Shrestha Amrita, K C Kusha, Baral Abal, Shrestha Rojina, Shrestha Rabina
Koshi Hospital, Biratnagar, Koshi Province.
Department of Health Services, Epidemiology and Disease Control Division.
Ann Med Surg (Lond). 2023 Nov 16;86(1):530-534. doi: 10.1097/MS9.0000000000001512. eCollection 2024 Jan.
INTRODUCTION: Cutaneous larva migrans (CLM) is a dermatitis caused by the invasion and migration of parasitic larvae of hookworms, primarily affecting tropical and subtropical regions. This report presents a case of CLM in a Nepali child and provides an overview of the literature on this condition. CASE REPORT: A 4-year-old boy from a rural area in Nepal presented with a pruritic skin lesion on his left foot, initially misdiagnosed as fungal infection. The lesion gradually expanded, forming a serpiginous erythema, and became intensely pruritic. The patient's family had poor socioeconomic conditions, and the child frequently walked barefoot in an area with many domestic and stray dogs. Diagnosis was confirmed clinically, and treatment with oral albendazole and antihistamines resulted in complete resolution of symptoms. DISCUSSION: CLM is a neglected zoonotic disease, with an underestimated burden in developing countries due to underreporting and misdiagnosis. The larvae of spp. are common culprits, causing a localized inflammatory reaction as they migrate through the skin. Diagnosis is mainly clinical and routine investigations usually reveal no abnormality. Complications may include secondary bacterial infections, allergies, and rare migration to internal organs. Treatment options include albendazole or ivermectin, with preventive measures emphasizing hygiene, footwear use, and pet deworming. CONCLUSION: CLM is a neglected disease that primarily affects marginalized communities in tropical regions. Raising awareness among healthcare providers, conducting observational studies, and developing treatment guidelines, especially for children, are essential steps to address this public health concern. Preventive efforts, such as promoting hygiene and footwear use, should be encouraged to reduce CLM incidence.
引言:皮肤幼虫移行症(CLM)是一种由钩虫寄生幼虫侵入和移行引起的皮炎,主要影响热带和亚热带地区。本报告介绍了一名尼泊尔儿童的CLM病例,并概述了关于这种病症的文献。 病例报告:一名来自尼泊尔农村地区的4岁男孩左脚出现瘙痒性皮肤病变,最初被误诊为真菌感染。病变逐渐扩大,形成匐行性红斑,并变得剧烈瘙痒。患者家庭社会经济条件差,孩子经常在有许多家养和流浪狗的地区赤脚行走。临床确诊后,口服阿苯达唑和抗组胺药治疗使症状完全缓解。 讨论:CLM是一种被忽视的人畜共患病,由于报告不足和误诊,其在发展中国家的负担被低估。 属的幼虫是常见病因,它们在皮肤中移行时会引起局部炎症反应。诊断主要依靠临床,常规检查通常无异常。并发症可能包括继发性细菌感染、过敏以及罕见的向内部器官移行。治疗选择包括阿苯达唑或伊维菌素,预防措施强调卫生、穿鞋子和给宠物驱虫。 结论:CLM是一种被忽视的疾病,主要影响热带地区的边缘化社区。提高医疗服务提供者的认识、开展观察性研究以及制定治疗指南,尤其是针对儿童的指南,是解决这一公共卫生问题的关键步骤。应鼓励采取预防措施,如促进卫生和穿鞋子,以降低CLM的发病率。
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