Case report 1149 An unusual case of Toxocara canis of the ascending colon Chrysanthos Georgiou a , Yiannis Efstathiades a , Nicoleta Dimitriou a , Michael Theophanous a and Dionisis Voros b A 52-year-old Cypriot woman was admitted to the surgical department of Larnaca General Hospital complaining of diarrhea and pain in the right upper and lower quadrants, which was reproduced by clinical examination. A palpable mass was also felt in the region. The white blood cell count was 8420/ll: 73.9% neutrophils, 13.3% lymphocytes and 6.9% eosinophils. Erythrocyte sedimentation rate was 80 mm/h. Parasitic examination of the stools was negative. A colonoscopy located a small mass near the ileoceacal valvule, which was sent for a biopsy. A barium enema and computed tomography scan revealed the same lesion to have expanded into the ascending colon. Despite negative biopsy reports, other findings suggestive of colon cancer prompted us to perform a right hemicolectomy and ileotransverse end to side anastomosis. The mass was found to be expanding into the surrounding fat tissue and into the regional lymph notes. Surprisingly, histological examination of the mass revealed visceral larva migrans, owing to ascaris Toxocara canis or Toxocara cati. Eur J Gastroenterol Hepatol 19:1149–1153  c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins. European Journal of Gastroenterology & Hepatology 2007, 19:1149–1153 Keywords: ocular larva migrans, Toxocara canis, Toxocara cati, visceral larva migrans a Larnaca General Hospital, Larnaca, Cyprus and b Areteeio Hospital, University of Athens, Athens, Greece Correspondence to Chrysanthos Georgiou, 2 Chiou Street, 1021, Kaimakli, Nicosia, Cyprus, Greece Tel: + 357 99611428; e-mail: chr.georgiou@gmail.com Received 17 October 2006 Accepted 13 March 2007 Introduction Toxocariasis is a parasitic infection the occurrence of which can be due either to Toxocara canis or to Toxocara cati, ascarid nematodes in the order Ascarida, superfamily Ascaridiodea, family Toxocaridae. Toxocara canis and T. cati are distributed worldwide. Outdoor parks in urban and suburban settings are highly contaminated with the embryonated eggs of T. canis and T. cati. Definitive hosts of T. canis and T. catis are the domestic dog and cat, especially the young ones. Nondefinitive hosts are humans; cattle, pigs and sheep might be a source of human and animal infection if raw or inadequately cooked meat or offal is ingested. Toxocariasis is more common in children under 12 years old. Having a young puppy at home is a risk factor for toxocariasis. Growing up in a poor neighborhood is associated with a higher rate of seropositivity for toxocariasis than being raised in a middle-income locality. Adult patients institutionalized for mental retardation are also at high risk [1]. Seroprevalence studies show that 2–3% of adults and 7–14% of schoolchildren have been exposed to T. canis [1]. No reports are found on toxocariasis in either Cyprus or Greece. Seropositivity, however, has been reported in the world to range from 1% in children in Madrid [2] to 86% in rural children in the Caribbean [3]. Studies carried out in Latin America reveal a prevalence of 21.8–23.9% in Brazil [4–6] and 9.72% in Venezuela [7]. Nigeria has a prevalence of 29.8% [8], although Fan et al. [9,10] reported a prevalence of 46 and 76.6%, respectively, in 2003 and 2004, among the aborigines of Taiwan a prevalence of 43% was reported in Sri Lanka [11]. Alderete et al. [12] reported 38% in Sa ˜o Paulo, Brazil. Lower values of 12.1 and 9.72% were published in North Brazil [13] and Venezuela, respectively [14]. Some reports indicate that males have a higher opportunity of getting infected by T. canis [15]. In contrast, Magnaval and Baixench [16] indicate that females are more frequently infected than males. To the best of our knowledge, intestinal toxocariasis with clinical manifestations has not been reported. Case report A 52-year-old Cypriot woman was admitted into the surgical department of Larnaca General Hospital, com- plaining of diarrheas and pain in the right iliac fossa and the right upper quadrant. She had undergone an appendectomy, tonsillectomy, cholecystectomy and the removal of a large leiomyoma from the uterus. She was also suffering from osteoar- thritis, hiatal hernia, gastric ulcer, uterovaginal prolapse and hypertension and was allergic to penicillin. She did not smoke or drink. 0954-691X  c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.