Larva migrans: Description, Causes and Risk Factors:ICD-10:Cutaneous larva migrans: B76.9.
Visceral larva migrans: B83.0.
Internal parasites, including worms, are adapted to live in specific animal hosts. These parasites have complex life cycles that begin and end in the intestine of the animal host. Adult worms live in the intestines and lay eggs which are then passed in the feces of the host animal. Once passed from the animal, the parasite eggs will develop into larvae or immature worms. Animals can become infected by eating eggs or larvae found in feces, fecal-contaminated soil or water, or in an infected animal such as a rodent. Infected female animals can also pass the parasites to their young through their breast milk.When the worms migrate through the skin of the host, it is called cutaneous (skin) larva migrans. If the worm larvae migrate through various internal organs of the host, it is called visceral larva migrans. Sometimes the worm larvae may invade the eye of the host. This is called ocular (eye) larva migrans. Humans and a wide range of animal species can be a?ected by this disease.Humans can get infested by various worm species after (accidently) ingesting the parasite eggs (oral) or by eating tissues from an infested animal and by penetration (direct contact) of the worm larvae through the skin. Animal hookworms are the most common cause of cutaneous larva migrans while roundworms common to dogs and cats are the most important causes of visceral and ocular larva migrans in humans.A number of different roundworms can cause cutaneous larva migrans:Ancylostoma braziliense: the most common; hosts are wild and domestic dogs and cats; primarily found in central and southern USA, Central and South America and the Caribbean.
Ancylostoma caninum: hosts are dogs; primarily found in Australia.
Uncinaria stenocephala: hosts are dogs; primarily found in Europe.
Bunostomum phlebotomum: hosts are cattle.
Ancylostoma tubaeforme: hosts are cats.
Strongyloides papillosus: hosts are sheep, goats, and cattle.
Strongyloides westeri: hosts are horses.
Risk factors:Sunbathing and walking on the beach barefoot.
Children may have been playing in sandpits.
Soil under housing and at construction sites may also be contaminated.
Symptoms:Cutaneous larva migrans will appear as raised, reddened “tracts” or lines in the a?ected area, commonly the foot or arms. Signs of visceral larva migrans will vary depending on the organ infested. Ocular larva migrans will result in vision problems and can lead to blindness.Diagnosis:Diagnosis is usually clinical.Skin biopsy ahead of the leading tract may show a larva in a burrow and inflammatory infiltrate.Optical coherence tomography can identify the larvae in the epidermis and allow direct removal.Treatment:Cutaneous larva migrans is a self-limiting infection but can be treated with albendazole or ivermectin. Most cases will resolve within 4-8 weeks because the larva cannot penetrate the dermis, cannot reproduce, and eventually die.Treatment with anthelmintics can shorten the disease course, ease pruritus and lead to resolution of skin tracts within one week. Liquid nitrogen cryotherapy for the progressive end of the larval burrow is another alternative treatment. However, it is painful and multiple treatments are usually needed. Antihistamines and topical corticosteroids can be added to the treatment to help pruritus.Good hygiene and regular deworming of pets will reduce the chance of human exposure. Children should not play in areas possibly contaminated with animal feces. Keep play areas, lawns and gardens around your home free of animal waste by disposing of pet feces regularly and covering sandboxes when not in use. Always wash your hands after handling soil or touching animals.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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