EL SÍNDROME DE LARVA MIGRANS CUTÁNEO Y LAS MASCOTAS.THE CUTANEOUS LARVA MIGRANS SYNDROME AND PETS /

 El síndrome de Larva Migrans Cutáneo y las mascotas (perros y gatos). !!! 

 The Cutaneous Larva Migrans Syndrome and pets (dogs and cats). !!! 

EDITORIAL ESPAÑOL 
====================
Hola amigos de la red, DERMAGIC de nuevo con ustedes. El tema de hoy  EL SÍNDROME LARVA MIGRANS CUTÁNEA, Y LAS MASCOTAS (PERROS Y GATOS)  

Nos encantan las mascotas, sobre todo los perros y gatos. Pero en la mierda (caca) de estos bellos animales hay unos parásitos que pueden pasar a la piel cuando la tocamos o ingerimos, 

 El sitio favorito para contraerla es la PLAYA o el CAMPO donde nuestras  lindas mascotas hacen  su mierda. Luego venimos nosotros e ingenuamente ponemos en contacto alguna parte de nuestro cuerpo (principalmente el pie) con el pupú-caca, y la larva penetra nuestra piel directamente desde las heces provocando la enfermedad. 

También en los hogares donde hay perros y gatos no controlados por el veterinario. En fin una enfermedad más donde el hombre es  accidentalmente contaminado por el animal. 

Hoy en dia descrita en algunas publicaciones como "el souvenir de los viajeros y turistas" que la contraen en sus viajes de vacaciones. Varios parásitos son los agentes causales pero los más comunes son: ANCYLOSTOMA CANINUM y ANQUILOSTOMA. BRAZILIENSE. 

La LARVA MIGRANS CUTÁNEA, es una enfermedad SUPERFICIAL, el parásito vive en la capa superficial de la piel, haciendo túneles a medida que crece, denominada también "erupción progresiva ", pero es autolimitada y con un buen tratamiento desaparece sin dejar complicaciones en la mayoría de los casos, pero... 

Hay otra variante de la LARVA MIGRANS QUE ES LA VISCERAL (PROFUNDA) causada por otros parásitos como el Toxocara canis (Perro) y otros mas, donde el el parasito "migra: a órganos profundos como: CAVIDAD VISCERAL OJO, CEREBRO, MÚSCULOS Y OTROS. esta es más peligrosa y puede dejar secuelas si no es detectada y tratada a tiempo. 

De modo pues que cuiden las lindas mascotas, llévenlas regularmente al veterinario y tengan cuidado cuando vayan a la playa y el campo para evitar esta enfermedad ! 

En las referencias conocerás la enfermedad y sus variantes, los agentes causales y las opciones terapéuticas

En el attach: la larva, el niño, la mascota, y otras más.  

 
Saludos a todos !!! 

Dr. José Lapenta

Dr. José M. Lapenta

EDITORIAL ENGLISH 
===================
Hello friends of to the net, DERMAGIC again with you. Today's topic THE CUTANEOUS
LARVA MIGRANS SYNDROME AND PETS (DOGS AND CATS).  We love pets, mainly the dogs and cats. But in  the feces (poop) of these beautiful animals there are some parasites  that can pass to the skin when we touch or ingest them. 

The favorite site to contract them is the BEACH or THE FIELD  where  our pretty pets make its  feces. Then we come and frankly we put some part of our body (mainly the foot) in contact with them, and the larva penetrates our skin directly from the feces causing the disease.

Also in homes where there are dogs and cats not controlled by the veterinarian. In short another disease where the man is accidentally contaminated by the animal.

Nowadays described in some publications as "the souvenir of travelers and tourists" who contract it during their vacations. Several parasites are the causal agents but the most common are: ANCYLOSTOMA CANNINUM and ANCYLOSTOMA BRAZILIENZE.

The  cutaneous larva migrans, is a superficial disease, the parasite lives in the superficial layer of the skin, making tunnels as it grows, also called "creeping eruption", but it is self-limited and with a good treatment disappears without leaving complications in the majority of cases, but ...

There is another variant of the LARVA MIGRANS SYNDROME THAT IS THE VISCERAL VARIANT (DEEP) caused by other parasites such as Toxocara cannis (Dog) and others, where the parasite "migrates: to deep organs such as: VISCERAL CAVITY, EYE, BRAIN, MUSCLE AND OTHERS This is more dangerous and can have sequelae if it is not detected and treated on time.

So take care of the cute pets, take them regularly to the veterinarian and be careful when go to the beach and the countryside or field to avoid this disease!

In the references you will know the disease and its variants, the causal agents and the therapeutic options

In the attach: the larva, the boy, the pett, and others.

Greetings to all.

Dr. José Lapenta

Dr. José M. Lapenta

================================================================
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES 
================================================================
============================================================ 
0.) CUTANEOS, VISCERAL and OCULAR LARVA MIGRANS 
============================================================ 
1.) Souvenir from the Hamptons - a case of cutaneous larva migrans of 
six 
months' duration. 
2.) Effectiveness of a new therapeutic regimen with albendazole in 
cutaneous larva migrans. 
3.) [Migrant erythema as clinical presentation of cutaneous larva 
migrans 
in Mexico City] 
4.) Larva migrans within scalp sebaceous gland. 
5.) Cutaneous larva migrans, sacroileitis, and optic neuritis caused by 
an 
unidentified organism acquired in Thailand. 
6.) Perianal cutaneous larva migrans in a child. 
7.) [Infections with Baylisascaris procyonis in humans and raccoons] 
8.) Cutaneous larva migrans complicated by erythema multiforme [see 
comments] 
9.) Cutaneous larva migrans associated with water shoe use. 
10.) Cutaneous larva migrans infection in the pediatric foot. A review 
and 
two case reports. 
11.) Creeping eruption of larva migrans--a case report in a beach volley 

athlete. 
12.) Albendazole: a new therapeutic regimen in cutaneous larva migrans. 
13.) A primary health care approach to an outbreak of cutaneous larva 
migrans. 
14.) Autochthonous cutaneous larva migrans in Germany. 
15.) High prevalence of Ancylostoma spp. infection in dogs, associated 
with 
endemic focus of human cutaneous larva migrans, in Tacuarembo, Uruguay. 
16.) Persistent cutaneous larva migrans due to Ancylostoma species. 
17.) [A case of Dirofilaria repens migration in man] 
18.) [Cutaneous larva migrans, autochthonous in France. Apropos of a 
case] 
19.) Cutaneous larva migrans in travelers: synopsis of histories, 
symptoms, 
and treatment of 98 patients. 
20.) [Nematode larva migrans. On two cases of filarial infection] 
21.) Larva migrans that affect the mouth. 
22.) Immunological studies on human larval toxocarosis. 
23.) [Larva migrans] 
24.) Effect of albendazole on Ancylostoma caninum larvae migrating in 
the 
muscles of mice. 
25.) [Ocular manifestations of toxocariasis] 
26.) Toxocara infestations in humans: symptomatic course of toxocarosis 
correlates significantly with levels of IgE/anti-IgE immune complexes. 
27.) [Long-term observations of ocular toxocariasis in children and 
youth] 
28.) [A case of uveitis due to gnathostoma migration into the vitreous 
cavity] 
29.) [The ocular form of toxocariasis] 
30.) [Visceral larval migrans (Human toxocariasis) cause of 
hypereosinophilia and visceral granulomas in adults] 
31.) Visceral larva migrans syndrome complicated by liver abscess. 
32.) Visceral larva migrans and tropical pyomyositis: a case report. 
33.) [2 cases of toxocariasis (visceral larva migrans)] 
34.) [Visceral larva migrans. A rare cause of eosinophilia in adults] 
35.) [Visceral larva migrans: a mixed form of presentation in an adult. 
The 
clinical and laboratory aspects] 
36.) Visceral larva migrans induced eosinophilic cardiac pseudotumor: a 
cause of sudden death in a child. 
37.) [Toxocariasis. A cosmopolitan parasitic zoonosis] 
38.) Visceral larva migrans mimicking rheumatic diseases. 
39.) Hepatic granulomas due to visceral larva migrans in adults: 
appearance 
on US and MRI. 
40.) [Ascaridiasis zoonoses: visceral larva migrans syndromes] 
41.) Hepatic visceral larva migrans: evolution of the lesion, diagnosis, 

and role of high-dose albendazole therapy. 
42.) Neuroimaging studies of cerebral "visceral larva migrans" syndrome. 

43.)[Acute eosinophilic pneumonia and the larva migrans syndrome: 
apropos 
of a case in an adult] 
44.)Toxocariasis simulating hepatic recurrence in a patient with Wilms' 
tumor. 
45.) Hepatic imaging studies on patients with visceral larva migrans due 
to 
probable Ascaris suum infection. 
46.) Encephalopathy caused by visceral larva migrans due to Ascaris 
suum. 
47.) [Imported skin diseases (see comments)] 
48.) [Incidence of Toxocara ova--especially ova of visceral larva 
migrans 
in beach sand of Warnemunde in 1997] 
49.) Pets and Parasites. 
50.) Cutaneous larva migrans in travelers: synopsis of histories, 
symptoms, 
and treatment of 98 patients. 
51.) Cutaneous larva migrans. 
52.)[Current therapeutic possibilities in cutaneous larva migrans] 
53.) Cutaneous larva migrans due to Pelodera strongyloides. 
54.) Oral albendazole for the treatment of cutaneous larva migrans. 
55.) Cutaneous larva migrans in northern climates. A souvenir of your 
dream 
vacation. 
56.) Creeping eruption. A review of clinical presentation and management 
of 
60 cases presenting to a tropical disease unit. 
57.) Dermatoses associated with travel to tropical countries: a 
prospective 
study of the diagnosis and management of 269 patients presenting to a 
tropical disease unit. 
58.) Larva currens and systemic disease. 
59.) Hookworm folliculitis. 
60.) [Prurigo and further diagnostically significant skin symptoms in 
strongyloidosis] 
61.) Gnathostomiasis, or larva migrans profundus. 
62.) Visceral larva migrans caused by Trichuris vulpis. 
63.) Creeping disease due to larva of spiruroid nematoda. 
64.) Creeping eruption due to larvae of the suborder Spirurina--a newly 
recognized causative parasite. 
65.) Linear lichen planus mimicking creeping eruption. 
66.) Diagnosis and management of Baylisascaris procyonis infection in an infant with nonfatal meningoencephalitis. 
67.) [Human gnathostomiasis. The first evidence of the parasite in South 
America] 
68.) Efficacy of ivermectin in the therapy of cutaneous larva migrans 
[letter] 
69.) Hookworm-related cutaneous larva migrans in northern Brazil: resolution of clinical pathology after a single dose of ivermectin.
70.) session of carbon dioxide laser: a study of 0.1111/jocd.12296. [Epub ahead of print]
ten cases in the Philippines.
71.) Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin.
============================================================ 
============================================================ 
*  CUTANEOUS LARVAL MIGRANS (Creeping Eruption) * 
============================================================  
SOURCE: 
Mandell, Douglas and Bennett's 
Principles and Practice of Infectious Diseases 
Fourth Edition 

Cutaneous larval migrans is characterized as serpiginous, reddened, 
elevated, pruritic skin lesions usually caused by Ancylostoma 
braziliense, 
the dog and cat hookworm. 1,20 Other animal hookworms including A. 
caninum, 
Uncinaria stenocephala, Bunostomum phlebotomum, and others; the human 
hookworms, Strongyloides stercoralis and Gnathostoma spinigerum; and, 
rarely, insect larvae can cause similar findings. Like human hookworms, 
A. 
braziliense larvae infect dogs and cats by burrowing through the skin. 
The 
adults reside in the intestine and shed eggs, which undergo development 
into infectious larvae outside the body in places protected from 
desiccation and temperature extremes, such as sandy, shady areas around 
beaches or under houses. Infections are most common in warmer climates 
such 
as the southeastern United States and occur in children more commonly 
than 
in adults. Larvae penetrate the skin, causing tingling followed by 
itching, 
vesicle formation, and typically raised, reddened, serpiginous tracks 
that 
mark the prior route of the parasite. In severe infections, persons may 
have hundreds of tracks. Little further development of the parasite 
occurs. 
Usually there are few, if any, systemic symptoms, but some reports have 
documented lung infiltrates and, rarely, severe lung dysfunction and 
recovery of parasites in the sputum. Eosinophilia has been noted in some 

infections.  The skin lesions are readily recognized, and the diagnosis 
is 
made clinically. Biopsy specimens usually show an eosinophilic 
inflammatory 
infiltrate, but the migrating parasite is usually not identified. For 
this 
reason, biopsies are usually not indicated to establish the diagnosis. 
Without treatment, skin lesions gradually disappear. Both topical (10% 
aqueous suspension qid)  thiabendazole and oral administration (25 mg/kg 

bid for 2 days)  are effective. In one study, most patients treated with 

thiabendazole responded within the first week compared to the more than 
4 
weeks required for comparable improvement in the placebo-treated group. 
Successful treatment with albendazole or ivermectin  has been reported. 

