.  Immunol Rev. 2004;  75-88
• 15 Higashiyama Y, Sakata H, Obase Y, Sakata S, Shimafugi T, Mori M, Ishino T, Kohno S, Saito A, Hara K. A case of bacterial meningitis induced by strongyloidiasis (Jap).  Kansenshogaku Zasshi. 1997;  71 680-683
• 16 Innes J R, Shoho C. Nematodes, nervous disease, and neurotropic virus infection; observations in animal pathology of probable significance in medical neurology.  Br Med J. 1952;  2 366-368
• 17 Kayes S G. Human toxocariasis and the visceral larva migrans syndrome: correlated immunopathology.  Chem Immunol. 1997;  66 99-124
• 18 Lambertucci J R, Teixeira R, Navarro M MM, Coelho P MZ, Ferreira M D. Liver abscess and schistosomiasis. A new association.  Rev Soc Bras Med Trop. 1990;  23 239-240
• 19 Lubiniecki A S, Cypess R H, Lucas J F. Synergistic interaction of two agents in mice: Japanese B encephalitis virus and Trichinella spiralis.  Am J Trop Med Hyg. 1974;  23 235-241
• 20 Maizels R M, Balic A, Gomez-Escobar N, Nair M, Taylor M D, Allen J E. Helminth parasites - masters of regulation.  Immunol Rev. 2004;  201 89-116
• 21 Mochizuki H, Tomimura T, Oka T. Cerebrospinal nematodiasis as a provoking factor in Japanese B encephalitis: an experimental approach.  J Infec Dis. 1954;  95 260-266
• 22 Moreira-Silva S F, Leão M E, Mendonça H FS, Pereira F EL. Prevalence of anti-Toxocara antibodies in a random sample of inpatients at a children hospital in Vitória, Espirito Santo, Brazil.  Rev Inst Med Trop São Paulo. 1998;  40 259-261
• 23 Moreira-Silva S F, Pereira F EL. Toxocara infection, intestinal nematodes and pyogenic liver abscess: a possible association.  J Trop Pediatr. 2000;  46 167-172
• 24 Moreira-Silva S F, Leite A L, Brito E F, Pereira F E. Nematode infections are risk factors for staphylococcal infection in children.  Mem Inst Oswaldo Cruz. 2002;  97 395-399
• 25 Moreira-Silva S F, Rodrigues M G, Pimenta J L, Gomes C P, Freire L H, Pereira F E. Toxocariasis of the central nervous system: with report of two cases.  Rev Soc Bras Med Trop. 2004;  37 169-174
• 26 Nookala S, Srinivasan S, Kaliraj P, Narayanan R B, Nutman T B. Impairment of tetanus-specific cellular and humoral responses following tetanus vaccination in human lymphatic filariasis.  Infect Immun. 2004;  72 2598-2604
• 27 Pavri M K, Ghalsasi G R, Dastour D K, Goverdhan M K, Lallitha V S. Dual infections of mice: visceral larva migrans and sublethal infection with Japanese encephalitis virus.  Trans Roy Soc Trop Med Hyg. 1975;  69 99-110
• 28 Pereira F EL, Musso C, Castelo J S. Pathology of pyogenic liver abscess in children.  Pediatr Developmen Pathol. 1999;  2 537-543
• 29 Rocha H, Oliveira V S, Oliveira M MG. The interaction of gram negative bacteria and S mansoni in mice with experimental schistosomiasis.  Mem Inst Oswaldo Cruz. 1980;  75 161-172
• 30 Sabin E A, Araujo M I, Carvalho E M, Pearce E J. Impairment of tetanus toxoid-specific Th1-like immune responses in humans infected with Schistosoma mansoni.  J Infect Dis. 1996;  173 269-272
• 31 Shope R E. The swine lungworm as a reservoir and intermediate host for swine influenza virus. II. The transmission of swine influenza virus by the swine lungworm.  J Exp Med. 1941;  74 49-68
• 32 Shope R E. The swine lungworm as a reservoir and intermediate host for swine influenza virus. IV - the demonstration of masked swine influenza virus in lungworm larvae and swine under natural conditions.  J Exp Med. 1943;  77 127-138
• 33 Sprent J FA. On the invasion of central nervous system by nematodes. I. The incidence and pathological significance of nematode in the central nervous system.  Parasitology. 1955;  45 31-40
• 34 Syverton J T, MacKoy O R, Koomen J. The transmission of the virus of lymphocytic choriomeningitis by Trichinella spiralis.  J Exp Med. 1947;  85 759-769
• 35 Tristao-Sa R, Ribeiro-Rodrigues R, Johnson L T, Pereira F E, Dietze R. Intestinal nematodes and pulmonary tuberculosis.  Rev Soc Bras Med Trop. 2002;  35 533-535
• 36 Tycac B. In: Sprent JFA. On the invasion of central nervous system by nematodes. I. The incidence and pathological significance of nematode in the central nervous system.  Parasitology. 1955;  45 31
• 37 Wen-Sing C, Hsing-Jo C. Cerebral paragonimiasis complicated by epidemic B encephalitis.  Chin Med J. 1956;  74 387-392
• 38 Yen-Fang L, Ching-Lan Teng, Kai L. Cerebral cysticercosis as a factor of aggravating Japanese B encephalitis.  Chin Med J. 1957;  75 1010-1017
• 39 Young S W, Higashi G, Kamel R, El Abdin A Z, Mikhail A. Interaction of Salmonellae and schistosomes in host parasite relationship.  Trans Roy Soc Trop Med Hyg. 1973;  67 797-802