Research Article
Cutaneous Larva Migrans in a Newborn of 3 Weeks
Salissou Laouali *, Moussa Doulla M, Ouedraogo Maimouna M, Ousmane Sareye, Souleymane Brah, Djibo Ali and Eric Adehossi E
Corresponding Author: Salissou Laouali, Training and Research Unit of Medical Sciences, Abdou Moumouni University of Niamey
Received: September 29, 2017; Revised: October 26, 2017; Accepted: October 13, 2017
Citation: Laouali S, Doulla M M, Maimouna M O, Sareye O, Brah S, et al., (2017) Cutaneous Larva Migrans in a Newborn of 3 Weeks, 3(2): 168-171.
Copyrights: ©2017 Laouali S, Doulla M M, Maimouna M O, Sareye O, Brah S, et al.. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Also referred to as creeping dermatitis, Cutaneous Larva Migrans (CML) is a parasitic disease caused by hookworm larvae in a dead end in moist soil. More common in children, it is rare in adults and exceptional in infants. We report a case in a 3-week-old Newborn that was sent to us by the pediatric department of the National Hospital of Niamey. Contamination was made by contact with clothes soiled by moist soil containing larvae. The presence of stray cats in the house was confirmed by the mother. Local treatment with albendazole in preparation with a cream resulted in complete healing after 2 weeks.

Keywords: Cutaneous Larva Migrans, Newborn, Albendazole, Niger

INTRODUCTION
Cutaneous Larva Migrans (CML), also known as  "migrant helminthiasis", "dermatitis serpiginosus", "creeping eruption", or "sand worm" is a zoodermatosis caused by cutaneous penetration of helminth larvae, usually parasites of the small bintestines of cats and dogs [1]. It is first described in 1874 by Lee RJ [2], as a benign skin condition. More noticeable in tropical and subtropical countries, it is caused by the accidental migration of an animal nematode larva into the surface part of the skin. The most incriminated larvae are: Ancylostoma caninum, Ancylostoma brasiliense and Uncinaria stenocephala [3].

 
We report a case in a 3-week-old Newborn that was sent to us by the pediatric department of the National Hospital of Niamey. Local treatment with albendazole as a mixture in a cream, led to complete cure after 2 weeks.


OBSERVATION
This was a three-week-old newborn that we received in consultation with the Department of Dermatology at the National Hospital of Niamey, Niger (west Africa). The duration of the illness before the consultation was 7 days. Crying and agitation link to prurit was the reason for pediatric consultation. No treatment has been done locally and by the general route. Physical examination revealed numerous serpiginous erythematous lesions at the back without excoriation, measuring several centimeters in length (Figure 1). At the interrogation, the mother of the baby revealed the presence of stray cats in the family environment. After the laundry, the newborn's clothes are spread out in the courtyard of the house on a rope where some of them fall to be in contact with the soil soiled with larvae. The general condition of the newborn was normal, without any other cutaneous affection. Base line hematological and biochemical investigations were within normal limits. According to epidemiological and clinic aspects, diagnosis of CLM was made.  A local treatment combining albendazole mixed in a moisturizing cream was carried out. One week after initiation of treatment, inactivation of serpiginous erythematous furrows (Figure 2) was observed; two weeks later, the total disappearance of the furrows was seen (Figure 3). No local side effects were noted.

DISCUSSION
Rare in temperate countries, CML is reported mainly in tropical countries [4,5]. The reported cases mainly concern the 1 to 5 year age group [6]; adults appear to be more affected during travel due to the presence of cats roaming on beaches and hotels [7-9]. The peculiarity of this observation is the appearance of Cutaneous Larva Migrans in a newborn of three weeks; Classically, the serpiginous erythematous lesion is objective [5,7,8,10] and was present in this newborn. The location of the lesions is mainly in the areas most in contact with the damp and soiled soil and concerns the pelvic limbs [7, 11,12]; in this small patient, contamination of the back skin, was indirect through the drying clothes that fell on a moist soil containing larvae. Many molecules used orally alone or in combination have proved to be effective, the main ones being: albendazole, thiabendazole, mebendazole, and / or ivermectin [13]. The local treatment performed with thiabendazol [14] on another occasion also responds well with albendazol, with which our patient was cured in 2 weeks without side effects such as allergic contact dermatitis, pruritus and irritation [15].

CONCLUSION
The cutaneous larva migrans is classically favored by moisture and domestic host animals mainly cat and dog.

Neonatal infestations are exceptional and would be favored by wearing clothes soiled by wet soil containing larvae. Local treatment based on albendazole in a cream is always effective.

STATEMENT OF INFORMED CONSENT

Written informed consent was obtained from the patient’s father for publication of this article and any accompanying images.

 

CONFLICT OF INTEREST

None declared

 

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