Cutaneous larva migrans: Difference between revisions
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==Background== | ==Background== | ||
*Also known as creeping eruption or sandworm disease<ref name="Vano-Galvan" /> | *Also known as creeping eruption or sandworm disease<ref name="Vano-Galvan" /> | ||
*Caused by movement of hookworm larvae through epidermis<ref name="Prickett">Prickett KA, Ferringer TC. What's eating you? Cutaneous larva migrans. Cutis. 2015 Mar;95(3):126-8.</ref> | *Caused by movement of hookworm (helminth) larvae through epidermis<ref name="Prickett">Prickett KA, Ferringer TC. What's eating you? Cutaneous larva migrans. Cutis. 2015 Mar;95(3):126-8.</ref> | ||
**''Ancylostoma caninum'' and ''Ancylostoma braziliense'' are most common pathogens | **''Ancylostoma caninum'' and ''Ancylostoma braziliense'' are most common pathogens | ||
**Typically occurs due to contact with dog/cat feces in soil/sand | **Typically occurs due to contact with dog/cat feces in soil/sand | ||
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**History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment<ref name="Vano-Galvan">Vano-Galvan S, Gil-Mosquera M, Truchuelo M, Jaén P. Cutaneous larva migrans: a case report. Cases Journal. 2009;2:112. doi:10.1186/1757-1626-2-112.</ref> | **History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment<ref name="Vano-Galvan">Vano-Galvan S, Gil-Mosquera M, Truchuelo M, Jaén P. Cutaneous larva migrans: a case report. Cases Journal. 2009;2:112. doi:10.1186/1757-1626-2-112.</ref> | ||
[[File:LarvaMigrans2.png|thumb|CLM on thigh of child]] | |||
[[File:LarvaMigrans.png|thumb|CLM on leg of 32y/o M]] | [[File:LarvaMigrans.png|thumb|CLM on leg of 32y/o M]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Pruritis serpiginous eruption<ref name="Prickett" /> | *Pruritis serpiginous eruption<ref name="Prickett" /> | ||
**Pruritis can be | **Pruritis can be severe and intractable<ref name="Vano-Galvan" />, and can lead to impaired sleep and mood disturbance<ref name="Kincaid">Kincaid L, Klowak M, Klowak S, Boggild AK. Management of imported cutaneous larva migrans: A case series and mini-review. Travel Med Infect Dis. 2015 Jul 29.</ref> | ||
**Usually unilateral, but can be bilateral | **Usually unilateral, but can be bilateral | ||
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==Management== | ==Management== | ||
*Self-limited condition - larvae die within 2-8 weeks<ref name="Prickett" /> | *Self-limited condition - larvae die within 2-8 weeks<ref name="Prickett" /> | ||
**Goal of treatment is to relieve severe pruritis | |||
*Albendazole 400mg PO QD x3-5 days '''OR''' Ivermectin 12mg PO x1 '''OR''' topical thiabendazole TID x15 days | *Albendazole 400mg PO QD x3-5 days '''OR''' Ivermectin 12mg PO x1 '''OR''' topical thiabendazole TID x15 days | ||
*Mebendazole has poor oral bioavailability and does not work for cutaneous larva migrans<ref name="Kincaid" /> | |||
==Disposition== | ==Disposition== | ||
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==See Also== | ==See Also== | ||
*[[Helminth infections]] | |||
*[[Parasitic Disease]] | *[[Parasitic Disease]] | ||
*[[Travel Medicine]] | *[[Travel Medicine]] | ||
Revision as of 08:58, 18 August 2015
Background
- Also known as creeping eruption or sandworm disease[1]
- Caused by movement of hookworm (helminth) larvae through epidermis[2]
- Ancylostoma caninum and Ancylostoma braziliense are most common pathogens
- Typically occurs due to contact with dog/cat feces in soil/sand
- More common in warm/tropical areas
- History is typically of a patient sunbathing, walking on the beach, etc in a tropical environment[1]
Clinical Features
- Pruritis serpiginous eruption[2]
Differential Diagnosis
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Diagnosis
- Clinical diagnosis, based on history and physical exam
Management
- Self-limited condition - larvae die within 2-8 weeks[2]
- Goal of treatment is to relieve severe pruritis
- Albendazole 400mg PO QD x3-5 days OR Ivermectin 12mg PO x1 OR topical thiabendazole TID x15 days
- Mebendazole has poor oral bioavailability and does not work for cutaneous larva migrans[3]
Disposition
- Discharge
See Also
References
- ↑ 1.0 1.1 1.2 Vano-Galvan S, Gil-Mosquera M, Truchuelo M, Jaén P. Cutaneous larva migrans: a case report. Cases Journal. 2009;2:112. doi:10.1186/1757-1626-2-112.
- ↑ 2.0 2.1 2.2 Prickett KA, Ferringer TC. What's eating you? Cutaneous larva migrans. Cutis. 2015 Mar;95(3):126-8.
- ↑ 3.0 3.1 Kincaid L, Klowak M, Klowak S, Boggild AK. Management of imported cutaneous larva migrans: A case series and mini-review. Travel Med Infect Dis. 2015 Jul 29.