CUTANEOUS LARVAL MIGRANS

Synonym:

 Creeping eruption
Type of zoonosis:

 Saprozoonosis, Anthropozoonosis
Etiology:

 Cutaneous larval migrans (CLM) is caused by the larvae of the dog and cat hookworms,
Ancylostoma braziliense and Ancylostoma caninum. A number of other animal
hookworms, gnathostomiosis and strongyloidosis are rarely also causative agents.
Reservoir and incidence :

 Cutaneous larval migrans is prevalent throughout the tropic and subtropics.

 Human infection is common in contact with moist sandy soil (e.g., beaches, children's
sand piles) contaminated by dog or cat faeces.
Transmission:

 Direct skin contact with larvae (soil to skin contact, contamination with animal faeces).
Disease in animals:

 Loss of blood together with malnutrition produce anaemia.

 Severe enteritis causes haemorrhagic diarrhoea and weight loss from intestinal
malabsorption.
 Prenatal infection of the dog causes death of the foetal pups.
 Mild infections generally cause no clinical signs.
Disease in man:

 Intensely pruritic erythematous papules appear at the site of larval entry, particularly on
the hands or feet.
 Two to 3 days later, serpiginous eruptions appear as the larvae migrate at a rate of several
millimeters a day. The process continues for weeks or up to a year, and the lesions may
remain severely pruritic, vesiculate and become encrusted and secondarily infected.
 Without treatment, the larvae eventually die and are absorbed.
Diagnosis:

 Based on history and characteristic clinical signs.

Treatment:

 Treatment is not needed, but, antihistamines and antibiotic ointments can be applied
 Albendazole or thiabendazole can be taken.
Prevention and control:

 Decontaminate environment with sodium borate or sodium hypochlorite solution.

 Prevent environmental contamination.
 Minimize contact.
 Public health education.