=========================================================== 
* VISCERAL LARVA MIGRANS (Toxocariasis) * 
=========================================================== 
Visceral larva migrans (VLM) is a syndrome characterized in its most 
florid 
state by eosinophilia, fever, and hepatomegaly. It is caused primarily 
by 
infection with Toxocara canis but also be T. cati and other helminths 
less 
frequently. 
---------------------- 
Life Cycle in the Dog 
---------------------- 
Toxocara canis infects dogs and related mammals by a number of 
mechanisms. 
1 Most commonly, ingested eggs hatch in the small intestine, and the 
resulting larvae migrate to the liver, lung, and trachea. They are then 
swallowed and mature in the lumen of the small intestine, where eggs are 

shed. Other larvae migrate to and remain dormant in the muscles but are 
capable of development even years after the primary infection, 
particularly 
in pregnant bitches. During pregnancy, larvae again develop and infect 
the 
pups transplacentally and transmammarily. Not uncommonly, infective 
larvae 
are found in the feces of the pups. Eggs are not infectious when passed 
in 
the feces and take 3–4 weeks to develop. They are hardy and often remain 

viable for months. Large numbers of viable eggs contaminate the 
environment 
because of the high prevalence of infection in dogs and the ability of 
eggs 
to survive relatively harsh environmental conditions. 
Infection in Humans 
------------- 
Prevalence 
------------ 
Toxocariasis is prevalent wherever dogs are found and Toxocara eggs are 
able to survive. The prevalence of infection or disease in humans is not 

known, but seroepidemiology studies show wide differences in prevalence 
depending on the population tested. In the United States, seropositivity 

ranged from 2.8 percent in an unselected population to 23.1 percent in a 

kindergarten population in the southern United States to 54 percent in a 

selected rural community. None of the seropositive persons had 
recognizable 
disease. 
------------------------ 
Clinical Manifestations 
----------------------- 
VLM occurs most commonly in children less than 6 years of age. Disease 
manifestations vary and range from asymptomatic infection to fulminant 
disease and death, but it is increasingly appreciated that most 
infections 
are asymptomatic. Those who come to medical attention most commonly 
complain of cough, fever, wheezing, and other generalized symptoms. The 
liver is the organ most frequently involved, and hepatomegaly is a 
common 
finding, although almost any organ can be affected. Splenomegaly occurs 
in 
a minority, and lymphadenopathy has been noted. Lung involvement with 
radiologic findings has been documented in 32–44 percent, but 
respiratory 
distress occurs rarely. Skin lesions such as urticaria and nodules have 
also been described. Seizures have been noted to occur with increased 
frequency in VLM, but severe neurologic involvement is infrequent. Eye 
involvement in VLM is unusual but has been documented (see below under 
"Ocular Larva Migrans"). Eosinophilia, usually accompanied by 
leukocytosis, 
is the hallmark of VLM. Other laboratory findings include 
hypergammaglobulinemia and elevated isohemagglutinin titers to A and B 
blood group antigens, which are due to the host's immune response to 
cross-reacting antigens on the surface of T. canis larvae. 
------------ 
Diagnosis 
------------ 
The diagnosis of VLM is usually suggested clinically by the presence of 
eosinophilia and/or leukocytosis in a young child accompanied by 
hepatomegaly or signs and symptoms of other organ involvement. A history 
of 
pica and exposure to puppies is common. Patients are more commonly black 

and from rural areas. The diagnosis is definitively confirmed by finding 

larvae in the affected tissues by histologic examination or by digestion 
of 
tissue; however, larvae are frequently not found. The enzyme-linked 
immunosorbent assay (ELISA) employing extracts or excretory-secretory 
products of T. canis larvae appears specific and useful in confirming 
the 
clinical diagnosis. 8 However, toxocara antibody titers in populations 
without clinically apparent VLM vary dramatically, and elevated titers 
cannot definitively establish the diagnosis. 
---------------------- 
Differential Diagnosis 
---------------------- 
Eosinophilia, fever, and hepatomegaly are caused by other parasitic 
infections. These include acute schistosomiasis, Fasciola hepatica 
infections, Ascaris lumbricoides abscess of the liver, acute liver fluke 

infections (Clonorchis sinensis and Opisthorchis viverrini), 
complications 
from Echinococcus infection of the liver, Capillaria hepatica, and other 

invasive helminths. Diseases not caused by parasitic infections should 
also 
be considered. Children with mild disease may manifest only 
eosinophilia. 
------------------------- 
Treatment and Management 
------------------------- 
Most patients recover without specific therapy. Treatment with 
anti-inflammatory or anthelmintic drugs may be considered with severe 
complications that are usually due to involvement of the brain, lungs, 
or 
heart. There is no proven effective therapy, although thiabendazole, 
mebendazole, diethylcarbamazine, and other anthelmintics have been used. 

Indeed, injury to the parasite may provoke a more intense inflammatory 
response leading to worsening of the clinical picture. Corticosteroids 
have 
been used with and without specific antilarval therapy, with some 
reports 
of improvement. 
------------ 
Prevention 
------------ 
VLM can be easily prevented by a number of simple but effective measures 

that prevent T. canis eggs from contaminating the environment and 
children 
from ingesting eggs. Dogs, particularly puppies, should be periodically 
tested and treated for T. canis and other worms. Pica should be 
prevented. 

=============================================== 
* Ocular Larva Migrans * 
================================================ 
Ocular larval migrans (OLM) is caused by an infection of the eye with T. 

canis larvae. Although a present or past history of clinically 
recognized 
VLM has occasionally been noted, almost all patients present with 
unilateral eye involvement without a past history or present systemic 
symptoms or signs. Presumably, a larva by chance becomes entrapped in 
the 
eye, resulting in an eosinophilic inflammatory mass. Children are most 
commonly affected and, on the average, are older (mean, 8.6 years in one 

study) than those diagnosed with VLM. The findings are most commonly 
those 
of a posterior or peripheral inflammatory mass. In fact, this entity was 

first recognized after examination of eyes enucleated for the treatment 
of 
presumed retinoblastoma.  Eosinophilia, hepatomegaly, and other signs 
and 
sympoms of VLM are lacking. The diagnosis is established clinically. 
Although the serum titers to toxocara larvae are higher than those of a 
control population, many patients with OLM have low or negative titers. 
However, elevated vitreous 11 and aqueous fluid titers to toxocara 
larvae 
compared to serum levels have been documented and appear to be useful in 

establishing the diagnosis. There is no specific therapy. 

============================================================ 
============================================================ 
1.) Souvenir from the Hamptons - a case of cutaneous larva migrans of 
six 
months' duration. 
============================================================ 
Mt Sinai J Med 1999 Oct-Nov;66(5-6):334-5   (ISSN: 0027-2507) 

Esser AC; Kantor I; Sapadin AN [Find other articles with these Authors] 
Department of Dermatology, Mount Sinai School of Medicine, One East 
100th 
Street New York, NY, USA. 

Cutaneous larva migrans is a distinctive serpiginous eruption caused by 
a 
reaction to burrowing hookworms. The infection is usually self-limited, 
normally lasting 2-8 weeks, but may persist for more than a year if 
misdiagnosed. Biopsies of the creeping eruption rarely reveal an 
organism. 
Thus, it is important for the infection to be recognized clinically, so 
that effective treatment may begin. We found topical thiabendazole to be 

fast and effective in treating this case of cutaneous larva migrans of 
six 
months' duration. 

============================================================ 
2.) Effectiveness of a new therapeutic regimen with albendazole in 
cutaneous larva migrans. 
============================================================ 
Eur J Dermatol 1999 Jul-Aug;9(5):352-3   (ISSN: 1167-1122) 

Veraldi S; Rizzitelli G [Find other articles with these Authors] 
Institute of Dermatological Sciences, IRCCS, University of Milan, Via 
Pace 
9, 20122 Milan, Italy. 

Twenty-four (13 males and 11 females) adult Caucasian patients affected 
by 
cutaneous larva migrans, characterized by extensive and/or multiple 
lesions, were treated with oral albendazole according to a new 
therapeutic 
regimen (400 mg/day for 7 days). No other topical or systemic drug was 
used 
nor any physical treatment. All patients were cured at the end of the 
therapy. No recurrence was observed. No side effect was either 
complained 
of or observed, nor was any laboratory abnormality recorded. On the 
basis 
of this study, albendazole is effective in cutaneous larva migrans 
characterized by extensive and/or multiple lesions. This new therapeutic 

regimen avoids no response and recurrence, which are not uncommonly 
observed following shorter (e.g.: 1-5 days) therapies with albendazole. 
The 
longer duration of the therapy is not accompanied by the appearance of 
more 
severe and/or new side effects or laboratory abnormalities. 
 

============================================================ 
3.) [Migrant erythema as clinical presentation of cutaneous larva 
migrans 
in Mexico City] 
[Eritema migratorio como presentacion clinica de larva migrans cutanea 
en 
la ciudad de Mexico.] 
============================================================ 
Gac Med Mex 1999 May-Jun;135(3):235-8   (ISSN: 0016-3813) 

Halabe-Cherem J; Nellen-Hummel H; Jaime-Gamiz I; Lifshitz-Guinzberg A; 
Morales-Cervantes R; Gallegos-Hernandez V; Malagon-Rangel J [Find other 
articles with these Authors] 

Cutaneous larva migrans (CLM) is a ubiquitous self-limited skin 
eruption, 
most frequently caused by the larvae of dog and cat hookworms. Although 
CLM 
is most frequent in tropical climates, the infection is becoming more 
common in urban areas. CLM has been frequently misdiagnosed and/or 
treated 
inappropriately, and mimics rheumatic, infectious, vascular, or 
dermatologic diseases. We here in report the clinical presentation and 
management of 18 cases of CLM. 

============================================================ 
4.) Larva migrans within scalp sebaceous gland. 
============================================================ 
Rev Soc Bras Med Trop 1999 Mar-Apr;32(2):187-9   (ISSN: 0037-8682) 

Guimaraes LC; Silva JH; Saad K; Lopes ER; Meneses AC [Find other 
articles 
with these Authors] 
Faculdade de Medicina do Triangulo Mineiro, Hospital Helio Angotti 
(Associacao de Combate ao Cancer do Brasil Central), Universidade de 
Uberaba, MG. 

A case of larva migrans or serpiginous linear dermatitis on the scalp of 
a 
teenager is reported. An ancylostomid larva was found within a sebaceous 

gland acinus. The unusual skin site for larva migrans as well as the 
penetration through the sebaceous gland are highlighted. The probable 
mechanism by which the parasite reached the skin adnexa is discussed. 

============================================================ 
5.) Cutaneous larva migrans, sacroileitis, and optic neuritis caused by 
an 
unidentified organism acquired in Thailand. 
============================================================ 
J Travel Med 1998 Dec;5(4):223-5   (ISSN: 1195-1982) 

Potasman I; Feiner M; Arad E; Friedman Z [Find other articles with these 

Authors] 
Infectious Diseases Unit, and Ophthalmology Department, Bnai Zion 
Medical 
Center, the Rappaport School of Medicine, Technion, Haifa, Israel. 

We report the case of a 32-year-old pregnant woman with an unidentified 
intraocular parasite. The parasite, which had been acquired in Thailand, 

caused cutaneous larva migrans, sacroileitis, and 2 years later optic 
neuritis and panuveitis. The patient was successfully treated with 
ivermectin and albendazole. The diagnostic possibilities of this 
peculiar 
presentation are discussed. Parasitic infections are a leading cause of 
medical problems in travelers to tropical countries.1 While most 
parasites 
cause gastrointestinal problems, some may migrate throughout the body 
and 
lodge in critical organs. Ocular parasitic infections may occur by 
direct 
inoculation onto the eye,2 or incidentally during systemic migration. 
Subconjunctival parasites are easily diagnosed by removal and careful 
microscopic examination.3 Parasites, which lodge within the eye, are 
more 
difficult to diagnose, especially if not removed. In this report we 
describe a patient who presented with an intraocular parasite causing 
optic 
neuritis and panuveitis, 2 years after travel to Thailand. 

