Larva migrans cutanea and hookworm disease

Larva migrans cutanea and hookworm disease: description

Both larva migrans cutanea and hookworm disease are caused by insect larvae (mostly larvae of various worm species). The parasites enter the body of their host through the skin. It is only there that they become sexually mature and start to grow away.

The parasites are mainly distributed in the tropics and subtropics. The number of infected people worldwide is estimated at about one billion people. Travelers in these regions are also more likely to be affected when they come into contact with contaminated feces, for example on the beach.

Hookworm disease

The hookworm disease is caused by the worm species Ancylostoma duodenale and Necator americanus. The former occurs in Africa and Asia, the latter in the Americas. These hookworm species are adapted to humans and use it as a so-called end host, where the larvae ripen to adult worms.

The worm larvae penetrate the skin, but migrate from there quickly with the lymph or blood flow into the lungs. From there, they reach the throat via the larynx, are swallowed and finally reach the intestine. There, they grow into sexually mature worms within five weeks. They suck in about 0.2 ml of blood from the wall of the small intestine daily. In case of heavy infestation, they cause anemia.

The female worms lay up to 20,000 eggs daily, which are excreted with the human chair. At temperatures of at least 20 degrees Celsius, larvae mature in the soil after one to two days, which survive for up to one month in a moist, warm environment and can infect other people.

Larva migrans cutanea (skin mole)

“Larva migrans” means “wandering larva” to German. Thus, even the name of the disease indicates the most characteristic symptom. The disease manifests itself in clearly recognizable, tortuous, reddened lines on the skin. These arise when the parasites drill passages into the skin in which they travel.

Skin molt is usually caused by canine or cat hookworms such as Ancylostoma brasiliense or A. canium. Less common are other parasites, such as the horsefly larvae, the African tumbuffliegen or the miniature threadworm, the invaders. However, humans are a false host to these parasites: that is, the pathogens are not adapted to the conditions in the human body. The larvae therefore remain exclusively in the skin and do not migrate to the lungs or the intestine. They also can not develop into sexually mature animals and die after a few weeks to months.

Larva migrans cutanea and hookworm disease: symptoms

Larva migrans cutanea and hookworm disease often express themselves as early as a few hours after penetration of the larvae in the form of redness and itching.

Hookworm disease – symptoms

The larvae of the hookworm then migrate from the skin into the lungs and larynx. Patients often complain of coughing and nausea, hoarseness or shortness of breath. Ingestion causes the worms to enter the intestine, where they suck blood from the intestinal wall. In case of massive infestation, infected people develop anemia (iron deficiency anemia), which is accompanied by the following symptoms:

• Performance decline, weakness, difficulty concentrating
• a headache
• paleness
• Hair loss, brittle nails

In addition, the hookworms cause the following symptoms about one to four weeks after infection in the gastrointestinal tract:

• stomach pain
• Nausea and vomiting
• bloating
• Bloody-slimy diarrhea
• anorexia

The disease can lead to a strong protein loss. This increases the susceptibility to infection and can cause water retention (edema).

Skin mole – Symptoms

The larvae of the parasites can not penetrate deeper into the human body. Therefore, the complaints on the skin remain limited. This shows a diverse picture of vesicles, elevations and (papules). Later, the larvae begin to migrate in the skin and form ducts. From the outside these are visible in the form of reddened, twisted lines. The larvae usually sit one to two centimeters in front of a visible corridor and are invisible to the naked eye. They migrate daily up to three inches, causing a strong, often unbearable itching.

Larva migrans cutanea and hookworm disease: causes and risk factors

The causes of hookworm disease are worm larvae, those of larva migrans cutanea worm or fly larvae. The parasites first invade the skin, often on the feet or buttocks. Especially when walking barefoot, lying on the beach or while working in paddy fields, people get infected with the larvae.

A direct infection from person to person or from animal to human is not possible. The infection usually occurs through contact with contaminated feces. The inclusion of hookworms by larvae-containing foods is very rare, but not excluded.

Larva migrans cutanea and hookworm disease: investigations and diagnosis

To diagnose Larva migrans cutanea or hookworm disease, your doctor will first ask you about the medical history (anamnesis). He will ask you the following questions:

• Have you been in the tropics or subtropics lately?
• Did you walk a lot barefoot on vacation?
• Do you often lay on the beach?
• Since when are you having those complaints?
• At which part of the body did itching first appear?

Subsequently, your doctor will examine you physically. He recognizes a molt by means of the typical passages in the skin. A hookworm disease can be detected in the stool. In it are worm eggs, which can be seen under the microscope. In a chest X-ray, larvae may be detected in the lungs.

Larva migrans cutanea and hookworm disease: treatment

To treat worm diseases such as larva migrans, there are special worm remedies called anthelminthics. Depending on the type of worm, different preparations are used.

Hookworm disease – treatment

In a hookworm disease, especially the anemia must be treated. For this, the doctor prescribes iron supplements so that the body can build new blood cells. Furthermore, the worms can be controlled by anthelmintics. These include mebendazole, thiabendazole or pyrantel. Remedies for diarrhea or adequate fluid intake relieve further discomfort caused by hookworms.

Skin mole – treatment

This type of larva migrans heals by itself. Salts applied on affected skin accelerate healing. They contain, for example, thiabendazole, albendazole or ivermectin. In case of heavy infestation, the doctor also administers these agents in tablet form. In some cases, it can freeze the larvae in the skin. For this, the doctor uses an ethyl chloride spray. This procedure is only recommended if the seat of the larvae can be estimated with high reliability. Mostly it is one to two centimeters in front of a visible corridor. Since the whereabouts can not be accurately predicted, an operational distance is foreseen.

Larva migrans cutanea and hookworm disease: prevention

Larva migrans syndrome is best avoided by avoiding touching contaminated soils with bare skin. Therefore, when staying in the tropics and subtropics:

• Do not walk barefoot in subtropical and tropical areas when there is a risk of soil or beach being contaminated with feces.
• Avoid lying or bedding on beaches that may be contaminated by human faeces or dog and cat feces.
• Playgrounds and sandboxes should be protected from contamination by dog ​​and cat feces.
• Meaningful is also a regular deworming of the pets with suitable medicines (Anthelminthika).
• Infected persons should use toilet facilities in order not to spread the worm eggs.

A vaccine against Larva migrans is not available.

Larva migrans cutanea and hookworm disease: disease course and prognosis

In general, the prognosis is at Larva migrans cutanea and hookworm disease alright. In the first, the molt, about one percent of the larvae dies on their own every day. Therefore, this parasite infection is even after a few weeks without treatment.

The Hookworm disease also often heals without consequences. However, it can lead to life-threatening complications, so this form must be treated necessarily. Especially in children, the high blood loss that the parasites cause can be fatal. Added to this is the increased susceptibility to infection of the infected. The body can only fight off other illnesses badly.