Loffler's fibroblastic endocarditis complicating toxocarosis.

The authors report a case of Loffler's fibroblastic endocarditis complicati ng a toxocarosis infection. Parasitic infestation with toxocara canis is usually asymptomatic, but this was a very rare observation of cerebral involvement associated with sympto matic Loffler's endocarditis. This is an unusual form of restrictive cardia c disease constantly accompanied by prolonged hypereosinophilia. In addition to the classical signs of cardiac failure, an acute febrile ill ness imitating a connective tissue disease may be observed. Echocardiograph y helps diagnosis by showing endomyocardial fibrosis and adherent thrombosi s at one or both ventricular apices. The management of cardiac failure shou ld include, whenever possible, radical treatment of the hypereosinophilia. At an advanced stage, surgical endocardial decortication is the only means of improving symptoms and the prognosis of these patients.