Wilderness Medicine, First Aid, and Outdoor Skills
Cutaneous Larva Migrans (Hook Worm)

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Hook WormCutaneous larva migrans often presents itself as skin dermatitis. It appears as an irregularly shaped red line, either semi-circular or squiggly. The entrance of the organism, which is a very small worm, will often times cause a papule or a blister to form at the site. It is very commonly seen on the soles of the feet.

The hook worm is the most common species of cutaneous larva migrans, and is often found in the stool of dogs and cats, unlike the round worm, which is found in the stool of raccoons, more commonly in the Midwest. Hook worm rashes often itch. If untreated, they usually go away in 2-3 weeks, and are not a problem. In severe cases, in the acute phase, the adult worm can proceed to the intestine, and may cause colic or epigastric pain, flatulence, diarrhea and weight loss. The majority of infections is seen in the southeastern United States, and is commonly seen on beaches where individuals are walking their dogs.

The rash that you see here is a common presentation of cutaneous larva migrans. This young gentleman was lying in a field frequented by people walking their dogs and cats. He had one lesion on his back and one on his arm.

Healthcare Treatment and Prevention
Thiabendazole is the most commonly used drug. It is 25 mg./kg. twice daily for 2 days, and it does result in about a 90% cure rate. You can also use Albendazole, 400 mg. daily for 3 days, which is also very effective.

Hook Worm




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