Snapshot A 2-year-old boy is admitted to the hospital with a history of wheezing that is found to have hepatosplenomegaly and a prominent peripheral blood eosinophilia. Upon further questioning, it was found that he regularly plays in a sandbox at nursery and there are a host of cats living at his home. Introduction Caused by infection with Toxocara larvae lifecycle involves being carried by dogs or cats also found in sand boxes they can infect humans, but cannot mature within them Most common in chidren from 1-4 years of age this age group is more prone to ingestion of infective eggs humans are the dead-end host Mechanism & Pathophysiology migrate through the intestinal wall travel within the bloodstream cause inflammation and damage in various organs Presentation Present with fever hepatomegaly wheezing pulmonary disease eosinophilia Evaluation Labs eosinophiolia Diagnosis biopsies are not effective PCR ELISA 78% sensitivity and a 90% specificity serology antibodies to Toxocara Treatment Self resolves within weeks usually does not require treatment Pharmacologic corticosteroids indication severe cases albendazole indication preferred anti-parasitic medication