============================================================ 
6.) Perianal cutaneous larva migrans in a child. 
============================================================ 
Pediatr Dermatol 1998 Sep-Oct;15(5):367-9   (ISSN: 0736-8046) 

Grassi A; Angelo C; Grosso MG; Paradisi M [Find other articles with 
these 
Authors] 
Department of Pediatric Dermatology, Istituto Dermopatico 
dell'Immacolata, 
Rome, Italy. 

Cutaneous larva migrans (CLM) is a dermatosis characterized by the 
presence 
of parasites which migrate into the skin, forming linear or serpiginous 
lesions. We report a child with cutaneous larva migrans of interest 
because 
of the involvement of an unusual site and the patient's age. We confirm 
the 
efficacy of therapy consisting of administration of albendazole by 
mouth. 

============================================================ 
7.) [Infections with Baylisascaris procyonis in humans and raccoons] 
[Infecties met Baylisascaris procyonis bij de mens en de wasbeer.] 
============================================================ 
Tijdschr Diergeneeskd 1998 Aug 15;123(16):471-3   (ISSN: 0040-7453) 

Zagers JJ; Boersema JH [Find other articles with these Authors] 
Afdeling Parasitologie en Tropische Diergeneeskunde, Hoofdafdeling 
infectieziekten en Immunologie, Faculteit der Diergeneeskunde, 
Universiteit 
Utrecht. 

Baylisascaris procyonis is an ascarid which parasitizes the small 
intestine 
of raccoons. The parasite is not very pathogenic in the raccoon because 
larvae do not migrate in this host. In other animals the larvae migrate 
through the body. They do not develop into adult worms in the intestine 
but 
rather become encysted in granulomas, showing a preference for the 
brain. 
In humans these larvae cause different larva migrans syndromes. Patients 

with neural larva migrans syndrome show severe brain symptoms and the 
disease is sometimes fatal. This article describes the life cycle of the 

worm and the incidence, symptoms, diagnosis, treatment, and prevention 
of 
larva migrans syndromes, paying special attention to the Dutch 
situation. 

============================================================ 
8.) Cutaneous larva migrans complicated by erythema multiforme [see 
comments] 
============================================================ 
Cutis 1998 Jul;62(1):33-5   (ISSN: 0011-4162) 

Vaughan TK; English JC 3rd [Find other articles with these Authors] 
Dermatology Service, Evans Army Community Hospital, Fort Carson, 
Colorado, 
USA. 

Cutaneous larva migrans is an intensely pruritic serpiginous eruption 
caused by the dog or cat hookworm. Often, the disease is self-limiting 
and 
no other significant pathology develops; however, a significant 
localized 
inflammatory response to the nematode is extremely common. We present a 
case of cutaneous larva migrans in which a systemic inflammatory process 

ensued that was characteristic of erythema multiforme. We discuss 
possible 
mechanisms of this complication and review the literature. 

============================================================ 
9.) Cutaneous larva migrans associated with water shoe use. 
============================================================ 
J Eur Acad Dermatol Venereol 1998 May;10(3):271-3   (ISSN: 0926-9959) 

Swanson JR; Melton JL [Find other articles with these Authors] 
Division of Dermatology, Loyola University Medical Center, Maywood, IL 
60153, USA. 

It has been long suspected that footwear is protective against cutaneous 

larva migrans. This case report describes a woman who developed 
cutaneous 
larva migrans despite wearing 'protective' footwear. We forward a 
hypothesis by which recently popular water shoes may actually be 
conducive 
to the development of cutaneous larva migrans rather than having a 
protective function. 

============================================================ 
10.) Cutaneous larva migrans infection in the pediatric foot. A review 
and 
two case reports. 
============================================================ 
J Am Podiatr Med Assoc 1998 May;88(5):228-31   (ISSN: 8750-7315) 

Mattone-Volpe F [Find other articles with this Author] 
Children's Hospital of Philadelphia, PA, USA. 

Cutaneous larva migrans is the result of infestation of human skin by 
helminth larvae, which burrow through the epidermis. This route of 
infestation makes the foot a typical site for origination of this 
infection. Children, who frequently play barefoot in locations where the 

most common of the helminth larvae, the dog and cat hookworms, are 
endemic, 
are at particular risk for this disorder. This article reviews the 
differential diagnosis of cutaneous larva migrans and current concepts 
in 
management. Two cases of related children who presented to their 
pediatricians with this condition are reported. 

============================================================ 
11.) Creeping eruption of larva migrans--a case report in a beach volley 

athlete. 
============================================================ 
Int J Sports Med 1997 Nov;18(8):612-3   (ISSN: 0172-4622) 

Biolcati G; Alabiso A [Find other articles with these Authors] 
S. Gallicano Institute, Institute of Sports Sciences, Rome, Italy. 

The authors describe a case of cutaneous larva migrans in a beach volley 

athlete. This pathology is found more often in tropical zones than in 
European countries. There are no previous publications with regard to 
this 
condition in athletes. The nematode responsible for this affliction 
often 
is the Ancylostoma braziliense. Larval stage of the nematode migrates 
through the skin; within 72 hours after larval penetration, serpiginous, 

elevated tunnels are observed. This affliction can be complicated by 
Loeffler's syndrome. In the case described only dermatological 
involvement 
was observed. The patient was treated with 400 mg albendazole tablets 
twice 
a day for five days. Within two days of therapy the patient reported 
less 
itching; a medical control after ten days did not reveal any signs of 
active infection. 

============================================================ 
12.) Albendazole: a new therapeutic regimen in cutaneous larva migrans. 
============================================================ 
Int J Dermatol 1997 Sep;36(9):700-3   (ISSN: 0011-9059) 

Rizzitelli G; Scarabelli G; Veraldi S [Find other articles with these 
Authors] 
Institute of Dermatological Sciences, IRCCS, University of Milan, Italy. 

BACKGROUND: Various therapeutic modalities have been used to treat 
cutaneous larva migrans, including physical treatments (cryotherapy), 
topical drugs (tiabendazole), and systemic drugs (tiabendazole, 
albendazole, and ivermectin). Physical treatments are often ineffective 
and 
not devoid of side-effects. Topical tiabendazole is difficult to find in 

many countries; it is effective orally but frequently causes 
side-effects. 
Ivermectin has been used in a small number of patients. METHODS: Eleven 
(six men and five women) adult patients with cutaneous larva migrans 
characterized by multiple and/or diffuse lesions were treated with oral 
albendazole (400 mg daily for 7 days). No other topical or systemic 
drugs 
were used and no physical treatment was given. RESULTS: All patients 
were 
cured at the end of treatment. No side-effects were complained of or 
observed, and no laboratory abnormalities were recorded. No recurrences 
were observed. CONCLUSIONS: Albendazole is effective in the treatment of 

cutaneous larva migrans characterized by multiple and/or diffuse 
lesions. 
This new therapeutic regimen can reduce the number of no responses and 
recurrences, sometimes observed following shorter (e.g. 3-5 days) 
treatments with albendazole. The longer duration of treatment is not 
accompanied by the appearance of new and/or more severe side-effects. 

============================================================ 
13.) A primary health care approach to an outbreak of cutaneous larva 
migrans. 
============================================================ 
J S Afr Vet Assoc 1996 Sep;67(3):133-6   (ISSN: 0301-0732) 

McCrindle CM; Hay IT; Kirkpatrick RD; Odendaal JS; Calitz EM [Find other 

articles with these Authors] 
Department of Production Animal Medicine, Faculty of Veterinary Science, 

Medical University of Southern Africa, Medunsa, South Africa. 

Primary health care (PHC) has been defined by the World Health 
Organisation 
as essential health care made universally accessible to community 
members, 
with their full participation, at a cost affordable to the community. 
PHC 
could therefore be used in the prevention and treatment of zoonotic 
diseases in humans, as such diseases are more prevalent in disadvantaged 

communities. The successful use of PHC principles in the treatment and 
control of cutaneous larva migrans in children in a semi-rural, 
low-income 
community is discussed in this paper. Constraints to implementation of 
PHC 
principles were identified as resistance from health care professionals, 

lack of interdepartmental cooperation and bureaucratic delays. It is 
concluded that PHC principles can be used successfully for the 
prevention 
and treatment of specific zoonoses provided that an aetiological 
diagnosis 
is made and the epidemiology of the condition understood. The results 
also 
confirmed the relevance of the veterinarian in the control of zoonotic 
diseases as part of the PHC team. 

============================================================ 
14.) Autochthonous cutaneous larva migrans in Germany. 
============================================================ 
Trop Med Int Health 1996 Aug;1(4):503-4   (ISSN: 1360-2276) 

Klose C; Mravak S; Geb M; Bienzle U; Meyer CG [Find other articles with 
these Authors] 
Institute for Tropical Medicine, Berlin, Germany. 

Cutaneous larva migrans syndrome is extremely rare in Germany. However, 
three cases of this syndrome were diagnosed in patients from Berlin, 
Germany, in the summer of 1994. Exposure to the infective agent in 
endemic 
areas and close contact with animals were excluded. It is assumed that 
the 
extreme temperatures in summer 1994 favoured the conditions of 
infection. 

============================================================ 
15.) High prevalence of Ancylostoma spp. infection in dogs, associated 
with 
endemic focus of human cutaneous larva migrans, in Tacuarembo, Uruguay. 
============================================================ 
Parasite 1996 Jun;3(2):131-4   (ISSN: 1252-607X) 

Malgor R; Oku Y; Gallardo R; Yarzabal I [Find other articles with these 
Authors] 
Unidad de Biologia Parasitaria, Universidad de la Republica Oriental del 

Uruguay, Montevideo, Uruguay. 

A helminthological survey of the intestinal parasites in stray dogs was 
conducted in urban and suburban area of Tacuarembo, Uruguay, during 
winter 
time. Eighty stray dogs captured in the city were necropsied. Seventy 
nine 
dogs (98.8%) were positive for helminth infection. Seventy seven (96.3%) 

were parasitized by hookworms. Two species of hookworms were found: 
Ancylostoma caninum 96.3% and A. braziliense 49.4%. This is the first 
report of the prevalence of A. braziliense in Uruguay. Considering that 
incidences of human cutaneous larva migrans caused by the migration of 
hookworms larvae were restricted mainly to the northern part of Uruguay 
and 
that only A. caninum were reported to be prevalent in the southern part, 
it 
is supposed that A. braziliense is the primary causative agent of human 
cutaneous larva migrans in Uruguay. 

============================================================ 
16.) Persistent cutaneous larva migrans due to Ancylostoma species. 
============================================================ 
South Med J 1996 Jun;89(6):609-11   (ISSN: 0038-4348) 

Richey TK; Gentry RH; Fitzpatrick JE; Morgan AM [Find other articles 
with 
these Authors] 
Dermatology Service, Department of Medicine, Fitzsimons Army Medical 
Center, Aurora, CO 80045, USA. 

Cutaneous larva migrans is considered to be a self-limited parasitic 
infection of about 2 to 8 weeks' duration, though it has been reported 
to 
persist for as long as 55 weeks. In this case, a healthy 47-year-old 
white 
man had multiple serpiginous lesions typical of cutaneous larva migrans 
for 
18 months. A biopsy taken 2 months before presentation showed a parasite 

consistent with Ancylostoma species deep in a hair follicle. The patient 

initially responded to topical thiabendazole, but relapse occurred when 
therapy was discontinued. Oral thiabendazole cured the problem after 22 
months of infestation. Cutaneous larva migrans may sometimes be 
long-standing, here almost 2 years, even in a healthy patient. Organisms 

may reside deep in the hair follicles. Topical thiabendazole may not 
penetrate to this depth, necessitating oral thiabendazole therapy. 

============================================================ 
17.) [A case of Dirofilaria repens migration in man] 
[Sluchai migratsii Dirofilaria repens u cheloveka.] 
============================================================ 
Med Parazitol (Mosk) 1996 Jan-Mar;(1):44   (ISSN: 0025-8326) 

Artamonova AA; Nagornyi SA [Find other articles with these Authors] 

The paper reports a case of Dirofilaria repens subcutaneous parasitism 
with 
the larva migrans phenomenon in the North Causasus area where 
epidemiological prerequisites are available for spread of 
dirofilariasis. 
The clinical picture, surgical intervention, and the diagnosis of the 
infection are presented. The parasite is defined by the authors as 
Dirofilaria repens. 

