El síndrome de Larva Migrans Cutáneo y las mascotas (perros y gatos). !!!
The Cutaneous Larva Migrans Syndrome and pets (dogs and cats).
!!!
Actualizado 2025
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)
====================
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.
OTROS AGENTES CAUSALES:
- Ancylostoma ceylanicum, A. tubaeforme (perros y gatos)
- Gnathostoma spinigerum (gatos, perros, cerdos)
- Gnathostoma spinigerum (gatos, perros, cerdos)
- Uncinaria stenocephala (perros en Europa)
- Bunostomum phlebotomum (ganado)
- Pelodera strongyloides
- En raros casos, Ancylostoma duodenale, Necator americanus (uncinarias humanas), y strongyloides stercoralis.
- Bunostomum phlebotomum (ganado)
- Pelodera strongyloides
- En raros casos, Ancylostoma duodenale, Necator americanus (uncinarias humanas), y strongyloides stercoralis.
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 o
serpigimosa", pero es auto limitada y con un buen tratamiento desaparece
sin dejar complicaciones en la mayoría de los casos.
La LARVA MIGRANS CUTÁNEA presenta una variante denominada
PANICULITIS NODULAR MIGRATORIA: se presenta cuando las larvas migran hacia el panículo adiposo
(mas profundamente), formando nódulos, subcutáneos migratorios, edema y
eosinofilia. Los agentes causales que producen esta variante son:
- Gnathostoma spinigerum.
- Gnathostoma doloresis.
- Gnathostoma hispidum.
LARVA MIGRANS VISCERAL:
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 parásito "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.
AGENTES CAUSANTES DE LARVA MIGRANS VISCERAL:
- Toxocara canis (perros)
- Toxocara cati (gatos)
TRATAMIENTOS DE LA LARVA MIGRANS:
1.) Ivermectina:
Dosis: 200 mcg/kg (0.2 mg/kg) en dosis única (puede repetirse a los 7-14 días si persisten lesiones), para un adulto de 60 kg le corresponderían 2 pastillas de 6 mgr de ivermectin, que es la presentación original. Considerado actualmente el tratamiento mas eficaz.
Dosis: 200 mcg/kg (0.2 mg/kg) en dosis única (puede repetirse a los 7-14 días si persisten lesiones), para un adulto de 60 kg le corresponderían 2 pastillas de 6 mgr de ivermectin, que es la presentación original. Considerado actualmente el tratamiento mas eficaz.
2.) Albendazol:
La dosis es de 400 mgr dia por 3 a 4 dias seguidos. Se recomienda
repetir a la semana 3 o 4 dias mas. Tratamiento muy útil en los
niños, pues la presentación es también en suspension, aparte de las
tabletas que son de 200 mgr.
3.) Tiabendazol: (drofen):
3.) Tiabendazol: (drofen):
Dosis 25 mg/kg dia, por 2-5 dias (promedio 3 dias). No disponible en
Venezuela hoy dia.
TRATAMIENTO LOCAL:
- Criocirugia: (casi en
desuso por ser muy dolorosa), consiste aplicar "nitrógeno liquido" desde
afuera en el trayecto de la lesion, la larva muere por
"enfriamiento".
- Formulas magistrales: que
contienen albendazol o tinidazol para ser aplicadas externamente: la
absorción percutanea de las misma, "envenena" el parásito y
muere.
TRATAMIENTO SINTOMÁTICO:
- Antibióticos: si hay infección secundaria.
- Antihistamínicos orales:
Para controlar el prurito que puede ser intenso.
- Corticoides topicos: Para
disminuir la inflamación y evitar infección secundaria.
El tratamiento de la
LARVA MIGRANS PROFUNDA VISCERAL y OCULAR., suele ser mas prolongado, 6 a 18 meses promedio. El tratamiento de
la LARVA ocular puede incluir cirugía vitroretiniana, fotocoagulación
por láser y medicación para evitar daño ocular.
CONCLUSIONES:
- Instaurar tratamiento temprano para evitar secuelas organicas,
principalmente en los casos VISCERALES y OCULARES.
- La LARVA MIGRANS CUTANEA, clásica es relativamente fácil de
identificar y los tratamientos propuestos son altamente
efectivos.
- 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.
- 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.
