Cutaneous Larva Migrans Treatment & Management

Updated: Aug 02, 2017
  • Author: David T Robles, MD, PhD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Even though cutaneous larva migrans (CLM) is self-limited, the intense pruritus and risk for infection mandate treatment. Prevention is key and involves avoidance of direct skin contact with fecally contaminated soil.

Oral albendazole, oral ivermectin, or topical ivermectin are the usual treatment choices, [18, 19, 20] along with perhaps thiabendazole (not available in the United States). [21]

In the United States, albendazole at 400 mg/day for 3 days is recommended. Alternatively, ivermectin can be administered as a 12-mg dose and repeated the next day. Some also recommend trying topical treatment with topical ivermectin or topical thiabendazole compounded in a 10% suspension or 15% cream or topical metronidazole cream, all used four times daily. If effective, the topical therapies are expected to resolve the condition in 1 week.

Outside the United States, thiabendazole has been recommended for the treatment of cutaneous larva migrans, as has oral albendazole or ivermectin. [21] Thiabendazole is not available in the United States.

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Complications

A secondary bacterial infection in patients with cutaneous larva migrans (CLM), usually with Streptococcus pyogenes, may lead to cellulitis.

Allergic reactions may occur.

On rare occasions, Loeffler syndrome has been reported. [12]

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Consultations

Consultation with a dermatologist may be warranted.

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