What is CLM diagnosis?
Diagnosis. CLM is a clinical diagnosis based on the presence of the characteristic signs and symptoms and exposure history. For example, the diagnosis can be made based on presence of raised erythematous tracks with pruritis on the feet or lower extremities of a patient with recent travel history to tropical areas.
Can pyrantel pamoate be used topically?
The most straightforward products to use for this basic internal and external parasite control protocol are an oral dewormer containing pyrantel pamoate (Nemex® and Strongid® are the most commonly used products), and topical products such as imidacloprid (Advantage) and/or fipronil (Frontline).
What parasite causes cutaneous larva migrans?
Cutaneous larva migrans (CLM), also having been termed for the clinical sign of creeping eruption, is an infectious syndrome caused by multiple types of hookworms. This is most commonly transmitted by animal feces depositing eggs in the soil, with larvae entering humans through direct contact with skin.
Who is at risk for cutaneous larva migrans?
People of all ages, sex and race can be affected by cutaneous larva migrans if they have been exposed to hookworm larvae. It is most commonly found in tropical or subtropical geographic locations. Groups at risk include those with occupations or hobbies that bring them into contact with warm, moist, sandy soil.
Which is the best oral treatment for larva migrans?
Thiabendazole is the drug with which there has been the most experience in the oral treatment of cutaneous larva migrans [5, 9–12] (table 1). Thiabendazole is poorly effective when given as a single dose. For example, only 68% of 28 patients in 1 series were cured by a single dose of 50 mg/kg [5].
When to start thiabendazole for cutaneous larva migrans?
Topical thiabendazole is considered the treatment of choice for early, localised lesions. Oral treatment is given when the cutaneous larva migrans is widespread or topical treatment has failed. Itching is considerably reduced within 24–48 hours of starting antihelmintic treatment and within 1 week most lesions/tracts resolve.
How long does it take for larva migrans to heal?
In a series of 25 patients treated with a placebo, 12% healed by the end of the first week and 36% by the end of the fourth week; the longest period required for spontaneous healing was 11.2 weeks in this series [ 5 ], but the larvae have been known to migrate for up to 1 year [ 3 ].