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).
===================
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.
OTHER CAUSING AGENTS:
- Ancylostoma ceylanicum, A. tubaeforme (dogs and cats)
- Gnathostoma spinigerum (cats, dogs, pigs)
- Hookworm (dogs in Europe)
- Bunostomum phlebotomum (cattle)
- Pelodera strongyloides
- In rare cases, Ancylostoma duodenale, Necator americanus (human hookworms), and strongyloides stercoralis.
- Ancylostoma ceylanicum, A. tubaeforme (dogs and cats)
- Gnathostoma spinigerum (cats, dogs, pigs)
- Hookworm (dogs in Europe)
- Bunostomum phlebotomum (cattle)
- Pelodera strongyloides
- In rare cases, Ancylostoma duodenale, Necator americanus (human hookworms), and strongyloides stercoralis.
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.
CUTANEOUS LARVA MIGRANS presents a variant called
MIGRATORY NODULAR PANICULITIS:
it occurs when the larvae migrate deeper into the fat pad, forming
migratory subcutaneous nodules, edema, and eosinophilia. The causative
agents that produce this variant are:
- Gnathostoma spinigerum.
- Gnathostoma doloris.
- Gnathostoma hispidum.
VISCERAL LARVA MIGRANS:
There is another variant of LARVA MIGRANS, VISCERAL (DEEP) caused by other parasites such as Toxocara canis (dogs) and others. The parasite migrates to deep organs such as the VISCERAL CAVITY, EYES, BRAIN, MUSCLES, and others. This is more dangerous and can leave after-effects if not detected and treated promptly.
CAUSING AGENTS OF VISCERAL LARVA MIGRANS:
- Toxocara canis (dogs)
- Toxocara cati (cats)
LARVA MIGRANS TREATMENTS:
1.) Ivermectin:
Dose: 200 mcg/kg (0.2 mg/kg) as a single dose (can be repeated after 7-14 days if lesions persist). For a 60 kg adult, the dose would be: Two 6 mg ivermectin tablets, which is the original formulation. Currently considered the most effective treatment.
2.) Albendazole:
- Gnathostoma spinigerum.
- Gnathostoma doloris.
- Gnathostoma hispidum.
VISCERAL LARVA MIGRANS:
There is another variant of LARVA MIGRANS, VISCERAL (DEEP) caused by other parasites such as Toxocara canis (dogs) and others. The parasite migrates to deep organs such as the VISCERAL CAVITY, EYES, BRAIN, MUSCLES, and others. This is more dangerous and can leave after-effects if not detected and treated promptly.
CAUSING AGENTS OF VISCERAL LARVA MIGRANS:
- Toxocara canis (dogs)
- Toxocara cati (cats)
LARVA MIGRANS TREATMENTS:
1.) Ivermectin:
Dose: 200 mcg/kg (0.2 mg/kg) as a single dose (can be repeated after 7-14 days if lesions persist). For a 60 kg adult, the dose would be: Two 6 mg ivermectin tablets, which is the original formulation. Currently considered the most effective treatment.
2.) Albendazole:
The dose is 400 mg daily for 3 to 4 consecutive days. It is recommended
to repeat the treatment for 3 or 4 more days a week. This treatment is
very useful in children, as it also comes in suspension form, in addition
to the 200 mg tablets.
3.) Thiabendazole (Drofen):
3.) Thiabendazole (Drofen):
Dosage: 25 mg/kg daily, for 2-5 days (average: 3 days). Not currently
available in Venezuela.
LOCAL TREATMENT:
- Cryosurgery: (almost obsolete due to its very painful nature), consists of applying "liquid nitrogen" from the outside to the lesion. The larva dies due to "cooling."
- Magistral formulations: containing albendazole or tinidazole for external application: percutaneous absorption of the It "poisons" the parasite, and it dies.
SYMPTOMATIC TREATMENT:
- Antibiotics: if there is a secondary infection.
- Oral antihistamines: To control itching, which can be intense.
- Topical corticosteroids: To reduce inflammation and prevent secondary infection.
Treatment for deep VISCERAL and OCULAR larva migrans is usually longer, averaging 6 to 18 months. Treatment for ocular larva migrans may include vitroretinal surgery, laser photocoagulation, and medication to prevent eye damage.