============================================================ 
18.) [Cutaneous larva migrans, autochthonous in France. Apropos of a 
case] 
[Larva migrans cutanee autochtone en France. A propos d'un cas.] 
============================================================ 
Ann Dermatol Venereol 1995;122(10):711-4   (ISSN: 0151-9638) 

Zimmermann R; Combemale P; Piens MA; Dupin M; Le Coz C [Find other 
articles 
with these Authors] 
Clinique de Dermatologie, Hopital d'Instruction des Armees Desgenettes, 
Lyon. 

INTRODUCTION: Cutaneous larva migrans is rarely contracted in temperate 
countries. CASE REPORT: When his house became flooded, he had to stand 
for 
a long period of time with mud up to the thigh. Some days later, he 
developed multiple erythematous, serpiginous pruritic tracts moving 1-2 
cm 
per day over preexisting lesions of the right leg. Local and systemic 
treatment with thiabendazole led to rapid and definitive cure. 
DISCUSSION: 
Cutaneous larva migrans results from the migration of hookworm larvae in 

the dead-end human host. It is mainly an imported disease and native 
cases 
in Europe as reported here are rare. This case demonstrates that the 
conditions leading to the development of cutaneous larva migrans are 
rarely 
found simultaneously in temperate zones. 

============================================================ 
19.) Cutaneous larva migrans in travelers: synopsis of histories, 
symptoms, 
and treatment of 98 patients. 
============================================================ 
Clin Infect Dis 1994 Dec;19(6):1062-6   (ISSN: 1058-4838) 

Jelinek T; Maiwald H; Nothdurft HD; Loscher T [Find other articles with 
these Authors] 
Department of Infectious Diseases and Tropical Medicine, University 
Hospital, University of Munich, Germany. 

The symptoms, medical history, and treatment of 98 patients with 
cutaneous 
larva migrans (creeping eruption) who attended a travel-related-disease 
clinic during a period of 4 years are reviewed. This condition is caused 
by 
skin-penetrating larvae of nematodes, mainly of the hookworm Ancylostoma 

braziliense and other nematodes of the family Ancylostomidae. Despite 
the 
ubiquitous distribution of these nematodes, in the investigated group 
only 
travelers to tropical and subtropical countries were affected; 28.9% of 
the 
patients had symptoms for > 1 month, and for 24.5% the probable 
incubation 
period was > 2 weeks. The efflorescences typically were on the lower 
extremities (73.4% of all locations). The buttocks and anogenital region 

were affected in 12.6% of all locations, and the trunk and upper 
extremities each were affected in 7.1%. Only a minority of patients 
presented with eosinophilia or an elevated serum level of IgE. No other 
laboratory data appeared to be related to the disease. Therapy with 
topical 
thiabendazole was successful for 98% of the patients. Systemic 
antihelmintic therapy was necessary in two cases because of 
disseminated, 
extensive infection. 

============================================================ 
20.) [Nematode larva migrans. On two cases of filarial infection] 
[Wandernde Nematodenlarven. Uber zwei Falle von Filarienbefall.] 
============================================================ 
Pathologe 1994 Jun;15(3):171-5   (ISSN: 0172-8113) 

Bittinger A; Barth P; Kohler HH [Find other articles with these Authors] 

Medizinisches Zentrum fur Pathologie der Philipps-Universitat Marburg. 

With rapid air travel, so-called parasitic infections are becoming more 
important in northern hemisphere and temperate climates. Parasitic 
disease 
is usually taken to imply infections caused by protozoa and helminths. 
The 
most important helminthic infections in man and with world-wide 
incidence 
are schistosomiasis, hookworm, and filariasis. We report the 
clinico-pathological findings of two patients with filarial infection of 

soft tissue and lymphatic nodes. 

============================================================ 
21.) Larva migrans that affect the mouth. 
============================================================ 
Oral Surg Oral Med Oral Pathol 1994 Apr;77(4):362-7   (ISSN: 0030-4220) 

Lopes MA; Zaia AA; de Almeida OP; Scully C [Find other articles with 
these 
Authors] 
Faculty of Odontology, University of Campinas, Sao Paulo, Brazil. 

As air travel expands, tropical diseases are increasingly likely to be 
encountered. We report a case of a nematode infection from dogs and cats 

that appeared in the mouth as larva migrans, and we review the 
literature. 

============================================================ 
22.) Immunological studies on human larval toxocarosis. 
============================================================ 
Cent Eur J Public Health 1996 Dec;4(4):242-5   (ISSN: 1210-7778) 

Uhlikova M; Hubner J; Kolarova L; Polackova M [Find other articles with 
these Authors] 
Postgraduate Medical School, Prague, Czech Republic. 

The aim of the study was to characterize the antiparasite humoral 
response 
in patients with the syndrome of visceral larval toxocarosis. Specific 
IgG, 
specific IgE and total IgE immunoglobulins against Toxocara canis 
excretory/secretory antigens (TES) were detected by using ELISA 
technique. 
Antibody response was studied in complete sera as well as in 
immunoglobulin 
fractions (IgG and IgE), isolation of which was performed on Protein A 
Sepharose. It was observed that removal of IgG from the serum samples 
resulted mostly in increasing levels of anti-Toxocara IgE antibodies 
what 
agrees with the theory of the blocking effect of IgG in the immune 
response. The results demonstrated a little correlation between slgG and 

slgE in the sera of symptomatic patients, examined in ELISA reaction. 

============================================================ 
23.) [Larva migrans] 
[Le larbish.] 
============================================================ 
Sante 1995 Nov-Dec;5(6):341-5   (ISSN: 1157-5999) 

Chabasse D; Le Clec'h C; de Gentile L; Verret JL [Find other articles 
with 
these Authors] 
Laboratoire de parasitologie-mycologie, Consultations des maladies 
parasitaires et tropicales, CHU, Angers, France. 

Larbish, cutaneous larva migrans or creeping eruption, is a serpiginous 
cutaneous eruption caused by skin penetration of infective larva from 
various animal nematodes. Hookworms (Ancylostoma brasiliense, A. 
caninum) 
are the most common causative parasites. They live in the intestines of 
dogs and cats where their ova are deposited in the animal feces. In 
sandy 
and shady soil, when temperature and moisture are elevated, the ova 
hatch 
and mature into infective larva. Infection occurs when humans have 
contact 
with the infected soil. Infective larva penetrate the exposed skin of 
the 
body, commonly around the feet, hands and buttocks. In humans, the larva 

are not able to complete their natural cycle and remain trapped in the 
upper dermis of the skin. The disease is widespread in tropical or 
subtropical regions, especially along the coast on sandy beaches. The 
diagnosis is easy for the patient who is returning from a tropical or 
subtropical climate and gives a history of beach exposure. The 
characteristic skin lesion is a fissure or erythematous cord which is 
displaced a few millimeters each day in a serpiginous track. Scabies, 
the 
larva currens syndrome due to Strongyloides stercoralis, must be 
distinguished from other creeping eruptions and subcutaneous swelling 
lesions caused by other nematodes or myiasis. Medical treatments are 
justified because it shortens the duration of the natural evolution of 
the 
disease. Topical tiabendazole is safe for localized invasions, but 
prolonged treatment may be necessary. Oral thiabendazole treatment for 
three days is effective, but sometimes is associated with adverse 
effects. 
Trials using albendazole for one or four consecutive days appear more 
efficacious. More recent trials using ivermectine showed that a single 
oral 
dose can cure 100% of the patients; thus, this drug looks very promising 
as 
a new form of therapy. Individual prophylaxis consists of avoiding skin 
contact with soil which has been contaminated with dog or cat feces. 
Keeping dogs and cats off the beaches is illusory in tropical countries. 

============================================================ 
24.) Effect of albendazole on Ancylostoma caninum larvae migrating in 
the 
muscles of mice. 
============================================================ 
Chung Kuo Chi Sheng Chung Hsueh Yu Chi Sheng Chung Ping Tsa Chih 
12;3(214-7Unknown Paragraph TypeS1000-7423Unknown Paragraph Type 

Xiao S; Ren H; You J; Zhao L; Li B; Zhang C [Find other articles with 
these 
Authors] 
Institute of Parasitic Diseases, Chinese Academy of Preventive Medicine 
(WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis), 
Shanghai. 

When mice inoculated with 1,000 third-stage larvae of Ancylostoma 
caninum 
for 1 week were treated intragastrically (ig) with albendazole (Alb) 75, 

150 or 300 mg/kg.d for 3 days, the mean larva numbers collected from the 

muscles of each group were 2.7 +/- 1.7, 2.0 +/- 1.5 and 1.0 +/- 1.0, 
respectively, being much less than that 205 +/- 68 of the control group. 
In 
mice treated ig with Alb 150 mg/kg.d for 3 days, the concentrations of 
Alb 
and its effective metabolite, albendazole sulfoxide (AlbSO), were 
determined in plasma and the muscles at different intervals after the 
last 
medication using high performance liquid chromatography. The results 
showed 
that only low concentrations of Alb were detected in both plasma and the 

muscles. However, higher concentrations of AlbSO were found not only in 
the 
plasma (5.4-10.5 micrograms/ml), but also in the muscles (2.2-4.6 
micrograms/g). The higher contents of AlbSO in the muscles would be 
helpful 
for killing the Ancylostoma larvae migrating in the muscles of mice. 

============================================================ 
25.) [Ocular manifestations of toxocariasis] 
============================================================ 
[Ocne prejavy toxokarozy.] 
Bratisl Lek Listy 1999 Mar;100(3):161-3   (ISSN: 0006-9248) 

Gerinec A; Slivkova D [Find other articles with these Authors] 
Pediatric Ophthalmology Dpt, Faculty of Medicine, Comenius University, 
Bratislava, Slovakia. 

The paper reports about the ocular symptomatology of toxocariasis that 
represents a severe parasitic disease especially in children. Recently, 
the 
incidence of this disease is increasing. Diagnostic process has improved 
by 
means of newly developed laboratory methods. Ocular findings on retina 
are 
in toxocariasis identified very late. Despite many antihelmintics, 
steroids 
and surgical treatment, a poor treatment success has been achieved, and 
the 
sight remains often permanently severely affected. Because of the risk 
of 
blindness the most efficient arrangement is prophylaxy from the side of 
parents, teachers, veterinarions and the society as a whole. (Fig. 3, 
Ref. 
6.). 

============================================================ 
26.) Toxocara infestations in humans: symptomatic course of toxocarosis 
correlates significantly with levels of IgE/anti-IgE immune complexes. 
============================================================ 
Parasite Immunol 1998 Jul;20(7):311-7   (ISSN: 0141-9838) 

Obwaller A; Jensen-Jarolim E; Auer H; Huber A; Kraft D; Aspock H [Find 
other articles with these Authors] 
Department of Medical Parasitology, University of Vienna, Austria. 

Infestations of humans with the parasitic nematode T. canis are common 
in 
both developing and industrialized countries. Most infestations induce a 

clinically inapparent course of infection, however, severe clinical 
manifestations, i.e. visceral larva migrans (VLM) or ocular larva 
migrans 
(OLM) syndromes are observed. To find an explanation for the different 
courses of toxocarosis we examined several serological parameters: the 
expression of (i) specific IgE (Immunoblot, IB), (ii) specific IgG 
subclasses (IgG1-4, ELISA and the formation of (iii) IgE/anti-IgE immune 

complexes. Serum samples were obtained from persons with symptomatic 
(VLM, 
OLM) and asymptomatic course (AS) of the infestation. As antigen, T. 
canis 
excretory/secretory (TES) antigen from L3 larvae was used. Reactivity of 

IgE against SDS-PAGE separated TES antigens was marginally higher in 
toxocarosis patients (35%) than in asymptomatics (24%), but without 
statistical significance. TES-specific IgG (1-4), predominant subclass 
in 
all three groups was IgG1, followed by IgG2, IgG4 and IgG3. Subclass 
IgG1, 
2, 4 showed significant differences between patients with VLM associated 

symptoms and asymptomatic persons (P < 0.001) but not between patients 
with 
OLM associated symptoms and asymptomatics. Significantly elevated levels 
of 
IgE/anti-IgE immune complexes were detected in sera of patients with 
symptomatic course of the disease, both VLM and OLM (P < 0.001). Whereas 

specific IgG may act via antibody dependent cell-mediated cytotoxicity 
mechanisms, IgE/anti-IgE immune complexes might possibly participate in 
VLM 
and OLM by inducing type III hypersensitivity. 

