A patient presents with eosinophilia, urticaria, and a serpiginous skin rash that advances several centimetres per day. Travel history includes walking barefoot on a beach in South India. The causative organism and treatment are:
- A Strongyloides stercoralis (larva currens) — treated with ivermectin 200 µg/kg stat
- B Toxocara canis (visceral larva migrans) — treated with albendazole 400 mg twice daily for 5 days
- C Ancylostoma caninum/braziliense (cutaneous larva migrans) — treated with albendazole 400 mg daily for 3–7 days or ivermectin ✓
- D Loa loa (loiasis) — treated with diethylcarbamazine (DEC)
Explanation
Cutaneous larva migrans (creeping eruption) is caused by dog/cat hookworm larvae (Ancylostoma caninum, A. braziliense) that penetrate human skin but cannot complete their life cycle, wandering through the epidermis creating serpiginous, intensely pruritic tracks advancing 1–2 cm/day. Exposure via barefoot contact with warm sandy soil contaminated by animal faeces is classic. Treatment of choice is albendazole 400 mg daily for 3–7 days or ivermectin 200 µg/kg stat (single dose). Larva currens (Strongyloides) moves much faster (>10 cm/hour) and involves the perianal region. Loa loa causes subconjunctival migration in West Africa.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.