CONCLUSIONS:
- Establish early treatment to avoid organic sequelae, especially in visceral and ocular cases.
- Classical cutaneous larva migrans is relatively easy to identify, and the proposed treatments are highly effective.
- So, take care of your lovely pets, take them to the vet regularly, and be careful when go to the beach and the countryside to avoid this disease.
LOCAL TREATMENT:
- Cryosurgery: (almost obsolete due to its very painful nature), consists of applying "liquid nitrogen" from the outside to the lesion. The larva dies due to "cooling."
- Magistral formulations: containing albendazole or tinidazole for external application: percutaneous absorption of the It "poisons" the parasite, and it dies.
SYMPTOMATIC TREATMENT:
- Antibiotics: if there is a secondary infection.
- Oral antihistamines: To control itching, which can be intense.
- Topical corticosteroids: To reduce inflammation and prevent secondary infection.
Treatment for deep VISCERAL and OCULAR larva migrans is usually longer, averaging 6 to 18 months. Treatment for ocular larva migrans may include vitroretinal surgery, laser photocoagulation, and medication to prevent eye damage.
CONCLUSIONS:
- Establish early treatment to avoid organic sequelae, especially in visceral and ocular cases.
- Classical cutaneous larva migrans is relatively easy to identify, and the proposed treatments are highly effective.
- So, take care of your lovely pets, take them to the vet regularly, and be careful when go to the beach and the countryside to avoid this disease.
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.) CUTANEOUS, 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]
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
================================================================
============================================================
0.) CUTANEOUS, 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 LARVA 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 ------------
oxocariasis 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.
============================================================
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 LARVA 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 ------------
oxocariasis 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.
============================================================
3.3.) [Migrant erythema as clinical presentation of cutaneous
larva migrans in Mexico City] [Eritema migratorio
como presentación 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.
============================================================ r>4.4.) 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.
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19.) Cutaneous larva migrans in travelers: synopsis of histories, symptoms, and treatment of 98 patients.
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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.
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20.) [Nematode larva migrans. On two cases of filarial infection] [Wandernde Nematodenlarven. Uber zwei Falle von Filarienbefall.]
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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.
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21.) Larva migrans that affect the mouth.
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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.
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22.) Immunological studies on human larval toxocarosis.
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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.
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23.) [Larva migrans] [Le larbish.]
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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.
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24.) Effect of albendazole on Ancylostoma caninum larvae migrating in the muscles of mice.
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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.
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25.) [Ocular manifestations of toxocariasis]
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[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.).
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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.
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27.) [Long-term observations of ocular toxocariasis in children and youth] [Odlegle obserwacje toksokarozy ocznej u dzieci i mlodziezy.]
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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. font> <
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.
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28.) [A case of uveitis due to gnathostoma migration into the vitreous cavity]
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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.
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29.) [The ocular form of toxocariasis] [Ocni forma larvalni toxokarozy.]
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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.
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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.]
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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.
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31.) Visceral larva migrans syndrome complicated by liver abscess.
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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.
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32.) Visceral larva migrans and tropical pyomyositis: a case report.
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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.
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33.) [2 cases of toxocariasis (visceral larva migrans)] [Dos casos de toxocarosis (larva migrans visceral).]
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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.
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34.) [Visceral larva migrans. A rare cause of eosinophilia in adults] [Visceral larva migrans. En sjelden arsak til eosinofili hos voksne.]
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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.
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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.]
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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.
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36.) Visceral larva migrans induced eosinophilic cardiac pseudotumor: a cause of sudden death in a child.
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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.
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37.) [Toxocariasis. A cosmopolitan parasitic zoonosis] [La toxocarose une zoonose parasitaire cosmopolite.]
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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.
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38.) Visceral larva migrans mimicking rheumatic diseases.
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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.
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39.) Hepatic granulomas due to visceral larva migrans in adults: appearance on US and MRI.
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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).
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40.) [Ascaridiasis zoonoses: visceral larva migrans syndromes] [Zoonoses d'origine ascaridienne: les syndromes de Larva migrans visceral.]
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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.
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41.) Hepatic visceral larva migrans: evolution of the lesion, diagnosis, and role of high-dose albendazole therapy.
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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.
