Cutaneous larva migrans
Cutaneous larva migrans is caused by the larvae of dog and cat hookworms. Pruritic skin lesion are most commonly of the feet or buttocks. At increased risk are utility men, gardeners, and sea-bathers exposed to damp sandy soil contaminated with dog and cat feces.
CASES/YEAR
50,000 (US); 1,000,000 (Global)
OTHER NAMES
Creeping eruption;
INCUBATION
Usually a few days after penetration of larvae; [CCDM]
INITIAL SYMPTOMS
Pruritic skin lesion most commonly of feet or buttocks; [CCDM];
COMMENTS
Larvae of dog and cat hookworms, Ancylostoma braziliense and Ancylostoma caninum, are the source of cutaneous larva migrans. Cutaneous larva migrans appears as pruritic papules, vesicles, or red, serpiginous tracks. At increased risk are utility men, gardeners, and sea-bathers exposed to damp sandy soil contaminated with dog and cat feces. Ancylostoma caninum larvae can migrate to the small intestine and cause eosinophilic enteritis. [CCDM, p. 333] Travelers are infected while walking barefooted on beaches frequented by dogs or cats. Eosinophilia and systemic symptoms are rare. Without treatment, lesions are self-limited (2-8 weeks). [Guerrant, p. 767] Usually caused by the dog and cat hookworm, Ancylostoma braziliense; [Harrison ID, p. 1128]
SCOPE
In the USA, most common in the Southeast, especially in sandy, shady beaches or under houses; [PPID, p. 3475] Most travel cases associated with the Caribbean, Africa, Asia, & S. America on beaches/sandboxes where domestic animals may roam. [CDC Travel]
SIGNS & SYMPTOMS
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H eosinophilia
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S papules or plaques
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S skin blister or vesicles
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S skin lesion, linear or serpiginous
ENTRY
Skin or Mucous Membranes (Includes Conjunctiva)
SOURCE
Fecally Contaminated Soil
RISK FACTORS
- Travel to endemic area
- Walk barefooted in contaminated soil
TREATMENT
"Albendazole is very effective for treatment." [CDC Travel]
REFERENCES FOR CASES/YEAR
1. (US) Guesstimate: Assume that it is 5 X more common than visceral larva migrans;
2. (Global) Most common skin problem affecting travelers to tropical countries; [Guerrant, p. 767] Guesstimate: Assume that it is 5 X more common than visceral larva migrans;