Two clinical cases of cutaneous larva migrans among travelers returning from tropical countries

Abstract

After febrile conditions and diarrheal syndrome, skin diseases are the third most common medical problem among people returning from regions with the tropical climate. Hookworm-related cutaneous larva migrans is caused when animal filariform larva penetrates the human dermis. The larva is unable to move into deeper tissues and moves “migrates” in the dermis. The condition is also known as "creeping eruption" and most often affects the skin on the feet, buttocks and abdomen. Diagnosis is clinical, based on the typical cutaneous manifestations and recent travel history. Serologic tests or other diagnostic methods for cutaneous larva migrans are not available. The purpose of this work was to present two cases of a 30-year-old man and a 4-year-old child who were examined at the National Centre of Infectious and Parasitic Diseases in Sofia, Bulgaria, after tourist trip in Brazil and the Goa State of India, respectively. Reason for examination was itchy linear rash in both patients, located on the dorsal surface of the left foot in the man and the left gluteal region in the child. Based on the typical exanthema of the skin and the epidemiological history of visiting an endemic region, diagnosis of "cutaneous larva migrans" was made in both cases. Treatment with albendazole was applied, as directed, after which the clinical manifestations in both patients, resolved completely. The increasing travel of people across borders may result in an increased incidence of non-endemic or rarely seen in the temperate geographic regions diseases of which the physicians should be informed.