2nd August 2023

A 7-year-old boy is brought into the paediatric emergency department, presenting with a 2-day history of fever

A 7-year-old boy is brought into the paediatric emergency department, presenting with a 2-day history of fever, malaise, dry cough, wheeze and reduced activity. The family are on holiday in Tobago and has only been there a week. There is no history of asthma or atopy in the family, and prior to this, the boy has never been unwell.

Examination reveals hepatomegaly. Blood tests show a raised eosinophil count and elevated liver transaminases. On further questioning, the parents noticed their son eating sand out of a dog litter.

What is the most likely cause?

Select the SINGLE most appropriate option from the list below. Select ONE option only.