Cutaneous larva migrans: an unusual souvenir from a Scottish holiday.

Cutaneous larva migrans acquired in western Scotland. A reminder that with a warming climate, conditions conventionally restricted to the tropics may be contracted in the British Isles in the absence of foreign travel.

Is it canine DUSN?: Another view of retinopathies, some acquired, and others possibly "inherited": Another view of retinopathies, some acquired, and others possibly "inherited".

The term retinopathy has been used to group several heterogeneous retinal abnormalities that are clearly acquired or are suspected/proposed to be inherited. Some share characteristic focal/multifocal hyperreflective tapetal lesions with a dark center, and areas of non-tapetal depigmentation suggestive of patchy or diffuse outer retinal atrophy. Progression is variable, and some develop unilateral or bilateral fundus changes resembling the clearly inherited form of retinal degeneration referred to as PRA. In this Commentary and Review, we discuss the role of ocular larva migrans resulting in the entity we refer to as canine DUSN and suggest that it may be responsible for some of the retinal findings grouped under the retinopathy rubric that share this characteristic fundus lesion.

A Unique Case of Cutaneous Larva Migrans Acquired Within the Province of Quebec and Successfully Treated With Topical Ivermectin.

Cutaneous larva migrans (CLM) is a zoonotic helminthiasis frequently imported to Canada by travellers to beach destinations in the tropics. The preferred treatment is oral ivermectin. We present a case of CLM acquired within the province of Quebec, a first in our provincial health records. Our case also puts forward the use of topical ivermectin as a possibly effective CLM treatment approach as our patient was successfully treated with 1 month of an ivermectin 1% cream applied locally twice daily.

Larva migrans syndrome caused by Toxocara and Ascaris roundworm infections in Japanese patients.

Larva migrans syndrome (LMS) caused by Toxocara and Ascaris roundworms is generally believed to be more common in children, while a report from Japan suggests that it is more common in adults. We conducted a large-scale retrospective study to confirm these findings and to clarify what caused the difference between Japan and other countries, to reveal overlooked aspects of this disease. The clinical information of 911 cases which we diagnosed as Toxocara or Ascaris LMS during 2001 and 2015 was analysed. Information used included age, sex, address (city or county), chief complaint, present history, dietary history, overseas travelling history, medical imaging findings and laboratory data (white blood cell count, peripheral blood eosinophil number and total IgE). The sex ratio of the disease was 2.37 (male/female = 641/270). The number of patients not younger than 20 years old were 97.8 and 95.1 % among males and females, respectively. Major disease types were visceral, ocular, neural and asymptomatic. The visceral type was more prevalent in older patients, while younger patients were more vulnerable to ocular symptoms. More than two-thirds of the patients whose dietary habits were recorded had a history of ingesting raw or undercooked animal meat. LMS caused by Toxocara or Ascaris is primarily a disease of adult males in Japan, who probably acquired infections by eating raw or undercooked animal meat/liver. Healthcare specialists should draw public attention to the risk of raw or undercooked animal meat in Europe as well.

S1 guideline diagnosis and therapy of cutaneous larva migrans (creeping disease).

GUIDELINE OBJECTIVES: These guidelines aim to enhance patient care by optimizing the diagnosis and treatment of infections due to creeping disease (cutaneous larva migrans) and to raise awareness among doctors of current treatment options. METHODS: S1 guideline, non-systematic literature search, consensus process using a circular letter.

Follicular larva migrans.

Follicular larva migrans (FLM) is a rare and atypical clinical presentation of hookworm-related cutaneous larva migrans (HrCLM). FLM is characterized clinically by follicular, round, small, erythematous papules that are sometimes topped by vesicles or pustules. These lesions are usually located on the abdomen, back, buttocks and thighs and are accompanied by more or less severe pruritus. Some typical and/or short and fragmented tracks may also be visible. FLM is more resistant to anti-helminthic drugs than classical HrCLM: this is likely due to the deep location of larvae in hair follicles. We present two cases of FLM and a review of the literature.

Mini review: Hookworm-related cutaneous larva migrans.

Hookworm-related cutaneous larva migrans (HrCLM) is a parasitic skin disease caused by the migration of animal hookworm larvae in the epidermis. Since these larvae cannot penetrate the basal membrane of human skin, they remain confined to the epidermis and are unable to develop and complete their lifecycle. By consequence, HrCLM is a self-limiting disease. However, if not treated promptly, the skin pathology may persist for months. HrCLM is endemic in many resource-poor communities in the developing world. In high-income countries, HrCLM occurs sporadically or in the form of small epidemics. Travelers account for the great majority of cases seen by health-care professionals in high-income countries. Transmission occurs when naked skin comes into contact with contaminated soil. Exposure may also occur indoors. Exceptionally, larvae may be transmitted through fomites. The first clinical sign is a small reddish papule. Thereafter, the characteristic serpiginous, slightly elevated, erythematous track becomes visible. Itching becomes more and more intense. Excoriations induced by scratching facilitate bacterial superinfection of the lesion. The diagnosis is essentially clinical. It is supported by a recent travel history and the possibility of exposure. The drug of choice is ivermectin in a single dose (200 µg per kg bodyweight). Repeated treatments with albendazole (400 mg daily) are a good alternative in countries where ivermectin is not available.

Baylisascariasis: A young boy with neural larva migrans due to the emerging raccoon round worm.

A 17-month-old boy from Vancouver, Canada, presented with a 5-day history of progressive somnolence, ataxia, and torticollis. Additional investigations revealed eosinophilic encephalitis with deep white matter changes on MR imaging. On day 13, serology came back positive for Baylisascaris procyonis antibodies. While prophylaxis after ingestion of soil or materials potentially contaminated with raccoon feces can prevent baylisascariasis, timely treatment can sometimes alter a disastrous outcome. Populations of infected raccoons are propagating globally, but cases of Baylisascaris neural larva migrans have so far only been reported from North America.

Epidemiological and clinical characteristics of hookworm-related cutaneous larva migrans.

Hookworm-related cutaneous larva migrans is caused by the migration of animal hookworm larvae in the human skin. The disease mainly occurs in resource-poor communities in the developing world, but it is also reported sporadically in high-income countries and in tourists who have visited the tropics. Diagnosis is made clinically in the presence of a linear serpiginous track moving forward in the skin, associated with itching and a history of exposure. Itching is typically very intense and can prevent patients from sleeping. Bacterial superinfection occurs as a result of scratching. Treatment is based on oral drugs (albendazole or ivermectin) or the topical application of tiabendazole. To control hookworm-related cutaneous larva migrans at the community level, regular treatment of dogs and cats with anthelmintic drugs is necessary, but this is seldom feasible in resource-poor settings. Animals should be banned from beaches and playgrounds. For protection at the individual level, unprotected skin should not come into contact with possibly contaminated soil.