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Creeping eruption

Definition

A creeping eruption is infection with dog or cat hookworm larvae.

Alternative Names

Cutaneous larvae migrans; Ancylostoma braziliense

Causes, incidence, and risk factors

Hookworm eggs are found in the stool of infected dogs and cats. When the eggs hatch, the resulting larvae infest the soil and vegetation. When you touch this infested soil, the larvae can dig into your skin, causing an intense inflammatory response that leads to a rash and severe itching.

Creeping eruption is more common in countries with warm climates. In the U.S., the southeastern states have the highest rates of infection. The main risk factor for this disease is contact with damp, sandy soil contaminated with infected cat and dog feces. More children than adults become infected.

Symptoms

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

Signs and tests

Your health care provider will usually diagnose this condition by looking at your skin. Rarely, a skin biopsy may be done to rule out other conditions.

Treatment

Anti-parisitic drugs (thiabendazole or albendazole) may be used to treat the infection. Ivermectin may also work.

Expectations (prognosis)

Creeping eruption may go away by itself over a period of weeks to months. Treatment helps the infection go away more quickly and is highly successful.

Complications

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

Calling your health care provider

Make an appointment with your health care provider if you or your child have skin lesions that are snakelike, itchy, and migratory.

Prevention

Public sanitation and de-worming of dogs and cats have decreased hookworm infestation in the United States.

Hookwarm larvae often enter the body through bare feet, so wearing shoes in areas where hookworm infections are known to occur will help prevent infection.

References

Kazura JW. Nematode infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 378.

Review Date: 12/3/2008
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; 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 David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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