============================================================ 
27.) [Long-term observations of ocular toxocariasis in children and 
youth] 
[Odlegle obserwacje toksokarozy ocznej u dzieci i mlodziezy.] 
============================================================ 
Klin Oczna 1996;98(6):445-8   (ISSN: 0023-2157) 

Krukar-Baster K; Zygulska-Mach H; Sajak-Hydzik K; Kubicka-Trzaska A; 
Dymon 
M [Find other articles with these Authors] 
Katedry I Kliniki Okulistyki Collegium Medicum UJ w Krakowie. 

PURPOSE: To evaluate the clinical status and ELISA test changes in a 
group 
of children with ocular toxocariasis. METHODS: We enrolled 37 patients 
in 
the studies. The follow-up period lasted at least 3 years (3-15 years) 
after the diagnosis had been established. In all cases a complete 
ophthalmological examination and actual ELISA test were performed. We 
compared the clinical status in two groups of patients: one with 
positive 
and the other with negative ELISA test at the time of control 
examination. 
RESULTS: In a majority of initially positive serological patients the 
control ELISA test for Toxocara canis antigen was negative. In these 
cases 
various post-inflammatory lesions in the anterior and posterior pole of 
the 
eye were present. In 8 cases the ELISA test was positive, despite the 
absence of active inflammatory process. In 5 serologically positive 
patients the active inflammation was observed. In more than 50% of cases 

the visual acuity was decreased. CONCLUSION: Ocular toxocariasis is a 
long-lasting, severe type of uveitis that requires long treatment and 
causes dramatic visual impairment. ELISA test is a sensitive method 
indicating the intensity of inflammation in ocular toxocariasis. 

============================================================ 
28.) [A case of uveitis due to gnathostoma migration into the vitreous 
cavity] 
============================================================ 
Nippon Ganka Gakkai Zasshi 1994 Nov;98(11):1136-40   (ISSN: 0029-0203) 

Sasano K; Ando F; Nagasaka T; Kidokoro T; Kawamoto F [Find other 
articles 
with these Authors] 
Department of Ophthalmology, Nagoya National Hospital, Japan. 

We report a 26 year-old male patient who had floaters and hyperemia in 
his 
left eye following uveitis due to gnathostoma that had migrated into the 

vitreous cavity. Severe iridocyclitis and mild opacity of the vitreous 
body 
were observed, together with whitish-yellow subretinal tracks 
accompanied 
by dot and blot hemorrhages in the fundus. Slit lamp microscopic 
examination revealed a worm which writhed in the vitreous cavity. We 
performed vitrectomy to remove the worm from the anterior vitreous 
uneventfully, followed by prompt subsidence of the inflammatory signs. 
The 
worm was identified as a third instar larva of Gnathostoma doloresi. 
Eosinophilia and creeping eruption did not appear throughout the 
follow-up 
period. The patient was accustomed to eat live roaches and whitebait, as 

well as sliced raw beef liver. 

============================================================ 
29.) [The ocular form of toxocariasis] 
[Ocni forma larvalni toxokarozy.] 
============================================================ 
Cesk Oftalmol 1994 Jun;50(3):186-90   (ISSN: 0009-059X) 

Lobovska A; Zackova M [Find other articles with these Authors] 
III. klinika infekcnich a tropickych nemoci 1. LF UK, Praha. 

Ocular toxocariasis (ocular form of larval toxocariasis) arises mainly 
unilaterally and represents no rare disease. On 3rd Department of 
Infectology, 1st Faculty of Medicine, Charles University, Prague, 102 
patients with proved larval toxocariasis were treated from 1981 to 1990. 

Ocular toxocariasis concerned only one third of this number. Most 
frequent 
form was the retinal toxocaral granuloma (in 55.2%), positioned by two 
thirds at the posterior pole of retina. In one case, endophthalmitis led 
to 
amaurosis of the eye. Clinical forms typical for ocular toxocariasis are 

presented. No statistically significant difference was observed in 
treatment effects using thiobendazole or diethylcarbamazine. All 
patients 
with ocular toxocariasis were treated with systematic steroids. 

============================================================ 
30.) [Visceral larval migrans (Human toxocariasis) cause of 
hypereosinophilia and visceral granulomas in adults] 
[Larva migrante visceral (toxocariasis humana) causa de hipereosinofilia 
y 
granulomas viscerales en el adulto.] 
============================================================ 
Bol Chil Parasitol 1999 Jan-Jun;54(1-2):21-4   (ISSN: 0365-9402) 

Sapunar J; Fardella P [Find other articles with these Authors] 
Departamento de Medicina, Hospital Clinico, Universidad de Chile. 

A 24-year-old woman 2-3 months after a normal parturation presented 
geophagy. Due to hypermenorrhea she consulted a gynecologist and in a 
hemogram a 57% (6,893 x mm3) hypereosinophilia was detected. A chest TAC 

showed bilateral pulmonary nodules. The following tests resulted 
positive: 
ELISA IgG for toxocariasis 1:1000, isohemagglutinins anti A 1:2048 and 
anti 
B 1:512. The patient was treated with albendazole and prednisone during 
10 
days. One month after treatment eosinophilia decreased to 2.590 x mm3 
and 
ELISA IgG for toxocariasis descended to 1:128. Different aspects of 
human 
toxocariasis are commented. When hypereosinophia is observed in adult 
patients, toxocariasis must be checked. 

============================================================ 
31.) Visceral larva migrans syndrome complicated by liver abscess. 
============================================================ 
Scand J Infect Dis 1999;31(3):324-5   (ISSN: 0036-5548) 

Rayes A; Teixeira D; Nobre V; Serufo JC; Goncalves R; Valadares L; 
Lambertucci JR [Find other articles with these Authors] 
Department of Internal Medicine, Infectious Disease Branch, School of 
Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. 

We describe a case of visceral larva migrans syndrome complicated by 
liver 
abscess, pericardial effusion and ascites. To our knowledge, these 
findings 
have not been reported previously. The structural and immunological 
alterations caused by visceral larva migrans are thought to lead to the 
development of visceral abscesses. 

============================================================ 
32.) Visceral larva migrans and tropical pyomyositis: a case report. 
============================================================ 
Rev Inst Med Trop Sao Paulo 1998 Nov-Dec;40(6):383-5   (ISSN: 0036-4665) 

Lambertucci JR; Rayes A; Serufo JC; Teixeira DM; Gerspacher-Lara R; 
Nascimento E; Brasileiro Filho G; Silva AC [Find other articles with 
these 
Authors] 
Departamento de Clinica Medica, Faculdade de Medicina da UFMG, Belo 
Horizonte, MG, Brazil. lamber@net.em.com.br. 

We report a case of tropical pyomyositis in a boy who presented with a 
severe febrile illness associated with diffuse erythema, and swelling in 

many areas of the body which revealed on operation extensive necrotic 
areas 
of various muscles that required repeated debridement. The patient gave 
a 
history of contact with dogs, and an ELISA test for Toxocara canis was 
positive. He also presented eosinophilia and high serum IgE levels. 
Staphylococcus aureus was the sole bacteria isolated from the muscles 
affected. We suggest that tropical pyomyositis may be caused by the 
presence of migrating larvae of this or other parasites in the muscles. 
The 
immunologic and structural alterations caused by the larvae, in the 
presence of concomitant bacteremia, would favour seeding of the bacteria 

and the development of pyomyositis. 

============================================================ 
33.) [2 cases of toxocariasis (visceral larva migrans)] 
[Dos casos de toxocarosis (larva migrans visceral).] 
============================================================ 
Enferm Infecc Microbiol Clin 1996 Nov;14(9):548-50   (ISSN: 0213-005X) 

Lopez-Velez R; Turrientes MC; Malo Q; Fenoy MS; Guillen JL [Find other 
articles with these Authors] 
Unidad de Medicina Tropical y Parasitologia Clinica, Hospital Ramon y 
Cajal, Madrid. 

BACKGROUND: Different epidemiological studies have demonstrated that 
specific anti-Toxocara antibodies are detected in the serum of a high 
percentage of the Spanish population. But very few clinical cases of 
visceral larva migrans are being confirmed. METHODS AND RESULTS: Two 
cases 
of visceral toxocarosis, in two sisters, are described. In the first, 
the 
prevailing clinic was swelling of joints and upper respiratory tract 
symptoms; and asthma and cutaneous allergic manifestations in the second 

patient. Both cases presented with an elevated blood eosinophil count, 
high 
levels of total IgE and high titlers of anti-Toxocara antibodies. All 
symptoms disappeared after treatment with diethylcarbamazine and they 
remain asymptomatic several months after. CONCLUSIONS: In pediatric 
population, toxocarosis should be ruled out in every patient with 
respiratory symptoms, allergic cutaneous manifestations and elevated 
blood 
eosinophil count. The anti-Toxocara antibodies assay is of great value 
in 
establishing the diagnosis of this parasitic disease. 

============================================================ 
34.) [Visceral larva migrans. A rare cause of eosinophilia in adults] 
[Visceral larva migrans. En sjelden arsak til eosinofili hos voksne.] 
============================================================ 
Tidsskr Nor Laegeforen 1996 Sep 20;116(22):2660-1   (ISSN: 0029-2001) 

Lund-Tonnesen S [Find other articles with this Author] 
Infeksjonsseksjonen Medisinsk avdeling, Haukeland Sykehus 5021, Bergen. 

Toxocariasis is a cosmopolitan infection of dogs and cats with a 
roundworm 
resembling Ascaris. Man becomes infected by ingesting eggs from the 
environment. The infection occurs mainly in children. There are two 
distinct syndromes: visceral larva migrans and ocular toxocariasis. The 
author describes the case of a 70 year old Norwegian female with 
visceral 
larva migrans. One month after a visit to Spain she developed fever, 
hepatomegaly and marked eosinophilia. Liver biopsy revealed subacute 
hepatitis with eosinophilic leucocyte infiltration. Toxocara ELISA was 
strongly positive. Treatment with albendazol 400 mg b.i.d. and 
prednisone 
10 mg daily for three weeks was successful. A clinical relapse after 
three 
months was treated in the same way for one month. Prolonged treatment is 

recommended. To our knowledge, this is the first reported case of 
visceral 
larva migrans in an adult Norwegian. Epidemiology, diagnosis and 
treatment 
are discussed. 

============================================================ 
35.) [Visceral larva migrans: a mixed form of presentation in an adult. 
The 
clinical and laboratory aspects] 
[Larva migrans visceral: forma mista de apresentacao em adulto. Aspectos 

clinicos e laboratoriais.] 
============================================================ 
Rev Soc Bras Med Trop 1996 Jul-Aug;29(4):373-6   (ISSN: 0037-8682) 

Barra LA; dos Santos WF; Chieffi PP; Bedaque EA; Salles PS; Capitao CG; 
Vianna S; Hanna R; Pedretti Junior L [Find other articles with these 
Authors] 
Instituto de Infectologia Emilio Ribas, Instituto de Medicina Tropical 
de 
Sao Paulo, Brasil. 

We relate a case of an 18-year-old man, resident of Xapuri (state of 
Acre, 
Brazil), with a history of repeated episodes of meningoencephalitis 
(three 
in one year), each one was examined by a local doctor. In our service 
(Emilio Ribas Institute of Infectology) we observed a patient with 
polyjoint aches, radiological and bronchoscopic pulmonary alterations 
(without clinical features), meningeal and brain stem 
manifestations--with 
normal brain computed tomography and cerebrospinal fluid. Blood 
eosinophils 
and serological Toxocara canis test (ELISA) were greatly increased. With 

the hypothesis of Toxocariasis (visceral larva migrans) we administered 
thiabendazole that brought complete clinical and laboratory remission. 
Inspite of a new episode of headache with meningeal manifestation 
approximately one month later (treated with dexamethasone resulting in a 

full remission after three days) we have not found other manifestations 
in 
approximately three and a half years of ambulatory care. 

============================================================ 
36.) Visceral larva migrans induced eosinophilic cardiac pseudotumor: a 
cause of sudden death in a child. 
============================================================ 
J Forensic Sci 1995 Nov;40(6):1097-9   (ISSN: 0022-1198) 

Boschetti A; Kasznica J [Find other articles with these Authors] 
Medical Examiner for Suffolk County, Commonwealth of Massachusetts, 
Boston, 
USA. 

