Cutaneous larva migrans

Abstract

Cutaneous larva migrans (CLM) is due by the presence of different types of worm’s larvae in the human skin. It affects more frequency the people from tropical and subtropical area, but rare in temperate places (1).The objective of the study is a clinical presentation of the CLM, a rare zoonosis, which can affect humans accidentally. A retrospective study was made using the informations from the news medical manuscripts and the clinical observation paper of the patient. We present a case of 2 years old female patient, who presents in September 2009, in the Infectious Diseases Department of Pneumology Hospital of Oradea, for a serpinginous papulo-erythematous, pruritic skin track localized initially on the posterior thoracic wall. She was from rural area, didn’t have any pets at home and did not travel in other foreign countries ever. The mother said that the child usually was playing in neighbor’s yard and they have a dog. The patient was primary treated in other department with antihistaminic drugs and antibiotics with no positive results. After that, the affected area grows with the migration of the track on the anterior thorax, then on neck, associated with the apparition of another 2 tracks: one on the right buttock and the other one in the right retroauricular area. The laboratory test revealed leukocytosis with peripheral eosinophilia associated with anemia. Skin biopsy didn’t reveal any etiology. Diagnosis was CLM according to the clinical manifestation and history. Two cures of Albendazol (400 mg/d for 3 days, then another 400 mg/d for 5 days) were prescribed. One recurrence appeared after the first cure of treatment, but not after the last one.: CLM is a rare condition in the temperate area, especial in the autumn period, to a child who hasn’t been in an endemic area. Identification of the larvae by skin biopsy was negative. The CLM had an atypical localization. The hookworm anemia is a rare complication of the CLM, and it is present at children or pregnant females. The contamination of the environment in which the child was playing was probably the cause that leaded to the appearances of the zoonosis.