Unité de Recherche sur Les Maladies Infectieuses et Tropicales émergentes (URMITE) CNRS-IRD UMR 6236, Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France; Service de Parasitologie-Mycologie, Faculté de Médecine, UCAD, BP 5005 Dakar-Fann, Senegal.
Service de Parasitologie-Mycologie, Faculté de Médecine, UCAD, BP 5005 Dakar-Fann, Senegal.
Travel Med Infect Dis. 2017 Nov-Dec;20:61-64. doi: 10.1016/j.tmaid.2017.06.003. Epub 2017 Jun 15.
Cutaneous larva migrans (CLM) is caused by the penetration and migration of canine or feline hookworm larvae into the skin, and frequently affects travelers from high-income countries returning from tropical and sub-tropical areas. Unfortunately, this pathology is neglected due to poor understanding among both physicians and travelers. This study describes the profile of cases reported in Marseille, France.
A retrospective study was performed in two specialized hospitals between 2003 and 2015. Data on socio-demographics, clinical aspects and treatment were collected. Diagnosis was based on travel history and symptoms.
Forty-three patients with a diagnosis of CLM were recorded in this study. They were aged between 14 and 70 and 51% were male. They were infected while visiting the Americas (37%), Africa (33%), Asia (28%) and (in the case of one patient) Portugal. The mean timescale for diagnosis was 41 days. Track lesions associated with pruritus in the lower limbs were the most common symptoms. Nine had a history of super-infection. Sixteen patients received treatment prior to referral including six who were administered antiparasitic drugs. A one-day treatment with ivermectin, administered at our facility, resulted, in most instances, in a favorable outcome.
This study reports 43 cases of CLM acquired mainly in Africa, Asia and the Americas but also, for the first time, CLM acquired during travel to Portugal. The data show the need for increased awareness of CLM prevention and treatment in order to optimize pre-travel advice and case management. Travelers need to understand how CLM is transmitted and the need to avoid contact with soil and sand contaminated by dogs and cats. In particular, footwear and sun chairs should be used on beaches.
皮肤幼虫移行症（cutaneous larva migrans，CLM）是由犬或猫钩虫幼虫穿透和迁移到皮肤中引起的，常影响来自高收入国家的旅行者从热带和亚热带地区返回时感染。不幸的是，由于医生和旅行者对此了解甚少，这种病理学常常被忽视。本研究描述了法国马赛报告的病例特征。
对 2003 年至 2015 年期间两家专科医院的病例进行回顾性研究。收集了社会人口统计学、临床方面和治疗的数据。根据旅行史和症状做出诊断。
本研究共记录了 43 例 CLM 患者。患者年龄在 14 至 70 岁之间，其中 51%为男性。他们在访问美洲（37%）、非洲（33%）、亚洲（28%）和葡萄牙（一例）时感染了该病。诊断的平均时间为 41 天。下肢伴有瘙痒的轨迹病变是最常见的症状。9 例有继发感染史。在转诊前，有 16 例接受了治疗，包括 6 例接受了驱虫药治疗。在我们医院，一天的伊维菌素治疗在大多数情况下取得了良好的效果。
本研究报告了 43 例主要在非洲、亚洲和美洲获得的 CLM 病例，但也是首次报告在葡萄牙旅行期间获得的 CLM 病例。这些数据表明，需要提高对 CLM 预防和治疗的认识，以优化旅行前咨询和病例管理。旅行者需要了解 CLM 的传播方式，并避免接触被狗和猫污染的土壤和沙子。特别是在海滩上，应使用鞋类和沙滩椅。