A case of fatal cardiac larva migrans in a 10-year-old boy is described. 

The autopsy findings were quite dramatic, with a bosselated, sessile 
polypoid mass involving the left ventricular myocardium and protruding 
into 
the ventricular lumen. The precise morphologic characterization of the 
zoonotic ascarid larva was impaired by advanced resorption of the larva 
by 
an inflammatory infiltrate. Nonetheless, morphometry of the larval 
remnants 
strongly suggested the raccoon ascarid, Baylisascaris procyonis, as the 
causative agent. 

============================================================ 
37.) [Toxocariasis. A cosmopolitan parasitic zoonosis] 
[La toxocarose une zoonose parasitaire cosmopolite.] 
============================================================ 
Allerg Immunol (Paris) 1995 Oct;27(8):284-91   (ISSN: 0397-9148) 

Humbert P; Buchet S; Barde T [Find other articles with these Authors] 
Service Dermatologie, CHU Saint-Jacques, Besancon. 

The infection by Toxocara canis transmitted by dogs (30% of them are 
infected in our countries) and less frequently by cats lead to larva 
migrans visceral syndrome with neurological manifestations, 
ophtalmological 
affection and various cutaneous manifestations observed in 24% of the 
extra-ocular infections: chronic urticaria often associated with 
asthmatic 
manifestations and chronic rhinitis, angio-oedema or local oedema 
reaching 
particularly the eyclid, chronic pruritus associated with lesions due to 

scratching or to nodular prurigo. An hypereosinophilia is an argument in 

favour of a progressive infection. High total IgE is an hallmark of 
visceral infections by parasites and total IgE level is well correlated 
with the presence of intra-tissular larva. The serological diagnosis is 
based on the determination of specific IgG by ELISA which appears also 
to 
be interesting for the patient's follow up. The western blot method 
seems 
to be more specific than the other methods and so is useful to confirm a 

diagnosis. The treatment given as early as possible is based on the use 
of 
diethylcarbamazine but also of thiabendazole, albendazole and 
mebendazole. 
Prophylaxis of toxocara infection includes the prohibition of dog access 
to 
children games areas but also a frequent turn over of the sand in public 

parks. 

============================================================ 
38.) Visceral larva migrans mimicking rheumatic diseases. 
============================================================ 
J Rheumatol 1995 Mar;22(3):497-500   (ISSN: 0315-162X) 

Kraus A; Valencia X; Cabral AR; de la Vega G [Find other articles with 
these Authors] 
Department of Immunology and Rheumatology, Instituto Nacional de la 
Nutricion Salvador Zubiran, Mexico City, Mexico. 

OBJECTIVE. To report rheumatologic or rheumatologic-like manifestations 
of 
the visceral larva migrans (VLM) syndrome. METHODS. We carried out a 
prospective study of patients with VLM seen in a private practice 
setting 
in Mexico City between 1990 and 1993. RESULTS. From a population of 600 
patients we identified 6 patients (5 women) with VLM. Three patients 
complained of arthralgia; in 4 a history of migratory cutaneous lesions 
was 
elicited, and in one monoarthritis of the right knee was found. One 
patient 
had deep edema that suggested thrombophlebitis of the right arm; the man 
in 
our series had right testicular swelling during followup. In 2 cases, 
panniculitis was documented by biopsy and in one, small vessel 
vasculitis. 
Four patients had frequent contact with dogs and one with cats; 4 
patients 
frequently ate raw fish. The diagnosis of VLM was confirmed either by 
the 
clinical picture, biopsy, or ELISA. CONCLUSION. The spectrum of 
rheumatological manifestations in VLM may be wider than previously 
thought. 

============================================================ 
39.) Hepatic granulomas due to visceral larva migrans in adults: 
appearance 
on US and MRI. 
============================================================ 
Abdom Imaging 1994 May-Jun;19(3):253-6   (ISSN: 0942-8925) 

Jain R; Sawhney S; Bhargava DK; Panda SK; Berry M [Find other articles 
with 
these Authors] 
Department of Radio-diagnosis, All India Institute of Medical Sciences, 
Ansari Nagar, New Delhi. 

Visceral larva migrans is a syndrome characteristically involving 
children 
with a history of pica, and usually presents with fever, abdominal pain, 

tender hepatomegaly, and hypereosinophilia. Hepatic granulomas of 
visceral 
larva migrans are rare in adults. We describe three adult patients with 
hepatic lesions which on histopathology demonstrated characteristic 
granulomas of visceral larva migrans. All patients had abdominal 
sonograms 
and two had additional MR scans of the liver. Both ultrasound and 
magnetic 
resonance imaging demonstrated characteristic appearances which have not 

been described previously (viz., ill-defined central necrotic areas 
surrounded by concentric thick walls and perifocal edema in the liver 
parenchyma). 

============================================================ 
40.) [Ascaridiasis zoonoses: visceral larva migrans syndromes] 
[Zoonoses d'origine ascaridienne: les syndromes de Larva migrans 
visceral.] 
============================================================ 
Bull Acad Natl Med 1994 Apr;178(4):635-45; discussion 645-7   (ISSN: 
0001-4079) 

Petithory JC; Beddok A; Quedoc M [Find other articles with these 
Authors] 
Department de biologie medicale E. Brumpt Centre Hospitalier, Gonesse. 

The syndrome of Visceral Larva Migrans is a zoonotic disease due to the 
migration in human of nematodes larval, specially ascarid. Since the 
larvae 
fail to complete their migrating cycle in humans, the diagnosis of 
Toxocariasis infection remains only serologic. We have been able to 
demonstrate by the technique of agar diffusion and the Western-blotting 
method that the etiology due to Toxocara canis was twice as much 
frequent 
as the one due to Toxocara cati in the syndrome of Visceral and Ocular 
Larva Migrans. The use of numerous antigens from adult nematodes, mainly 

Ascaris suum, has shown, than in France, in the syndrome of VLM at least 

12% of the cases were certainly due to other nematodes. Nippostrongylus 
brasiliensis (or another similar nematode) of the rat might be 
responsible. 
The existence of numerous clinical and biological cases found negative 
in 
serology, allow us to suggest that some other larval nematodes, may be 
from 
wild animals, might play an etiological role. 

============================================================ 
41.) Hepatic visceral larva migrans: evolution of the lesion, diagnosis, 

and role of high-dose albendazole therapy. 
============================================================ 
Am J Gastroenterol 1994 Apr;89(4):624-7   (ISSN: 0002-9270) 

Bhatia V; Sarin SK [Find other articles with these Authors] 
Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India. 

An unusual presentation of hepatic involvement of visceral larva migrans 
is 
described. A 45-yr-old male presented with fever, pain in the right 
upper 
quadrant, and persistent eosinophilia. Ultrasound initially detected a 
solitary hypoechoic area in the right lobe of the liver which rapidly 
progressed to multiple lesions with peripheral hyperechoic lesions. 
Aspiration from the lesion revealed Charcot-Leyden crystals and sheets 
of 
eosinophils. Serology for Toxocara canis was strongly positive. 
Prolonged 
and high-dose albendazole therapy, in combination with antibiotics, was 
required to treat the patient effectively. 

============================================================ 
42.) Neuroimaging studies of cerebral "visceral larva migrans" syndrome. 

============================================================ 
J Neuroimaging 1994 Jan;4(1):39-40   (ISSN: 1051-2284) 

Zachariah SB; Zachariah B; Varghese R [Find other articles with these 
Authors] 
Department of Neurology, University of South Florida College of 
Medicine, 
H. Lee Moffitt Cancer Center, Tampa, FL. 

"Visceral larva migrans" syndrome is a zoonotic disease caused by the 
migration or presence in human tissue of nematode larva from lower-order 

animals. This syndrome includes generalized illness, eosinophilia, and 
symptoms arising from larval invasions of different organs including the 

liver, lungs, eyes, and central nervous system. There has been only one 
case report of the computed tomographic (CT) and magnetic resonance 
imaging 
(MRI) appearances of cerebral toxocaral disease. Described here is a 
patient with cerebral toxocaral disease with a high eosinophil count and 

toxocaral titer in the serum and abnormal CT and MRI findings who had 
spontaneous recovery of the clinical symptoms. 

============================================================ 
43.)[Acute eosinophilic pneumonia and the larva migrans syndrome: 
apropos 
of a case in an adult] 
[Pneumopathie eosinophilique aigue et syndrome de Larva migrans. A 
propos 
d'un cas chez un adulte.] 
============================================================ 
Rev Mal Respir 1994;11(6):593-5   (ISSN: 0761-8425) 

Bouchard O; Arbib F; Paramelle B; Brambilla C [Find other articles with 
these Authors] 
Clinique de Pneumologie, CHU de Grenoble. 

Toxocariasis is a frequent disease in children, but the severe clinical 
manifestations are rare in the literature (diffuse interstitial 
pneumonia 
with hypoxaemia and acute severe asthma). The diagnosis is made thanks 
to 
the reliability of serological techniques (the ELISA test and using 
antigen 
excretion-secretion tests of the larvae of Toxocara canis). The authors 
report a case of acute severe eosinophilic pneumonia whose outcome was 
rapidly favourable following steroid therapy; the existence of positive 
Toxocara canis serology with a contamination risk of the patient in the 
domestic environment leads us to integrate the clinical picture into the 

larva migrans syndrome. 

============================================================ 
44.)Toxocariasis simulating hepatic recurrence in a patient with Wilms' 
tumor. 
============================================================ 
Med Pediatr Oncol 1994;22(3):211-5   (ISSN: 0098-1532) 

Almeida MT; Ribeiro RC; Kauffman WM; Maluf Junior PT; Brito JL; 
Cristofani 
LM; Jacob CA; Odone-Filho V [Find other articles with these Authors] 
Instituto da Crianca, Hospital das Clinicas, Universidade Estadual de 
Sao 
Paulo, Brazil. 

We report the case of a 3-year-old girl with stage I Wilms' tumor of 
favorable histology. During the course of chemotherapy 5 months 
post-diagnosis, an abdominal ultrasonogram revealed hypoechoic areas 
consistent with hepatic tumor recurrence. A liver biopsy performed to 
rule 
out recurrence of the malignancy was suggestive of toxocariasis and the 
diagnosis was confirmed by serologic testing. Although the patient had 
few 
classic signs of visceral larva migrans, her eosinophilia and family 
social 
history should have suggested this possibility. This case demonstrates 
that 
hepatic toxocariasis should be considered in evaluating hepatic 
hypoechoic 
lesions in a child, even when features typical of the disease are 
absent. 

============================================================ 
45.) Hepatic imaging studies on patients with visceral larva migrans due 
to 
probable Ascaris suum infection. 
============================================================ 
Abdom Imaging 1999 Sep-Oct;24(5):465-9   (ISSN: 0942-8925) 

Hayashi K; Tahara H; Yamashita K; Kuroki K; Matsushita R; Yamamoto S; 
Hori 
T; Hirono S; Nawa Y; Tsubouchi H [Find other articles with these 
Authors] 
Department of Internal Medicine II, Miyazaki Medical College, Kiyotake, 
Miyazaki 889-1692, Japan. 

Visceral larva migrans (VLM) is a disease usually observed in children 
in 
which the larvae of animal parasites invade and reside in human tissues 
for 
long periods. Although the common causal species of VLM are Toxocara 
canis 
and T. cati, we identified three adult patients with VLM, probably due 
to 
Ascaris suum, whose diagnosis was made by specific immunoserological 
tests. 
The patients complained of respiratory symptoms, and laboratory tests 
showed pronounced eosinophilia, but neither larvae nor eggs were 
detected 
in stool samples. We present the findings of various imaging studies of 
the 
patients. Multiple small hypoechoic mass lesions were demonstrated by 
ultrasound tomography, which disappeared after anti-helminthic therapy. 
Hepatic mass lesions were detected as low-density areas on computed 
tomography, as high signal intensities on T2-weighted magnetic resonance 

images, as space-occupying regions in liver scintigraphy, and as 
yellow-white nodules in laparoscopy. Although biopsied liver tissue 
specimens showed marked infiltrations of eosinophiles in the portal 
tracts 
and hepatic sinusoids, neither larvae nor eggs could be identified. 

