Cutaneous larva migrans | |
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Other names | CLM |
Typical "creeping eruption" associated with cutaneous larva migrans | |
Specialty | Infectious diseases |
Cutaneous larva migrans (abbreviated CLM) is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). The parasites live in the intestines of dogs, cats, and wild animals; they should not be confused with other members of the hookworm family for which humans are definitive hosts, namely Ancylostoma duodenale and Necator americanus .
Colloquially called creeping eruption [1] [2] due to its presentation, the disease is also somewhat ambiguously known as " ground itch " or (in some parts of the southern United States) "sandworms", as the larvae like to live in sandy soil. Another vernacular name is plumber's itch. The medical term CLM literally means "wandering larvae in the skin".
The infection causes a red, intensely pruritic (itchy) eruption and may look like twirling lesions. [3] The itching can become very painful and if scratched may allow a secondary bacterial infection to develop. Cutaneous larva migrans usually heals spontaneously over weeks to months and has been known to last as long as one year. [3] However the severity of the symptoms usually causes those infected to seek medical treatment before spontaneous resolution occurs. After proper treatment, migration of the larvae within the skin is halted and relief of the associated itching can occur in less than 48 hours (reported for thiabendazole). [1]
This is separate from the similar cutaneous larva currens which is caused by Strongyloides . Larva currens is also a cause of migratory pruritic eruptions but is marked by 1) migratory speed on the order of inches per hour 2) perianal involvement due to autoinfection from stool and 3) a wide band of urticaria. [4]
Hookworm eggs are shed in infected dog (or other animal) feces and are transferred to the ground and to beach sand, where they develop over a period of 1–2 weeks into an infectious larval form (filariform larvae). [5] The filariform larvae can burrow through intact skin which comes into contact with soil or sand that is contaminated with feces. Although they are able to infect the deeper tissues of other animals (through to the lungs and then the intestinal tract), humans are incidental hosts and the larvae are only able to penetrate the epidermis of the skin. [1] They create the typical wormlike burrows which are visible underneath the skin. These parasites apparently lack the collagenase enzymes required to penetrate through the basement membrane deeper into the dermal layers of the skin. [6]
Observing the lesions with the naked eye is sufficient to make a clinical diagnosis. Finding the larvae is difficult due to their small size and identifying the species to which they belong is more complicated. Therefore, careful observation of the serpiginous lesions, which progressively increase in length, as well as a history of contact with sandy soil contaminated with dog or cat feces, mainly on beaches, is considered sufficient for a correct diagnosis. [1]
CLM can be treated in a number of different ways:
Strongyloides stercoralis is a human pathogenic parasitic roundworm causing the disease strongyloidiasis. Its common name in the US is threadworm. In the UK and Australia, however, the term threadworm can also refer to nematodes of the genus Enterobius, otherwise known as pinworms.
Toxocariasis is an illness of humans caused by the dog roundworm and, less frequently, the cat roundworm. These are the most common intestinal roundworms of dogs, coyotes, wolves and foxes and domestic cats, respectively. Humans are among the many "accidental" or paratenic hosts of these roundworms.
Gnathostomiasis, also known as larva migrans profundus, is the human infection caused by the nematode Gnathostoma spinigerum and/or Gnathostoma hispidum, which infects vertebrates.
Hookworm infection is an infection by a type of intestinal parasite known as a hookworm. Initially, itching and a rash may occur at the site of infection. Those only affected by a few worms may show no symptoms. Those infected by many worms may experience abdominal pain, diarrhea, weight loss, and tiredness. The mental and physical development of children may be affected. Anemia may result.
Albendazole is a broad-spectrum antihelmintic and antiprotozoal agent of the benzimidazole type. It is used for the treatment of a variety of intestinal parasite infections, including ascariasis, pinworm infection, hookworm infection, trichuriasis, strongyloidiasis, taeniasis, clonorchiasis, opisthorchiasis, cutaneous larva migrans, giardiasis, and gnathostomiasis, among other diseases.
Necator americanus is a species of hookworm commonly known as the New World hookworm. Like other hookworms, it is a member of the phylum Nematoda. It is an obligatory parasitic nematode that lives in the small intestine of human hosts. Necatoriasis—a type of helminthiasis—is the term for the condition of being host to an infestation of a species of Necator. Since N. americanus and Ancylostoma duodenale are the two species of hookworms that most commonly infest humans, they are usually dealt with under the collective heading of "hookworm infection". They differ most obviously in geographical distribution, structure of mouthparts, and relative size.
Strongyloidiasis is a human parasitic disease caused by the nematode called Strongyloides stercoralis, or sometimes the closely related S. fülleborni. These helminths belong to a group of nematodes called roundworms. These intestinal worms can cause a number of symptoms in people, principally skin symptoms, abdominal pain, diarrhea and weight loss, but also many other specific and vague symptoms in disseminated disease, and severe life-threatening conditions through hyperinfection. In some people, particularly those who require corticosteroids or other immunosuppressive medication, Strongyloides can cause a hyperinfection syndrome that can lead to death if untreated. The diagnosis is made by blood and stool tests. The medication ivermectin is widely used to treat strongyloidiasis.
