Background: Toxocara Canis is the ascaris parasite in dogs, cats and foxes, and is the causative agent of visceral larva migrans in human. Although toxocara infections are usually subclinical and self-limited, severe clinical manifestations such as pulmonary effusion, cardiac tamponade and ascites have been reported as rare clinical presentations.

Objective: To present the rare complication manifestation of toxocariaris which is life-threatening.
Case: A 15-year-old male was referred to our institution for further evaluation and management of multiple effusion (pleural effusion, pericard effusion and ascites. Chest computed tomography (CT) demonstrated bilateral pleural and pericardial effusions. Abdominal CT angiograph revealed hepatomegaly passive hepatic congestion. Laboratory findings showed white blood cell count of 10,020 /?l with 7.2% eosinophils; hemoglobin level 10.8 g/dl; and platelet count 372,000 /?l. Examination of ascites specimen analysis revealed exudate with eosinophils and basophils more than 10%. Serum screening for parasites was performed and confirmed high titer of Toxocara (3.18). The patient was given albendazole for 7 weeks and methyl prednisolone, eventually clinical improvement  occured.
 
Conclusion: Toxocariasis should be considered as a possible diagnosis in an child with multiple effusion with eosinophilia, which is still an important clinical feature of visceral larva migrans that provide a clue to the diagnosis.