============================================================ 
46.) Encephalopathy caused by visceral larva migrans due to Ascaris 
suum. 
============================================================ 
J Neurol Sci 1999 Apr 1;164(2):195-9   (ISSN: 0022-510X) 

Inatomi Y; Murakami T; Tokunaga M; Ishiwata K; Nawa Y; Uchino M [Find 
other 
articles with these Authors] 
Department of Neurology, Kumamoto University School of Medicine, Japan. 

We described a patient with encephalopathy associated with visceral 
larva 
migrans (VLM) caused by Ascaris suum. He suffered from drowsiness, 
quadriparesis, eosinophilia and elevated serum IgE levels. Brain 
magnetic 
resonance (MR) imaging revealed multiple cerebral cortical and white 
matter 
lesions. Serological tests indicated recent infection with A. suum. 
Pulse 
steroid therapy relieved the patient's central nervous system symptoms 
and 
marked improvement of lesions on brain MR images. We concluded that the 
encephalopathy in this patient was probably caused by VLM due to Ascaris 

suum. 

============================================================ 
47.) [Imported skin diseases (see comments)] 
[Importhuidziekten.] 
============================================================ 
Ned Tijdschr Geneeskd 1998 Dec 12;142(50):2746-50   (ISSN: 0028-2162) 

Cairo I; Faber WR [Find other articles with these Authors] 
Afd. Huidziekten, Academisch Medisch Centrum/Universiteit van Amsterdam. 

In two Dutch subjects who had been on holiday in the tropics, a woman 
aged 
32 and a man of Surinam descent aged 52 years, and in two men aged 21 
and 
38 years who had arrived from the tropics in the Netherlands, one 
recently 
and one 15 years previously, import skin diseases were diagnosed: larva 
migrans cutanea, cutaneous leishmaniasis, mycetoma and lobomycosis. The 
diagnosis was based on the anamnesis, the clinical picture and 
histopathological findings. The patients were cured by administration of 

antimicrobial agents and (or) excision. When travellers or immigrants 
from 
the tropics present with skin lesions, an imported skin disease should 
be 
considered. 

============================================================ 
48.) [Incidence of Toxocara ova--especially ova of visceral larva 
migrans 
in beach sand of Warnemunde in 1997] 
[Studie zum Vorkommen von Wurmeiern--insbesondere von Eiern des 
Hundespulwurmes (Larva migrans visceralis-Syndrom) im Strandsand von 
Warnemunde 1997.] 
============================================================ 
Gesundheitswesen 1998 Dec;60(12):766-7   (ISSN: 0941-3790) 

Schottler G [Find other articles with this Author] 
Landeshygieneinstitut Rostock. 

Beach sand was examined and analysed in 1997 at several locations in 
Warnemunde, a North-East German seaside resort, especially for the 
incidence of the nematode genuo Toxocara. Two of 126 samples contained 
Toxocara. The author points out measures to decrease the risk of 
infection. 

============================================================ 
49.) Pets and Parasites. 
============================================================ 
AU: Juckett-G 
AD: West Virginia University School of Medicine, Morgantown, USA. 
SO: Am-Fam-Physician. 1997 Nov 1; 56(7): 1763-74, 1777-8 
CP: UNITED-STATES 
AB: Which parasites can be transmitted by household cats and dogs? 
Certainly a variety of potentially dangerous helminths and protozoa can 
be 
transmitted to humans from pets but, for the most part, very special 
conditions must be present before this occurs. Small children, pregnant 
women and immunocompromised persons are three groups at greater 
potential 
risk than the general population. Infants and toddlers may contract 
visceral or cutaneous larva migrans, tapeworm infections and, rarely, 
other 
helminths or protozoa. Pregnant women and their offspring are at special 

risk for toxoplasmosis. Immunocompromised persons (including those with 
acquired immunodeficiency syndrome) are susceptible to multiple 
infections 
but especially to cryptosporidiosis, an underdiagnosed zoonosis present 
in 
contaminated water supplies. Other zoonotic infections (Echinococcosis, 
Dirofilariasis) rarely appear in the general population but, when they 
do 
occur, pose very real diagnostic challenges. The risk of disease 
transmission from pets can be minimized by taking a few simple 
precautions 
such as avoiding fecal-oral contact, not emptying the cat's litterbox if 

pregnant, washing hands carefully after handling pets, worming pets 
regularly and supervising toddler-pet interactions. In most cases, the 
psychologic benefits of pet ownership appear to outweigh the reducible 
risks of disease transmission. 

============================================================ 
50.) Cutaneous larva migrans in travelers: synopsis of histories, 
symptoms, 
and treatment of 98 patients. 
============================================================ 
SO  - Clin Infect Dis  1994 Dec;19(6):1062-6 
AU  - Jelinek T; Maiwald H; Nothdurft HD; Loscher T 
PT  - JOURNAL ARTICLE 
AB  - The symptoms, medical history, and treatment of 98 patients with 
cutaneous larva migrans (creeping eruption) who attended a 
travel-related-disease clinic during a period of 4 years are reviewed. 
This 
condition is caused by skin-penetrating larvae of nematodes, mainly of 
the 
hookworm Ancylostoma braziliense and other nematodes of the family 
Ancylostomidae. Despite the ubiquitous distribution of these nematodes, 
in 
the investigated group only travelers to tropical and subtropical 
countries 
were affected; 28.9% of the patients had symptoms for 1 month, and for 
24.5% the probable incubation period was 2 weeks. The efflorescences 
typically were on the lower extremities (73.4% of all locations). The 
buttocks and anogenital region were affected in 12.6% of all locations, 
and 
the trunk and upper extremities each were affected in 7.1%. Only a 
minority 
of patients presented with eosinophilia or an elevated serum level of 
IgE. 
No other laboratory data appeared to be related to the disease. Therapy 
with topical thiabendazole was successful for 98% of the patients. 
Systemic 
antihelmintic therapy was necessary in two cases because of 
disseminated, 
extensive infection. 

============================================================ 
51.) Cutaneous larva migrans. 
============================================================ 
SO  - South Med J  1993 Nov;86(11):1311-3 
AU  - Jones WB 2d 
PT  - JOURNAL ARTICLE 
AB  - The case of cutaneous larva migrans presented here is typical for 
its 
mechanism and geographic location of infection, evolution of lesions, 
and 
prompt response to treatment. Except for pinworms, helminth infections 
are 
rarely thought of in emergency departments away from the areas where the 

parasites are especially prevalent. The several-day incubation period 
and 
modern-day ease of travel should place this illness on one's list of the 

differential diagnoses of pruritic lesions regardless of the location of 

practice. This case serves as a reminder that in a mobile society, 
diseases, as well as patients, can travel. 

============================================================ 
52.)[Current therapeutic possibilities in cutaneous larva migrans] 
============================================================ 
SO  - Hautarzt  1993 Jul;44(7):462-5 
AU  - Wolf P; Ochsendorf FR; Milbradt R 
PT  - JOURNAL ARTICLE; REVIEW (24 references); REVIEW, TUTORIAL 
AB  - The recommendations for the treatment of cutaneous larva migrans 
are 
not uniform, and the recommended methods are neither always available 
nor 
always effective. If only the skin is affected, primarily topical 
therapy 
is indicated. Topical thiabendazole combines efficacy with missing 
systemic 
side-effects. In Germany the pure substance has to be used or Mintezol 
tablets must be purchased from abroad. Topical mebendazole and freezing 
with liquid nitrogen are less effective and involve side-effects. If 
topical treatment fails, systemic therapy is required. The recognized 
treatment with oral thiabendazole (2 days) is associated with numerous 
side-effects. There are now two new, safer drugs that should be 
preferred: 
albendazole (400 mg/day for 3 days), available in Germany as Eskazole, 
or 
ivermectin (single dose of 200 micrograms/kg). The latter can be ordered 

from the manufacturer under the trade name of Mectizan. 

============================================================ 
53.) Cutaneous larva migrans due to Pelodera strongyloides. 
============================================================ 
SO  - Cutis  1991 Aug;48(2):123-6 
AU  - Jones CC; Rosen T; Greenberg C 
PT  - JOURNAL ARTICLE 
AB  - A twenty-year-old landscape worker was evaluated for a widespread 
cutaneous eruption consisting of papules, pustules, and burrows. 
Cutaneous 
scrapings revealed live and dead larvae of a free-living soil nematode, 
Pelodera strongyloides. This is the third instance of human dermatitis 
due 
to this organism, and the first reported in an adult host. 

============================================================ 
54.) Oral albendazole for the treatment of cutaneous larva migrans. 
============================================================ 
SO  - Br J Dermatol  1990 Jan;122(1):99-101 
AU  - Jones SK; Reynolds NJ; Oliwiecki S; Harman RR 
PT  - JOURNAL ARTICLE 
AB  - Cutaneous larva migrans is becoming more common in the U.K. with 
the 
popularity of tropical countries as holiday destinations. We describe 
the 
increasing use of a new benzimidazole derivative, albendazole, which is 
very effective in the treatment of cutaneous larva migrans. In contrast 
to 
thiabendazole, it is virtually free from side-effects and should, we 
feel, 
become the treatment of choice for this condition. 

============================================================ 
55.) Cutaneous larva migrans in northern climates. A souvenir of your 
dream 
vacation. 
============================================================ 
SO  - J Am Acad Dermatol  1982 Sep;7(3):353-8 
AU  - Edelglass JW; Douglass MC; Stiefler R; Tessler M 
PT  - JOURNAL ARTICLE 
AB  - Three young women recently returned to the metropolitan Detroit 
area 
with cutaneous larva migrans. All three had vacationed at a popular club 

resort on the Caribbean island of Martinique. Cutaneous larva migrans is 

frequently seen in the southern United States, Central and South 
America, 
and other subtropical areas but rarely in northern climates. Several 
organisms can cause cutaneous larva migrans, or creeping eruption. The 
larvae of the nematode Ancylostoma braziliense are most often the 
causative 
organisms. Travel habits of Americans make it necessary for 
practitioners 
in northern climates to be familiar with diseases contracted primarily 
in 
warmer locations. The life cycle of causative organisms and current 
therapy 
are reviewed. 

============================================================ 
56.) Creeping eruption. A review of clinical presentation and management 
of 
60 cases presenting to a tropical disease unit. 
============================================================ 
SO  - Arch Dermatol  1993 May;129(5):588-91 
AU  - Davies HD; Sakuls P; Keystone JS 
PT  - JOURNAL ARTICLE 
AB  - BACKGROUND AND DESIGN--Cutaneous larva migrans is an infection 
with a 
larval nematode, most frequently by dog or cat hookworms. It has a 
characteristic presentation that is easily recognizable. We reviewed the 

charts of 60 patients with cutaneous larva migrans who presented to the 
Tropical Disease Unit, Toronto (Ontario) Hospital, during a 6-year 
period. 
RESULTS--Ninety-five percent of the patients were Canadians who had 
recently returned from the tropics or subtropics, notably the Caribbean. 

Almost all patients had a linear or serpiginous, very pruritic larval 
track. Topical thiabendazole was efficacious in 52 (98%) of 53 patients 
treated. Albendazole cured six (88%) of seven patients treated. Because 
of 
adverse effects, oral thiabendazole and liquid nitrogen were not 
utilized. 
CONCLUSION--We conclude that topical thiabendazole and oral albendazole 
are 
very effective and safe modalities for the treatment of cutaneous larva 
migrans. 

============================================================ 
57.) Dermatoses associated with travel to tropical countries: a 
prospective 
study of the diagnosis and management of 269 patients presenting to a 
tropical disease unit. 
============================================================ 
SO  - Clin Infect Dis  1995 Mar;20(3):542-8 
AU  - Caumes E; Carriere J; Guermonprez G; Bricaire F; Danis M; 
Gentilini M 
PT  - JOURNAL ARTICLE 
AB  - The full spectrum of skin diseases related to travel in tropical 
areas is unknown. We prospectively studied 269 consecutive patients with 

travel-associated dermatosis who presented to our tropical disease unit 
in 
Paris during a 2-year period. The median age of these patients was 30 
years; 137 patients were male; 76% of the patients were tourists; 38% 
had 
visited sub-Saharan Africa; and 85% had been appropriately vaccinated 
against tetanus. Cutaneous lesions appeared while the patient was still 
abroad in 61% of cases and after the patient's return to France in 39%. 
The 
diagnosis was definite in 260 cases; 137 of these cases (53%) involved 
an 
imported tropical disease. The most common diagnoses were cutaneous 
larva 
migrans (25%); pyodermas (18%); pruritic arthropod-reactive dermatitis 
(10%); myiasis (9%); tungiasis (6%); urticaria (5%); fever and rash 
(4%); 
and cutaneous leishmaniasis (3%). Hospitalization was necessary in 27 
cases 
(10%), with a median duration of 5 days (range, 2-21 days). Travelers 
should be advised on how to avoid exposure to the agents and vectors of 
infectious dermatoses. Travel first-aid kits should include insect 
repellents and antibiotics effective against bacterial skin infections. 

