Pediatric Cutaneous Larva Migrans Follow-up

Updated: May 23, 2018
  • Author: Martha L Muller, MD; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Deterrence/Prevention

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  • Prevention of cutaneous larva migrans (CLM) is critical.

  • Advise patients to avoid sitting, lying, or walking barefoot on wet soil or sand.

  • Advise individuals to cover the ground with an impenetrable material when sitting or lying.

  • Pets should be dewormed.

  • Beaches that allow cats and dogs should be avoided.

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Complications

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  • Severely excoriated lesions causing secondary infection with Staphylococcus aureus or Streptococcus pyogenes may lead to edema, making the tracks less visible.

  • Heavy infestation of larvae may lead to Löffler syndrome, which is characterized by pulmonary infiltrates and eosinophilia. [17] In one study, only 12% of patients with Löffler syndrome and CLM had pulmonary symptoms, such as a cough. [18] Larvae localized to the skin may elicit a generalized sensitization with soluble antigens in the lung to cause the pulmonary infiltrates.

  • If human nematodes (ie, A duodenale, N americanus, S stercoralis) are the cause of CLM, topical treatments such as cryosurgery or 10% thiabendazole solution do not prevent systemic involvement. Monitor patients for several months after treatment for gastrointestinal and respiratory symptoms.

  • One individual with CLM reportedly experienced complications caused by erythema multiforme. [19]

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Prognosis

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  • Prognosis is excellent.

  • Even without treatment, the larvae eventually die and the cutaneous lesions resolve in weeks to months.

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Patient Education

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  • Advise individuals to cover sandboxes when not in use.

  • When on beaches, advise people to lie on beach towels, not directly on the sand, and to wear sandals or water socks.

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