gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Cutaneous larva migrans: rapid improvement of clinical pathology after treatment with ivermectin

Kutane larva migrans: schnelle Verbesserung der klinischen Pathologie nach ivermectin Therapie

Meeting Abstract

  • A. Schuster - Charité University Medicine Berlin, Institute of Microbiology and Hygiene, Berlin, Germany
  • H. Lesshafft - Charité University Medicine Berlin, Institute of Microbiology and Hygiene, Berlin, Germany
  • S. Talhari - Foundation for Tropical Medicine of Amazonas (FMTAM), Manaus, Brazil
  • S. Guedes de Oliveira - Foundation for Tropical Medicine of Amazonas (FMTAM), Manaus, Brazil
  • R. Ignatius - Charité University Medicine Berlin, Institute of Tropical Medicine, Berlin, Germany
  • H. Feldmeier - Charité University Medicine Berlin, Institute of Microbiology and Hygiene, Berlin, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocTRO 05-4

DOI: 10.3205/10kit056, URN: urn:nbn:de:0183-10kit0564

Veröffentlicht: 2. Juni 2010

© 2010 Schuster et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Cutaneous larva migrans (CLM) is a common but neglected parasitic skin disease caused by the migration of animal hookworm larvae in the epidermis. The disease is common in impoverished communities of the developing world; it is associated with considerable morbidity and results in life quality impairment.

Methods: Patients with CLM were identified through active case finding in two slums in Manaus, Amazonas State, Brazil. Patients were diagnosed clinically. Clinical pathology was assessed in a semi-quantitative manner. Patients were treated with ivermectin (200µg/kg) and were followed-up 2 and 4 weeks after treatment.

Results: 92 consecutive patients were included in the study: 69.6% were male and 30.4% were female. Median age was 9.5 years (IQR 5–44). The number of tracks ranged from 1-51 (median: 2, IQR 1–6), 70% of all patients had ≤4 tracks. The mean length of the track was 42 mm. Excoriations were observed in 49%, crusted lesions 62% and superinfection in 13% of all patients. Extremely itching bullous lesions occurred in 8% of all cases. 92% of the patients complained about pruritus and 73% about insomnia due to itching.

Follow-up examinations showed a significant decrease of the number of active lesions two weeks after treatment (p=0.01). The length of the tracks had decreased 9mm (IQR 2–3) after 2 weeks and 20 mm after 4 weeks (IQR 0–3) The proportion of superinfected lesions was reduced from 13% to 2% after 4 weeks (p=0.02). Pruritus significantly decreased in 60.2% of the patients after 2 weeks, and in 83.3% of the patients after 4 weeks. Pruritus-related insomnia decreased in 53.5% and 63.7%, respectively.

Conclusions: In a resource-poor setting most patients with CLM suffered from multiple infestation and showed important clinical pathology. A single dose of ivermectin significantly reduced clinical pathology within 2 to 4 weeks.


References

1.
Heukelbach J, Feldmeier. H. Epidemiological and clinical characteristics of hookworm related cutaneous larva migrans. Lancet Inf Dis. 2008;8:302-9.
2.
Jackson A, Heukelbach J, Calheiros CM, Soares Vde L, Harms G, Feldmeier H. A study in a community in Brazil in which cutaneous larva migrans is endemic. Clin Inf Dis. 2006;43:13-8.