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    Creeping eruption

    Cutaneous larvae migrans; Zoonotic hookworm; Ancylostoma caninum;Ancylostoma braziliensis;Bunostomum phlebotomum;Uncinaria stenocephala

    Creeping eruption is a human infection with dog or cat hookworm larvae (immature worm).

    Causes

    Hookworm eggs are found in the stool of infected dogs and cats. When the eggs hatch, the larvae infest any contaminated soil and vegetation.

    When you come into contact with this infested soil, the larvae can burrow into your skin. They cause an intense inflammatory response that leads to a rash and severe itching.

    Creeping eruption is more common in countries with warm climates. In the United States, the southeast has the highest rates of infection. The main risk factor for this disease is contact with damp, sandy soil that has been contaminated with infected cat or dog feces. More children than adultsare infected.

    Symptoms

    • Blisters
    • Itching, may be more severe at night
    • Raised, snakelike tracks in the skin that may spread over time, usually about 1 cm per day (severe infections may cause several tracks) usually occur on the feet and legs

    Exams and Tests

    Your health care providercan oftendiagnose this condition by looking at your skin. In rare cases, a skin biopsyis done to rule out other conditions. In very rare cases, a blood testis done to see if you have increased eosinophils.

    Treatment

    Anti-parasitic drugs such as thiabendazole, albendazole, or ivermectin may be used to treat the infection.

    Outlook (Prognosis)

    Creeping eruptionoften goes away by itself over weeks to months. Treatment helps the infection go away more quickly and is successful.

    Possible Complications

    • Bacterial skin infections caused by scratching
    • Spread of the infection through the bloodstream to the lungs or small intestine (rare)

    When to Contact a Medical Professional

    Make an appointment with your health care provider if you or your child have skin sores that are snakelike, itchy, or moving from one area to another.

    Prevention

    Public sanitation and deworming of dogs and cats have decreased hookworm infestation in the United States.

    Hookworm larvae often enter the body through bare feet, so wearing shoes in areas where hookworm infestations are known to occur helps prevent infection.

    References

    Diemert DJ. Intestinal nematode infections. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 365.

    Nash TE. Visceral larvae migrans and other unusual helminth infections. In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2009:chap 291.

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        Review Date: 11/10/2012

        Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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