ADULT TOXOCARA-CATI INFECTIONS IN US CHILDREN - REPORT OF 4 CASES

We report four cases of passage of subadult or adult Toxocara cati wor ms by young children ages 20 months to seven years. Worms were expelle d rectally in two cases and in two cases they were vomited. A single w orm was passed in two cases, three worms in one case, and 15 worms in the fourth case. All worms that were available for study were identifi ed as T. cati by morphologic criteria, including the arrow-shaped cerv ical alae and the digitiform shape of the male tail. None of the four children exhibited clinical signs of ocular or visceral larva migrans, and in two cases where serum samples were available, neither child ha d a titer to Toxocara. These results further the argument that these c hildren acquired the worms through the ingestion of immature worms pas sed by infected cats, not through the ingestion of infective eggs. Alt hough the children were generally not ill as a result of these unusual infections, it does serve to reinforce the public health issue that p otential serious consequences can occur where children have exposure t o an environment that has been contaminated with cat feces, or, more s pecifically, infective eggs, and could become infected with larval for ms of Toxocara.