25- cutaneous larva migrans

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Medical Parasitology:

Medical Parasitology Prof. Dr : Ahmed Bayoumy Professor of Parasitology Al-Azhar Faculty of Medicine

Nemathelminthes:

Nemathelminthes Nematoda ( round worms)

Classification:

Classification Intestinal (no ID host) Small intestine: Ascaris, Ancylostoma, Necator, Strongyloides, Trichinella, Trichostrongylus, Capillaria Large intestine: Enterobius, Trichuris Tissue (need ID host) Adults in tissue Filaria, Medina worm Larvae in tissues: Trichinella , Larva migrans

Cutaenous Larva Migrans:

Cutaenous Larva Migrans Creeping eruption Sand worm Plumber ’ s itch

PowerPoint Presentation:

Invasion of skin by filariform larvae of dog and cat hook worms Ancylostoma caninum Ancylostoma braziliense

Life cycle:

Life cycle

Cutaneous larva migrans:

Infected dog harboring A.caninum or A.braziliense in the small intestine Immature egg When human skin gets in contact with dog or cat excreta, infective larvae penetrate his bare-footed skin Infective filariform larva What happens when infective filariform larva of A.caninum or A.braziliense penetrate human skin? Cutaneous larva migrans Soil contaminated with infected dog stool

PowerPoint Presentation:

Beaches are common areas where human infection with A.caninum & A.braziliense may occur

Pathogenesis :

Pathogenesis Larvae migrate under the skin making visible serpentine tunnel. Erythematous, vesicular, secondary infection

Pathogenesis and Clinical Picture of CLM:

Pathogenesis and Clinical Picture of CLM Red itchy papule at the site of entry. Slightly elevated itchy erythematous serpiginous متعرجة tunnels which may become secondary infected. Advances at a rate of 1-2 cm / day for weeks or months till larvae die. Cutaneous larva migrans = Creeping eruption الطفح الزاحف Seen in skin of feet, hands, back and buttocks.

Diagnosis of Cutaneous Larva Migrans:

Diagnosis of Cutaneous Larva Migrans Advancing serpiginous tunnels. History of skin contact to soil. Larva is ahead of its track. High eosinophilia.

Treatment :

Treatment Thiabendazole ointment / several times /10 days Thiabendazole 25mg/ kg X 2 X 3 Albendazole 200 mg X 2 X 3 Antibiotics antihestaminics

Treatment of Cutaneous Larva migrans:

Treatment of Cutaneous Larva migrans Treatment of Visceral Larva migrans 1- Thiabendazole orally Repeated after one month 2- Corticosteroids In severe cases 2- Thiabendazole ointment 3- Antibiotics 4- Anti-histaminics

Control :

Control Application of larvicidals to soil Avoidance of barefoot Treatment of pet dogs Killing of stray dogs

Prevention and Control of Larva migrans:

Pet dogs and cats de-wormed. Stray dogs and cats eliminated. Prevention and Control of Larva migrans Cutaneous larva migrans Visceral larva migrans Avoid contaminated food, drink and hands Avoid skin contact with contaminated soil

Larva migrans:

Larva migrans Migration of larvae of nematodes in unsuitable hosts. Larvae cannot complete their normal development into adults. Invasion of human skin by filariform larvae of A.caninum & A.braziliense Invasion of human viscera by larvae of Toxocara canis & Toxocara cati Cutaneous larva migrans Visceral larva migrans

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