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42.) Neuroimaging studies of cerebral "visceral larva migrans" syndrome.
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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.
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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.]
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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.
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44.)Toxocariasis simulating hepatic recurrence in a patient with Wilms' tumor.
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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.
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45.) Hepatic imaging studies on patients with visceral larva migrans due to probable Ascaris suum infection.
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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.
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46.) Encephalopathy caused by visceral larva migrans due to Ascaris suum.
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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.
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47.) [Imported skin diseases (see comments)] [Importhuidziekten.]
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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.
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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.]
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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.
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49.) Pets and Parasites.
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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.
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50.) Cutaneous larva migrans in travelers: synopsis of histories, symptoms, and treatment of 98 patients.
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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.
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51.) Cutaneous larva migrans.
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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.
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52.)[Current therapeutic possibilities in cutaneous larva migrans]
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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.
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53.) Cutaneous larva migrans due to Pelodera strongyloides.
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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.
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54.) Oral albendazole for the treatment of cutaneous larva migrans.
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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.
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55.) Cutaneous larva migrans in northern climates. A souvenir of your dream vacation.
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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.
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56.) Creeping eruption. A review of clinical presentation and management of 60 cases presenting to a tropical disease unit.
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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.
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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.
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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.
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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.
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59.) Hookworm folliculitis.
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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.
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60.) [Prurigo and further diagnostically significant skin symptoms in strongyloidosis]
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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.
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61.) Gnathostomiasis, or larva migrans profundus.
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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.
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62.) Visceral larva migrans caused by Trichuris vulpis.
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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.
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63.) Creeping disease due to larva of spiruroid nematoda.
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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
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64.) Creeping eruption due to larvae of the suborder Spirurina--a newly recognized causative parasite.
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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
============================================================ font> <
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65.) Linear lichen planus mimicking creeping eruption.
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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.
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66.) Diagnosis and management of Baylisascaris procyonis infection in an infant with nonfatal meningoencephalitis.
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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.
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67.) [Human gnathostomiasis. The first evidence of the parasite in South America]
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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.
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68.) Efficacy of ivermectin in the therapy of cutaneous larva migrans [letter]
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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
=====================================================================================================================================
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.
============================================================ r>4.4.) Larva migrans within scalp sebaceous gland.
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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.
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5.) Cutaneous larva migrans, sacroileitis, and optic neuritis caused by an unidentified organism acquired in Thailand.
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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.
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6.) Perianal cutaneous larva migrans in a child.
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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.
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7.) [Infections with Baylisascaris procyonis in humans and raccoons]
[Infecties met Baylisascaris procyonis bij de mens en de wasbeer.]
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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.
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8.) Cutaneous larva migrans complicated by erythema multiforme [see comments]
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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.
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9.) Cutaneous larva migrans associated with water shoe use.
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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.
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10.) Cutaneous larva migrans infection in the pediatric foot. A review and two case reports.
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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.
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11.) Creeping eruption of larva migrans--a case report in a beach volley athlete.
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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.
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12.) Albendazole: a new therapeutic regimen in cutaneous larva migrans.
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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.
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13.) A primary health care approach to an outbreak of cutaneous larva migrans.
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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.
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14.) Autochthonous cutaneous larva migrans in Germany.
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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.
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15.) High prevalence of Ancylostoma spp. infection in dogs, associated with endemic focus of human cutaneous larva migrans, in Tacuarembo, Uruguay.
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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.
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16.) Persistent cutaneous larva migrans due to Ancylostoma species.
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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.
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17.) [A case of Dirofilaria repens migration in man] [Sluchai migratsii Dirofilaria repens u cheloveka.]
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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.
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18.) [Cutaneous larva migrans, autochthonous in France. Apropos of a case] [Larva migrans cutanee autochtone en France. A propos d'un cas.]
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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.
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19.) Cutaneous larva migrans in travelers: synopsis of histories, symptoms, and treatment of 98 patients.
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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.
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20.) [Nematode larva migrans. On two cases of filarial infection] [Wandernde Nematodenlarven. Uber zwei Falle von Filarienbefall.]
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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.
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21.) Larva migrans that affect the mouth.
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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.
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22.) Immunological studies on human larval toxocarosis.
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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.
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23.) [Larva migrans] [Le larbish.]
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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.
