Larva migrans cutánea de origen autóctono en Guipúzcoa / Autochthonous cutaneous larva migrans infection in Guipúzcoa

INTRODUCCIÓN: Larva migrans cutánea (LM) es una erupción serpiginosa causada por helmintos nematodos que circulan por la epidermis. Se adquiere cuando la piel entra en contacto con tierra contaminada por heces de animales infestados por estos nematodos. Hasta ahora se consideraba como enfermedad importada de zonas tropicales y subtropicales. El objetivo fue estudiar los casos de LM diagnosticados como autóctonos por no haber salido de la provincia de Guipúzcoa recientemente. MATERIAL Y MÉTODOS: Estudio observacional transversal retrospectivo de los casos diagnosticados de LM en el Hospital Universitario Donostia de 2011 a 2015, sin viaje previo a ninguna zona endémica de este cuadro. El diagnóstico fue clínico ante las lesiones características. Las variables estudiadas fueron: edad, género, localización de las lesiones, fecha de inicio de los síntomas, posible fuente de contagio, datos anatomo-patológicos, tratamiento y evolución. RESULTADOS: Se han recogido 4 casos, todos varones, con una media de edad de 60 años. Tres casos presentaron lesiones en las extremidades inferiores, mientras que uno lo hizo en el tronco. Todos nuestros pacientes habían estado en contacto con tierra que pudiera estar contaminada por heces, siendo este el mecanismo de transmisión más probable. Se instauró tratamiento con albendazol oral, con resolución de las lesiones. CONCLUSIONES: La aparición de nuevos casos de LM de origen autóctono en Europa obliga al estudio de la/s especie/s causal/es, a una revisión epidemiológica de esta infestación y a planificar qué medidas se deberían tomar para evitar que una enfermedad considerada hasta ahora como importada, se convierta en autóctona

INTRODUCTION: Cutaneous larva migrans (LM) infection forms a serpiginous eruption caused by the migration of nematode helminths through the epidermis. The parasites are acquired when the skin comes into contact with soil contaminated by the feces of infected animals. Until now, infections have been believed to be imported from tropical and subtropical regions. Our aim was to study cases of cutaneous LM diagnosed in residents of the Spanish province of Guipúzcoa who had not recently traveled to such regions. Material and methods; Cross-sectional observational study of LM cases diagnosed in Hospital Universitario Donostia from 2011 to 2015 in patients who had not visited a region where this nematode infection is endemic. Clinical diagnoses were based on characteristic lesions. We studied the following variables: age, sex, site of lesions, date of onset of symptoms, possible source of contagion, pathologic findings, treatment, and clinical course. RESULTS: We found 4 cases, all in men (mean age, 60 years). Lesions were on the lower extremities in 3 patients and on the trunk in 1 patient. All had been in contact with soil that could have been contaminated by feces and was the most likely source of the parasite. The lesions disappeared after treatment with oral albendazole. CONCLUSIONS: The appearance of cases of autochthonous LM in Europe requires investigation of the culprit species, a review of the epidemiology of this infection, which was once considered imported, and the planning of public health measures to prevent it from becoming endemic

Autochthonous cutaneous larva migrans infection in Guipúzcoa. / Larva migrans cutánea de origen autóctono en Guipúzcoa.

INTRODUCTION: Cutaneous larva migrans (LM) infection forms a serpiginous eruption caused by the migration of nematode helminths through the epidermis. The parasites are acquired when the skin comes into contact with soil contaminated by the feces of infected animals. Until now, infections have been believed to be imported from tropical and subtropical regions. Our aim was to study cases of cutaneous LM diagnosed in residents of the Spanish province of Guipúzcoa who had not recently traveled to such regions. MATERIAL AND METHODS: Cross-sectional observational study of LM cases diagnosed in Hospital Universitario Donostia from 2011 to 2015 in patients who had not visited a region where this nematode infection is endemic. Clinical diagnoses were based on characteristic lesions. We studied the following variables: age, sex, site of lesions, date of onset of symptoms, possible source of contagion, pathologic findings, treatment, and clinical course. RESULTS: We found 4 cases, all in men (mean age, 60 years). Lesions were on the lower extremities in 3 patients and on the trunk in 1 patient. All had been in contact with soil that could have been contaminated by feces and was the most likely source of the parasite. The lesions disappeared after treatment with oral albendazole. CONCLUSIONS: The appearance of cases of autochthonous LM in Europe requires investigation of the culprit species, a review of the epidemiology of this infection, which was once considered imported, and the planning of public health measures to prevent it from becoming endemic.