Treatment

Cutaneous larva migrans is readily treated by application of 10% thiabendazole paste and an occlusive dressing for 24 hours. In severe cases, systemic treatment with albendazole or iver-mectin may also be used (Caumes et al., 1993). Biopsy, surgical excision or liquid nitrogen is contraindicated.

Eosinophilic enteritis is readily treated with 200 mg mebendazole and patients will respond rapidly to this. Failure to respond within 24 hours would suggest an alternative diagnosis. Relapse is common and this may reflect reinfection or may be a result of failure to respond to the initial treatment, and this may also be caused by L3 larvae that have undergone migration arrests (see above). Alternative therapies that may be beneficial include albendazole and ivermectin.

Fig. 19c.4 Typical skin lesion of cutaneous larva migrans

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