You are here:

Creeping eruption

Definition

Creeping eruption is a human infection with dog or cat hookworm larvae (immature worm).

Figures

Strongyloidiasis, creeping eruption on the back

Alternative Names

Cutaneous larvae migrans; Zoonotic hookworm; Ancylostoma caninum; Ancylostoma braziliensis; Bunostomum phlebotomum; Uncinaria stenocephala

Causes, incidence, and risk factors

Hookworm eggs are found in the stool of infected dogs and cats. When the eggs hatch, the larvae infest any contaminated soil and vegetation.

When you come into contact with this infested soil, the larvae can burrow into your skin. They cause an intense inflammatory response that leads to a rash and severe itching.

Creeping eruption is more common in countries with warm climates. In the United States, the southeast has the highest rates of infection. The main risk factor for this disease is contact with damp, sandy soil that has been contaminated with infected cat or dog feces. More children than adults are infected.

Symptoms

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

Signs and tests

Your health care provider can often diagnose this condition by looking at your skin. In rare cases, a skin biopsy is done to rule out other conditions. In very rare cases, a blood test is done to see if you have increased eosinophils.

Treatment

Anti-parasitic drugs such as thiabendazole, albendazole, or ivermectin may be used to treat the infection.

Expectations (prognosis)

Creeping eruption often goes away by itself over weeks to months. Treatment helps the infection go away more quickly and is successful.

Complications

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

Calling your health care provider

Make an appointment with your health care provider if you or your child have skin sores that are snakelike, itchy, or moving from one area to another.

Prevention

Public sanitation and deworming of dogs and cats have decreased hookworm infestation in the United States.

Hookworm larvae often enter the body through bare feet, so wearing shoes in areas where hookworm infestations are known to occur helps prevent infection.

References

Diemert DJ. Intestinal nematode infections. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 365.

Nash TE. Visceral larvae migrans and other unusual helminth infections. In: Mandell GL, Bennett JE, Dolan R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2009:chap 291.

Disclaimers

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions.
Call 911 for all medical emergencies.
Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).