Zoonotic hookworm infections

Abstract

Hookworms on occasion cause creeping lesions in the superficial layers of the human skin that have been designated as cutaneous larva migrans for the purpose of contrasting the condition with visceral larva migrans. Currently, the disease is presenting most commonly to physicians specializing in tropical or travel medicine in patients who have just visited a tropical beach and are presenting with serpiginous tracks in their skin. The serpiginous tracts can persist for week, and are often pruritic, may be associated with accompanying bulla, and can rarely lead to secondary sequelae. The larval are likely to penetrate ultimately to deeper tissues, where they may be persisting in the tissues of humans in the same fashion as they would within the tissues of any other vertebrate paratenic host.Most hookworm larvae are capable of penetrating the skin and causing lesions that are similar to cutaneous larvae migrans. However, the geographic distribution of cases still seems to suggest that only one species, A. braziliense, is the offending species. The other species appear to spend less time in the skin of the human host, and if they do cause lesions, they appear to produce lesions that are more vesicular or that cause disease of a markedly shorter duration. It seems that the development of improved molecular methods will ultimately lead to the means of more carefully discrimination the geographical location of the offending species and may someday be able to identify specific larvae from lesions.There are other manifestations of zoonotic hookworm infection. These include the infection of the human intestinal tract with the adults of the canine/feline hookworm Ancylostoma ceylanicum; the induction of cases of eosinophilic colitis in people with the canine hookworm, Ancylostoma caninum; suspected cases of ocular larva migrans due to hookworm larvae, and the rare case of cutaneous larva migrans due to hookworm species that are only rarely associated with human infections.