Larva migrans

Created 2008.

Learning objectives

• Identify and manage cutaneous larva migrans

Introduction

In New Zealand, endemic larva migrans (creeping eruption) is very rare in New Zealand, but travellers to South East Asia regularly present with cutaneous larva migrans. Affected areas are usually the feet and lower legs, or any part of the body that has been in contact with soiled ground.

The eruption is due to penetration of the skin by dog hookworm larvae (usually Ankylostoma species), which are unable to complete their life cycle in humans as they cannot penetrate the basement membrane.

The larva travels several centimetres under the skin causing an irritable track 3-5mm in width that persists for one to three months.

Bali

Thailand

Larva migrans

Management

Cutaneous larva migrans may be destroyed using anthelmintics:

• Mebendazole 200mg bd for 4 days
• Albendazole 400mg daily for 3 days (more effective, available under Section 29)

Activity

Describe the adverse effects of albendazole.