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Lai CH et al Eosinophilic meningitis caused by Angiostrongylus cantonensis after ingestion of raw frogs Am J Trop Med Hyg 2007 Feb;76(2):399 402 [PMID: 17297055] Mentz MB et al Drug trials for treatment of human angiostrongyliasis Rev Inst Med Trop Sao Paulo 2003 Jul Aug;45 (4):179 84 [PMID: 14502343] Tsai HC et al Outbreak of eosinophilic meningitis associated with drinking raw vegetable juice in southern Taiwan Am J Trop Med Hyg 2004 Aug;71(2):222 6 [PMID: 15306715]

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collection can be indexed, for example, by an integer value and also by a string value, depending on the needs of the client. Example 14-2 illustrates a string index. The indexer calls FindString( ), which is a helper method that returns a record based on the value of the string provided. Notice that the overloaded indexer and the indexer from Example 14-1 are able to coexist.

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The dog roundworm Toxocara canis, the cat roundworm Toxocara cati, and less commonly other helminths may cause visceral larva migrans T canis is highly prevalent in dogs Humans are infected after ingestion of eggs in material contaminated by dog or other feces With T canis, infection is spread principally by puppies and lactating females, and the eggs must be on the ground for several weeks before they are infectious After ingestion by humans, larvae migrate to various tissues but cannot complete their life cycle Visceral larva migrans is seen principally in young children Most infections are asymptomatic The most commonly involved organs are the liver and lungs Presentations include cough, fever, wheezing, hepatomegaly, splenomegaly, lymphadenopathy, pulmonary infiltrates, and eosinophilia Involvement of the CNS can occur rarely, leading to eosinophilic meningitis and other abnormalities Ocular larva migrans is a distinct syndrome, usually in children older than is typical for visceral larva migrans Children present with visual deficits, pain, and a retinal mass, which can be confused with retinoblastoma Baylisascaris procyonis, a roundworm of raccoons, can rarely cause visceral larva migrans in humans, with typically more severe manifestations than those with T canis, including eosinophilic meningitis and eye disease The diagnosis of visceral larva migrans is suggested by the finding of eosinophilia in a child with hepatomegaly or other signs of the disease, especially with a history of exposure to puppies The diagnosis is confirmed by the identification of larvae in a biopsy of infected tissue, usually performed when other diseases are suspected Serologic tests may be helpful; an available ELISA was estimated to have 78% sensitivity and 92% specificity Most patients recover without specific therapy, although symptoms may persist for months Treatment with antihelminthics or corticosteroids may be considered in severe cases No drugs have been proven to be effective, but albendazole (400 mg twice daily for 5 days), mebendazole, thiabendazole, diethylcarbamazine, and ivermectin have been used, and albendazole has been recommended as the treatment of choice.

Despommier D Toxocariasis: clinical aspects, epidemiology, medical ecology, and molecular aspects Clin Microbiol Rev 2003 Apr;16(2):265 72 [PMID: 12692098] Gavin PJ et al Baylisascariasis Clin Microbiol Rev 2005 Oct; 18(4):703 18 [PMID: 16223954] Good B et al Ocular toxocariasis in schoolchildren Clin Infect Dis 2004 Jul 15;39(2):173 8 [PMID: 15307025] Moreira-Silva SF et al Toxocariasis of the central nervous system: with report of two cases Rev Soc Bras Med Trop 2004 Mar Apr;37(2):169 74 [PMID: 15094904] Vidal JE et al Eosinophilic meningoencephalitis due to Toxocara canis: case report and review of the literature Am J Trop Med Hyg 2003 Sep;69(3):341 3 [PMID: 14628955]

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