831

Strongvloides stercoralis. Reviews of Infectious Diseases, 3, 397-407.

Jones? C. A. (1950). Clinical studies in human strongy- loidiasis. I. Semeiology. Gastroenrerology, 16, 743-756.

Jones, C. A. & Abadie, S. H. (1954). Studies in human strongyloidiasis. II. A comparison of the efficacy of diagnosis by examination of feces and duodenal fluid. American Journal of Clinical Pathology, 24, 1154-1158.

Kuberski, T. T., Gabor, E. P. & Boudreaux, D. (1975). Disseminated strongyloidiasis. A complication of the immunosuppressed host. Western Journal of Medicine, 122, 504-509.

Maayan, S., Wormser, G. I’., Widerhorn, J., Sy, E. R., Kim. Y. H. &Ernst, 1. A. (1987). Stron~loidesstercoralis hyperinfection in a- patient with acquired immune deficiency syndrome. American Journal of Medicine, 83, 945-948.

Pelletier, L. L. (1984). Chronic strongyloidiasis in world war II Far East ex-prisoners of war. American Journal of Tropical Medicine and Hygiene, 3, 55-61.

Purtilo, D. T., Meyers, W. M. & Connor, D. H. (1974). Fatal strongyloidiasis in immunosuppressed patients. American Journal of Medicine, 56, 488-493.

Smallman, L. A., Young, J. A., Shot&rid-Webb, W. R., Carey, M. P. & Michael, J. (1986). Strongyloides stercoralis hyperinfestation syndrome with Escherichia coli meningitis: report of two cases. 3oumal of Clinical Pathology, 39, 366370.

Sturchler, D. (1987). Parasitic disease of the small intestinal tract. In: Baillihe’s Clinical Gastroenterology, vol. 1. London: Bail&e Tmdall, pp. 397-424.

Received 9 November 1989; revised 4 June 1990; accepted for publication S June 1990

TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1990) 84, 831

1 Short Report 1

Albendazole in the therapy of cutaneous larva migrans

S. Sanguigni, M. Marangi, A. Teggi and F. De Rosa Department of Tropical and Infectious Diseases, University of Rome ‘La Sapienza’, Rome, Italy

Cutaneous larva migrans is characterized by the invasion of human shin by nematode larvae which are not normal parasites of man, such as Ancylostoma caninum, A. bras&we or Strongyloididae such as Strong+ides myopotami, S. procyonis and others. All these larvae are unable to complete their life cycle and migrate for a long time, at least one year, causing creeping eruption.

The disease is widespread in Africa, South and Central America, southern USA, India, and south- east Asia, and some cases have also been reported from southern France, Spain and Australia (MANSON- BAHR & BELL, 1987).

The therapy of this illness is usually based on local freezing with ethyl chloride or liquid nitrogen, local application of preparations such as benzimtdazole carbamates (usually mebendazole) in petroleum jelly, or the administration of thiabendazole orally (MAN- SON-BAHR & BELL, 1987). In our experience local treatments are time consuming and liquid nitrogen

Correspondence to Professor Sergio Sanguigni, Istituto di Clinica delle Malattie Tropicali e Infettive, Policlinico Umberto I, Via de1 Policlinico, 00162 Rome, Italy.

may cause severe necrosis, while oral thiabendazole may cause frequent side effects such as dizziness, nausea, hypotension and rashes.

In the past few years we have observed 26 cases of cutaneous larva migrans. All were Italian tourists from South and Central America (18 cases) and Africa (7 cases) or south-east Asia (1 case). ’

Based on the above considerations we administered to these 26 patients the new benzoimidazole carba- mate albendazole, which is absorbed orally and is relatively free of serious side-effects (SAIMOT et al., 1983).

Albendazole was given at dosage of 400 mg/d, divided into 2 doses, for 5 d. From the 2nd to 3rd day of therapy all clinical manifestations such as itching and cutaneous reactions disappeared and the larvae stopped moving. In only 2 cases, where the larvae were clearly in hypobiosis, was it necessary to repeat the treatment at the same dosage, as the larvae remained obviously alive:, the second course of treatment was fully effective.

No side effects were recorded and no relapses were observed after 6 months follow-up.

In our opinion albendazole is a real improvement in the therapy of this extremely troublesome, and sometimes severe, illness.

References Manson-Bahr, P. E. C. & Bell, D.R., editors (1987).

Mason’s Tropical Diseases, 19th edition. London: Bail- here Tindall.

Saimot, A. G., Cremieux, A. C., Hay, J. M., Meulemans, A., Giovanangeli, M. D., Delaitre, B. & Coulad, J. P. (1983). Albendaxole as a wtential treatment for human hydatidosis. Lancet, ii, 655-656.

y;;ived 18 April 1990; accepted fm publication 3 May