Cutaneous Larva Migrans (CLM) is a neglected tropical disease (NTD) caused by zoonotic Ancylostomatidae larvae, mainly Ancylostoma braziliense and Ancylostoma caninum, which infect dogs and cats. Humans are accidental hosts, acquiring infection when L3 larvae in contaminated soil penetrate the skin, producing serpiginous, pruritic lesions. We report a 24-year-old female from Quito, Ecuador, who developed a pruritic lesion on her right foot nine days after walking barefoot on wet, potentially fecally contaminated sand at Atacames Beach. Initial self-treatment with benzyl benzoate and herbal washes, followed by misdiagnoses as scabies and plantar warts, delayed proper care. Lesions progressed over three weeks with intense pruritus and functional impairment. CLM was correctly diagnosed by a podiatric technician 26 days post-exposure. Oral albendazole (400 mg/day for 4 days) led to rapid symptomatic relief within three days, with complete resolution by day 50. A survey analyzed by the McNemar Test revealed difficulties in recognizing early-stage CLM, regardless of experience or region among participants. Prevention requires personal protection, environmental sanitation, and regular anthelmintic treatment of dogs and cats. This case underscores the clinical consequences of delayed or incorrect diagnosis and highlights the need for enhanced healthcare training and One Health measures to reduce zoonotic diseases in Ecuador.
Sánchez-Peralta et al. (Mon,) studied this question.
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