Toxocara Species

  • Diagnosis
  • Background
  • Lab Tests
  • References
  • Related Topics

Indications for Testing

  • Appropriate exposure and symptoms

Laboratory Testing

  • Clinical diagnosis may be hampered by the inability to distinguish among parasitic infections
    • Baylisascaris procyonis, Fasciola hepatica, and Ascaris lumbricoides can also cause visceral larval migrans
  • Toxocariasis antibody detection (CDC)
  • Nonspecific
    • CBC will demonstrate eosinophilia in 30% of the cases
  • Serology
    • IgG antibody testing indicates previous infection
      • Single titer testing cannot distinguish between past and current infection


  • Tissue biopsy of involved site may demonstrate larvae (diagnostic)

Differential Diagnosis

Toxocariasis is caused by migration of the larvae from the roundworm Toxocara to organs and tissues. Toxocara larva migrans is the second most common helminthic infection in developed countries.


  • Incidence – one of the most common parasitic infections worldwide
  • Age – usually children 
  • Transmission – disease is acquired by ingestion of soil contaminated with embryonated Toxocara eggs


  • Toxocara species that infect humans are T. canis and T. cati
  • Ingested eggs hatch into larvae, travel across gut wall and migrate to liver or lungs through lymphatic and circulatory systems
  • Larvae then spread from lungs to other organs, causing damage by their migration and induction of granulomatous lesions

Clinical Presentation

  • Visceral larval migrans (VLM)
    • Asymptomatic, with mild eosinophilia
    • Cutaneous symptoms common – chronic prurigo, pruritus and/or urticaria and eczema
      • Symptoms persist a year or more
    • Severe and potentially fatal symptoms 
  • Ocular larval migrans
    • Frequently asymptomatic
    • Acute eye lesions caused by penetration of larvae into eyes
      • Vision loss in affected eye
  • Neural larval migrans
    • Fever, headache, seizures
  • Common larval migrans
    • Similar to VLM but less severe
Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Toxocara Antibody IgG by ELISA (Temporary Referral as of 06/28/17) 0099090
Method: Semi-Quantitative Enzyme-Linked Immunosorbent Assay


Toxocara antibody titers in populations without clinical symptoms of visceral larval migrans vary dramatically; elevated titers alone cannot definitively establish diagnosis

Because antibody response varies depending on worm burden and location, a negative result does not necessarily rule out toxocariasis infection


If results equivocal, repeat testing in 10-14 days

General References

Akao N, Ohta N. Toxocariasis in Japan. Parasitol Int. 2007; 56(2): 87-93. PubMed

Gavignet B, Piarroux R, Aubin F, Millon L, Humbert P. Cutaneous manifestations of human toxocariasis. J Am Acad Dermatol. 2008; 59(6): 1031-42. PubMed

Gottstein B, Piarroux R. Current trends in tissue-affecting helminths. Parasite. 2008; 15(3): 291-8. PubMed

Moreira GM, Telmo Pd, Mendonça M, Moreira AN, McBride AJ, Scaini CJ, Conceição FR. Human toxocariasis: current advances in diagnostics, treatment, and interventions. Trends Parasitol. 2014; 30(9): 456-64. PubMed

Rubinsky-Elefant G, Hirata CE, Yamamoto JH, Ferreira MU. Human toxocariasis: diagnosis, worldwide seroprevalences and clinical expression of the systemic and ocular forms. Ann Trop Med Parasitol. 2010; 104(1): 3-23. PubMed

Medical Reviewers

Last Update: July 2017