Beschreibung:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>The association of fever, focal hepatic lesions and peripheral hyper-eosinophilia (FHLH) can be observed in both infectious and non-infectious conditions. Fascioliasis, capillariasis, toxocariasis, all causes of visceral larva migrans (VLM), represent most of the former, whilst lymphomas, eosinophilic leukemias and mastocytosis belong in the non-infectious conditions.</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>We prospectively followed a young patient presenting with FHLH in the Tuscany region of Italy.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>The patient was subject to serological and parasitological examination in an attempt to clarify the origin of the lesions. Serologies for both <jats:italic>Fasciola hepatica</jats:italic> and <jats:italic>Toxocara</jats:italic> spp. were positive, with the latter presenting a higher index. We opted for treatment with a prolonged course of albendazole due to the serological results and being toxocariasis more frequent in our setting. The patient was then subject to radiological follow-up. The patient responded to treatment with albendazole as shown by a decrease in eosinophils, seronegativization for <jats:italic>Toxocara</jats:italic> spp., clinical and radiological improvement. Toxocariasis was hence considered the most likely diagnosis.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Parasitic infections cannot be disregarded in the presence of FHLH. Differential diagnosis between these parasitic infections can be challenging due to the presence of similar clinical presentations and serological cross-reactions, and follow-up of the patient is needed to ensure optimal treatment outcomes.</jats:p>
</jats:sec>