Naslov
Visceral larva migrans in returning travelers

Autori
Vrdoljak, Maja ; Lukas, Davorka ; Višković, Klaudija ; Gorup, Lari

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
1st South-East European Conference on Travel, Tropical, Migration Medicine and HIV & 2nd Croatian Congress on Travel, Tropical, Migration Medicine & HIV

Mjesto i datum
Dubrovnik, Hrvatska, 28.09.2017. - 01.10.2017

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
Larva migrans ; travelers

Sažetak
Background: Larva migrans is a group of clinical syndromes that result from the movement of parasite larvae through host tissues. The symptoms vary with the number of parasites and the tissues invaded. Typical target organs are the liver and lungs, causing symptoms classically described as visceral larva migrans (VLM). Organisms may also travel through the skin (cutaneous LM, CLM) or invade the eye (ocular LM). CLM is more frequent in tropical and subtropical countries and usually occurs as a result of human infection with the larvae of the dog or cat hookworms, Ancylostoma braziliense or Ancylostoma caninum. Hematogenous dissemination of larvae to the lungs is a rare complication of infection. Case presentation: 25-year-old female presented with progressive, pruritic cutaneous eruptions which appeared during her 12 day trip to Thailand. Her partner, who travelled with her, had the same skin lesions, but in lesser extent. On the day of return to Croatia, the female patient developed low-grade fever and dry cough. Four days later she was reffered to an infectologist. Clinical examination revealed bizarre erythematous, snake- like eruptions all over the body. Complete and differential blood count and basic biochemical tests were within reference range. Chest x-ray, on the other hand, showed bilateral infiltrates. Abdominal ultrasound and fundus examination were also performed and revealed no abnormalities. Control laboratory tests after 10 day empiric treatment with levofloxacine discovered growing eosinophilia (22% and 36% in differential blood count), with normal liver function tests and serum protein electrophoresis. Since the medical history and diagnostic findings highly suggested visceral larva migrans, further test were performed. Parasitological stool exams, however, were negative, as well as serology for Toxocara, Strongyloides and Trichinella. Skin biopsy results were nonspecific. The patient was empirically treated with ivermectin for 2 days. On follow-up significant regression of skin lesions was noted, laboratory examination showed normal levels of eosinophils and chest x-rays complete regression of infiltrates. Conclusions: Larva migrans has to be considered in travelers returning from a (sub)tropical areas with varying clinical manifestations or eosinophilia. Prognosis appears favorable with adequate treatment. Diagnostic methods are to be improved in our settings.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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