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24.) Effect of albendazole on Ancylostoma caninum larvae migrating in the muscles of mice.
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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.
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25.) [Ocular manifestations of toxocariasis]
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[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.).
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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.
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27.) [Long-term observations of ocular toxocariasis in children and youth] [Odlegle obserwacje toksokarozy ocznej u dzieci i mlodziezy.]
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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. font> <
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.
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28.) [A case of uveitis due to gnathostoma migration into the vitreous cavity]
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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.
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29.) [The ocular form of toxocariasis] [Ocni forma larvalni toxokarozy.]
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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.
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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.]
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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.
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31.) Visceral larva migrans syndrome complicated by liver abscess.
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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.
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32.) Visceral larva migrans and tropical pyomyositis: a case report.
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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.
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33.) [2 cases of toxocariasis (visceral larva migrans)] [Dos casos de toxocarosis (larva migrans visceral).]
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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.
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34.) [Visceral larva migrans. A rare cause of eosinophilia in adults] [Visceral larva migrans. En sjelden arsak til eosinofili hos voksne.]
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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.
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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.]
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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.
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36.) Visceral larva migrans induced eosinophilic cardiac pseudotumor: a cause of sudden death in a child.
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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.
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37.) [Toxocariasis. A cosmopolitan parasitic zoonosis] [La toxocarose une zoonose parasitaire cosmopolite.]
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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.
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38.) Visceral larva migrans mimicking rheumatic diseases.
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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.
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39.) Hepatic granulomas due to visceral larva migrans in adults: appearance on US and MRI.
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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).
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40.) [Ascaridiasis zoonoses: visceral larva migrans syndromes] [Zoonoses d'origine ascaridienne: les syndromes de Larva migrans visceral.]
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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.
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41.) Hepatic visceral larva migrans: evolution of the lesion, diagnosis, and role of high-dose albendazole therapy.
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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.
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42.) Neuroimaging studies of cerebral "visceral larva migrans" syndrome.
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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.
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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.]
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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.
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44.)Toxocariasis simulating hepatic recurrence in a patient with Wilms' tumor.
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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.
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45.) Hepatic imaging studies on patients with visceral larva migrans due to probable Ascaris suum infection.
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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.
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46.) Encephalopathy caused by visceral larva migrans due to Ascaris suum.
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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.
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47.) [Imported skin diseases (see comments)] [Importhuidziekten.]
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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.
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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.]
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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.
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49.) Pets and Parasites.
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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.
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50.) Cutaneous larva migrans in travelers: synopsis of histories, symptoms, and treatment of 98 patients.
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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.
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51.) Cutaneous larva migrans.
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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.
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52.)[Current therapeutic possibilities in cutaneous larva migrans]
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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.
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53.) Cutaneous larva migrans due to Pelodera strongyloides.
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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.
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54.) Oral albendazole for the treatment of cutaneous larva migrans.
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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.
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55.) Cutaneous larva migrans in northern climates. A souvenir of your dream vacation.
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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.
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56.) Creeping eruption. A review of clinical presentation and management of 60 cases presenting to a tropical disease unit.
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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.
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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.
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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.
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58.) Larva currens and systemic disease.
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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.
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59.) Hookworm folliculitis.
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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.
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60.) [Prurigo and further diagnostically significant skin symptoms in strongyloidosis]
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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.
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61.) Gnathostomiasis, or larva migrans profundus.
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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.
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62.) Visceral larva migrans caused by Trichuris vulpis.
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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.
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63.) Creeping disease due to larva of spiruroid nematoda.
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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
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64.) Creeping eruption due to larvae of the suborder Spirurina--a newly recognized causative parasite.
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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
============================================================ font> <
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65.) Linear lichen planus mimicking creeping eruption.
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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.
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66.) Diagnosis and management of Baylisascaris procyonis infection in an infant with nonfatal meningoencephalitis.
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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.
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67.) [Human gnathostomiasis. The first evidence of the parasite in South America]
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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.
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68.) Efficacy of ivermectin in the therapy of cutaneous larva migrans [letter]
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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.
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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.
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70.) session of carbon dioxide laser: a study of 0.1111/jocd.12296. [Epub ahead of print]
ten cases in the Philippines.
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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.
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71.) Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin.
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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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