============================================================ 
58.) Larva currens and systemic disease. 
============================================================ 
SO  - Int J Dermatol  1984 Jul-Aug;23(6):402-3 
AU  - Amer M; Attia M; Ramadan AS; Matout K 
PT  - JOURNAL ARTICLE 
AB  - Of 26 patients infested with Strongyloides stercoralis 10 (38.5%) 
were asymptomatic without systemic or cutaneous signs. Nine patients 
(34.6%) presented with systemic complaints only and seven patients 
(26.9%) 
had systemic and cutaneous manifestations. Further observations of the 
skin 
lesions on four of those with systemic and cutaneous manifestations 
revealed linear urticarial bands, extending to several centimeters 
within 1 
hour and persisting up to many days, waiting and waning. Blood 
examination 
showed eosinophilia in all patients. These findings confirm the concept 
that larva currens even alone should be considered a cutaneous sign of 
systemic disease. 

============================================================ 
59.) Hookworm folliculitis. 
============================================================ 
SO  - Arch Dermatol  1991 Apr;127(4):547-9 
AU  - Miller AC; Walker J; Jaworski R; de Launey W; Paver R 
PT  - JOURNAL ARTICLE 
AB  - A case of persistent folliculitis in a 21-year-old man was 
demonstrated to be due to Ancylostoma caninum larvae. Treatment with 
oral 
thiabendazole was curative. Cutaneous larva migrans may be due to A 
caninum, but this presentation appears to be unique. The literature 
concerning etiology and pathogenesis of larva migrans is discussed with 
reference to this case. 

============================================================ 
60.) [Prurigo and further diagnostically significant skin symptoms in 
strongyloidosis] 
============================================================ 
SO  - Hautarzt  1988 Jan;39(1):34-7 
AU  - Bockers M; Bork K 
PT  - JOURNAL ARTICLE 
AB  - An increasing incidence of strongyloidosis must be expected in 
European countries as a result of the increasing numbers of immigrants, 
as 
well as holiday-makers returning from tropical regions. In addition to 
gastrointestinal symptoms, dermatological complaints are predominant. 
Only 
rarely are cutaneous symptoms the only clinical manifestation of 
disease. 
The penetration of filariform larvae may cause "ground itch." In cases 
of 
chronic disease, larva currens is the most obvious sign and consists of 
linear urticarial wheals evoked by larva migration. The most common 
non-specific symptoms are rashes, pruritus and urticaria. A further 
symptom 
of strongyloidosis, intensely itching prurigo, is described in a 
20-year-old female Thai. Remission was achieved following tiabendazole 
therapy. 

============================================================ 
61.) Gnathostomiasis, or larva migrans profundus. 
============================================================ 
SO  - J Am Acad Dermatol  1984 Oct;11(4 Pt 2):738-40 
AU  - Feinstein RJ; Rodriguez-Valdes J 
PT  - JOURNAL ARTICLE 
AB  - Gnathostomiasis, or larva migrans profundus, is a significant 
cause 
of morbidity in many parts of the world, especially the Far East. Over 
forty cases have recently been reported from South America, and some of 
those patients are seeking diagnostic evaluation and treatment in the 
United States. A clinical course of painless migratory recurrent 
urticarial 
skin lesions in a patient who has eaten raw or poorly cooked freshwater 
fish should alert a physician to the diagnosis of gnathostomiasis. 

============================================================ 
62.) Visceral larva migrans caused by Trichuris vulpis. 
============================================================ 
SO  - Arch Dis Child  1980 Aug;55(8):631-3 
AU  - Sakano T; Hamamoto K; Kobayashi Y; Sakata Y; Tsuji M; Usui T 
PT  - JOURNAL ARTICLE 
AB  - Two brothers with visceral larva migrans caused by Trichuris 
vulpis 
were diagnosed after they had been investigated for an eosinophilia. 
Both 
patients were almost asymptomatic. The diagnosis of visceral larva 
migrans 
was based on the results of immunoelectrophoretic studies and no liver 
biopsy was performed. After administration of thiabendazole, the number 
of 
eosinophils and serum total IgE levels gradually decreased, and the 
patients have remained well. 

============================================================ 
63.) Creeping disease due to larva of spiruroid nematoda. 
============================================================ 
SO  - Int J Dermatol  1993 Nov;32(11):813-4 
AU  - Okazaki A; Ida T; Muramatsu T; Shirai T; Nishiyama T; Araki T 
PT  - JOURNAL ARTICLE 
============================================================ 
============================================================ 
64.) Creeping eruption due to larvae of the suborder Spirurina--a newly 
recognized causative parasite. 
============================================================ 
SO  - Int J Dermatol  1994 Apr;33(4):279-81 
AU  - Taniguchi Y; Ando K; Shimizu M; Nakamura Y; Yamazaki S 
PT  - JOURNAL ARTICLE; REVIEW (13 references); REVIEW OF REPORTED CASES 
============================================================ 

============================================================ 
65.) Linear lichen planus mimicking creeping eruption. 
============================================================ 
SO  - J Dermatol  1993 Feb;20(2):118-21 
AU  - Taniguchi Y; Minamikawa M; Shimizu M; Ando K; Yamazaki S 
PT  - JOURNAL ARTICLE; REVIEW (25 references); REVIEW OF REPORTED CASES 
AB  - A 42-year-old woman was referred to our hospital with a linear 
eruption on her right flank of two months duration. Because she had 
eaten 
loach-fish a month before she noticed the eruption, a creeping eruption  
due 
to Gnathostoma spp. was initially suspected, but the histological 
findings 
of the biopsy specimens showed typical features of lichen planus. Linear 

lichen planus is discussed based on the cases accumulated in the 
literature 
regarding the distribution of Blaschko lines. 

============================================================ 
66.) Diagnosis and management of Baylisascaris procyonis infection in an 

infant with nonfatal meningoencephalitis. 
============================================================ 
SO  - Clin Infect Dis  1994 Jun;18(6):868-72 
AU  - Cunningham CK; Kazacos KR; McMillan JA; Lucas JA; McAuley JB; 
Wozniak 
EJ; Weiner LB 
PT  - JOURNAL ARTICLE 
AB  - Baylisacaris procyonis, the common raccoon ascarid, is known to 
cause 
life-threatening visceral, neural, and ocular larva migrans in mammals 
and 
birds. Two human fatalities have been previously described; however, 
little 
is known about the spectrum of human disease caused by B. procyonis. In 
this report, the case of a 13-month-old child who had nonfatal 
meningoencephalitis secondary to B. procyonis infection is presented. 
The 
suspected diagnosis was confirmed with use of newly developed enzyme 
immunoassay and immunoblot techniques. The diagnosis, management, and 
prevention of B. procyonis infection in humans is discussed. Clinical, 
serological, and epidemiological evaluations established B. procyonis as 

the etiologic agent. The child survived his infection but continued to 
have 
severe neurological sequelae. The potential for human contact and 
infection 
with B. procyonis is great. There is no effective therapy; therefore, 
prevention is paramount. 

============================================================ 
67.) [Human gnathostomiasis. The first evidence of the parasite in South 

America] 
============================================================ 
SO  - Ann Dermatol Venereol  1983;110(4):311-5 
AU  - Ollague W; Ollague J; Guevara de Veliz A; Penaherrera S 
PT  - JOURNAL ARTICLE 
AB  - Reporting 4 cases of gnathostomiasis, a clinical review of this 
disease is given by the authors. In one of these cases the diagnosis 
could 
be established by evidencing the parasite. The name: nodular migratory 
eosinophilic panniculitis is suggested for this disease. 

============================================================ 
68.) Efficacy of ivermectin in the therapy of cutaneous larva migrans 
[letter] 
============================================================ 
MLID92328556 
Author(s)  Caumes E; Datry A; Paris L; Danis M; Gentilini M; Gaxotte P 
Source    Arch Dermatol 1992;128:994. 
Major MeSH Ivermectin ; Larva Migrans 
Minor MeSH Administration [Oral]; Adolescence; Middle Age; Prospective 
Studies 
Check Tag(s) Female; Human; Male 
Language English 
Pub. Year  1992 
Pub. Type  Letter 
 
=================================================================== 

=========================================================================
69.) Hookworm-related cutaneous larva migrans in northern Brazil: resolution of clinical pathology after a single dose of ivermectin.
==================================================================
Clin Infect Dis. 2013 Oct;57(8):1155-7. doi: 10.1093/cid/cit440. Epub 2013 Jun 27.

Schuster A1, Lesshafft H, Reichert F, Talhari S, de Oliveira SG, Ignatius R, Feldmeier H.
Author information

1Institute of Microbiology and Hygiene.

Abstract

To assess the effect of ivermectin on the morbidity caused by hookworm-related cutaneous larva migrans in patients in hyperendemic areas, we treated 92 patients (with 441 tracks in total) from Manaus, Brazil, with single-dose ivermectin (200 µg/kg). Four weeks later, patients had 60 tracks, and the associated morbidity improved significantly.
===========================================================
70.) session of carbon dioxide laser: a study of 0.1111/jocd.12296. [Epub ahead of print]
ten cases in the Philippines.
==========================================================
J Cosmet Dermatol. 2016 Nov 29. doi: 10.1111/jocd.12296. [Epub ahead of print
Soriano LF1,2, Piansay-Soriano ME1.
Author information

1MediSkin Dermatology Clinic, Davao Doctors Hospital, Davao City, Philippines.
2Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

Abstract
BACKGROUND:

Cutaneous larva migrans (CLM) has a detrimental effect on patients' emotional and physical quality of life. Due to local unavailability of gold standard oral treatments for CLM, carbon dioxide laser was attempted. We present a case series where a single session of carbon dioxide laser treatment was associated with cessation of signs and symptoms of CLM.
AIMS:

The aim of this study was to assess the efficacy of a single session of carbon dioxide laser in the treatment of CLM.
MATERIALS AND METHODS:

Ten cases (eight patients) with CLM were treated with one session of carbon dioxide laser treatment and followed up daily for the first week with photographic documentation and then weekly for the next 3 weeks to complete a 4 week follow-up period.
RESULTS:

The first cases in our series, who received one to two passes of fractional CO2 laser, experienced further larval migration for 2-3 days, after which no more progression was noted. For the next seven cases, we increased the number of CO2 laser passes to 3-4, and noted no further larval migration. At the end of the 4-week follow-up period, all CO2 laser-treated areas were completely healed, leaving postinflammatory hyperpigmentation of the serpiginous track.
CONCLUSION:

The results of this case series indicate the efficacy of a single session of CO2 laser in treating CLM. Further studies are required to identify the minimum number of passes required to effectively control CLM.
==================================================================
71.) Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin.
====================================================================
Clin Exp Dermatol. 2002 Jun;27(4):264-7.

del Mar Sáez-De-Ocariz M1, McKinster CD, Orozco-Covarrubias L, Tamayo-Sánchez L, Ruiz-Maldonado R.
Author information

1Department of Dermatology, National Institute of Pediatrics, Insurgentes Sur 3700 C, Mexico City 04530, Mexico.

Abstract

In addition to onchocerciasis and other filarial diseases, ivermectin has been used for the treatment of scabies, head lice, larva migrans and gnathostomiasis. However, there is concern regarding the safety of its use in children under 5 years of age or weighing less than 15 kg. We present our experience in 18 children (aged 14 months to 17 years), with scabies or cutaneous larva migrans successfully treated with ivermectin. They included four cases of crusted scabies associated with immunosuppression and seven cases of common scabies four of whom had associated clinical mental retardation, immunosuppression or hypomobility. A further seven patients had cutaneous larva migrans. Fifteen patients were cured with a single dose of ivermectin, and three patients with crusted scabies required a second dose. None of our patients suffered significant adverse effects. We believe that ivermectin is a safe and effective alternative treatment of cutaneous parasitosis in children.

========================================================

 

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