Parasitic Masquerader: Hepatic Larva Migrans Presenting as Microabscess-Like Lesions

Hepatic visceral larva migrans (VLM) is an uncommon zoonosis that develops when second-stage nematode larvae migrate from the gut into solid viscera. It is most commonly caused by Toxocara species, the ascarid of dogs and cats. Clinically, it presents as an infective/inflammatory pathology in preschool children, and radiologically, it reveals multiple hepatic space-occupying lesions that closely mimic bacterial microabscesses on routine ultrasonography (USG). We report a 4-year-old boy with abdominal pain, tender hepatomegaly, and marked eosinophilia who showed microabscess-like lesions on USG and poor response to antibiotics. Histopathological evidence revealed hepatic larva migrans, and the child recovered drastically with antihelminthic drug therapy. This case highlights the importance of correlating clinical history, laboratory findings, and characteristic imaging features to diagnose VLM and avoid unnecessary antibiotics or interventions.