Ancylostoma duodenale is a species of the roundworm genus Ancylostoma. It is a parasitic nematode worm and commonly known as the Old World hookworm. It lives in the small intestine especially the jejunum of definitive hosts, generally humans, where it is able to mate and mature. Ancylostoma duodenale and Necator americanus are the two human hookworm species that are normally discussed together as the cause of hookworm infection. They are dioecious. Ancylostoma duodenale is abundant throughout the world, including Southern Europe, North Africa, India, China, Southeast Asia, some areas in the United States, the Caribbean, and South America.
Uncinaria stenocephala is a nematode that parasitizes dogs, cats, and foxes as well as humans. It is rare to find in cats in the United States. Uncinaria stenocephala is the most common canine hookworm in cooler regions, such as Canada and the northern regions of the US, where it can be found primarily in foxes (40%). U. stenocephala is also one of the most common hookworms in the UK, called the northern hookworm, however it has a rather low prevalence. U. stenocephala is also considered to be zoonotic hookworms because they live in animals but can be transmitted to humans.
Gnathostoma spinigerum is a parasitic nematode that causes gnathostomiasis in humans, also known as its clinical manifestations are creeping eruption, larva migrans, Yangtze edema, Choko-Fuschu Tua chid and wandering swelling. Gnathostomiasis in animals can be serious, and even fatal. The first described case of gnathostomiasis was in a young tiger that died in the London Zoo in 1835. The larval nematode is acquired by eating raw or undercooked fish and meat.
Ancylostomiasis is a hookworm disease caused by infection with Ancylostoma hookworms. The name is derived from Greek ancylos αγκύλος "crooked, bent" and stoma στόμα "mouth".
Necatoriasis is the condition of infection by Necator hookworms, such as Necator americanus. This hookworm infection is a type of helminthiasis (infection) which is a type of neglected tropical disease.
Toxocara canis is a worldwide-distributed helminth parasite that primarily infects dogs and other canids, but can also infect other animals including humans. The name is derived from the Greek word toxon 'bow, quiver' and the Latin word caro 'flesh'. T. canis live in the small intestine of the definitive host. This parasite is very common in puppies and somewhat less common in adult dogs. In adult dogs, infection is usually asymptomatic but may be characterized by diarrhea. By contrast, untreated infection with Toxocara canis can be fatal in puppies, causing diarrhea, vomiting, pneumonia, enlarged abdomen, flatulence, poor growth rate, and other complications.
Oesophagostomum is a genus of parasitic nematodes (roundworms) of the family Strongylidae. These worms occur in Africa, Brazil, China, Indonesia and the Philippines. The majority of human infection with Oesophagostomum is localized to northern Togo and Ghana. Because the eggs may be indistinguishable from those of the hookworms, the species causing human helminthomas are rarely identified with accuracy. Oesophagostomum, especially O. bifurcum, are common parasites of livestock and animals like goats, pigs and non-human primates, although it seems that humans are increasingly becoming favorable hosts as well. The disease they cause, oesophagostomiasis, is known for the nodule formation it causes in the intestines of its infected hosts, which can lead to more serious problems such as dysentery. Although the routes of human infection have yet to be elucidated sufficiently, it is believed that transmission occurs through oral-fecal means, with infected humans unknowingly ingesting soil containing the infectious filariform larvae.
Ancylostoma braziliense is a species of hookworm belonging to the genus Ancylostoma. It is an intestinal parasite of domestic cats and dogs. Severe infection is often fatal to these pets, especially in puppies and kittens. The infection is particularly endemic in the southern United States. It is most often confused with the zoonotic hookworm species Ancylostoma ceylanicum because of their uncanny resemblance.
Ground itch refers to the inflammatory reaction resulting from certain helminthic invasions into the skin.
Larva currens, is an itchy skin condition caused by infections with Strongyloides stercoralis.
Gnathostoma hispidum is a nematode (roundworm) that infects many vertebrate animals including humans. Infection of Gnathostoma hispidum, like many species of Gnathostoma causes the disease gnathostomiasis due to the migration of immature worms in the tissues.
Hookworms are intestinal, blood-feeding, parasitic roundworms that cause types of infection known as helminthiases. Hookworm infection is found in many parts of the world, and is common in areas with poor access to adequate water, sanitation, and hygiene. In humans, infections are caused by two main species of roundworm, belonging to the genera Ancylostoma and Necator. In other animals the main parasites are species of Ancylostoma. Hookworm is closely associated with poverty because it is most often found in impoverished areas, and its symptoms promote poverty through the educational and health effects it has on children. It is the leading cause of anemia and undernutrition in developing countries, while being one of the most commonly occurring diseases among poor people. Hookworm thrives in areas where rainfall is sufficient and keeps the soil from drying out, and where temperatures are higher, making rural, coastal areas prime conditions for the parasite to breed.
Nematode infection in dogs - the infection of dogs with parasitic nemamotodes - are, along with tapeworm infections and infections with protozoa, frequent parasitoses in veterinary practice. Nematodes, as so-called endoparasites, colonize various internal organs - most of them the digestive tract - and the skin. To date, about 30 different species of nematode have been identified in domestic dogs; they are essentially also found in wild dog species. However, the majority of them often cause no or only minor symptoms of disease in adult animals. The infection therefore does not necessarily have to manifest itself in a worm disease (helminthosis). For most nematodes, an infection can be detected by examining the feces for eggs or larvae. Roundworm infection in dogs and the hookworm in dogs is of particular health significance in Central Europe, as they can also be transmitted to humans (zoonosis). Regular deworming can significantly reduce the frequency of infection and thus the risk of infection for humans and dogs.