Occupational risk of cutaneous larva migrans: A case report and a systematic literature review

utaneous larva migrans (CLM) is a parasitic zoonosis of warm tropical and subtropical areas, although autochthonous cases have been increasingly reported in Western European countries. Data on the prevalence of CLM as an occupational disease in workers exposed to potentially contaminated soil or in close contact with dogs and cats are scant. Herein, we report an autochthonous case of CLM in a dog breeder from southern Italy (Apulia region), along with a systematic literature review describing the risk of CLM infection, mainly according to job categories. The patient was referred to the dermatology unit presenting a serpiginous lesion on his hand, raising the suspected CLM diagnosis. In non-endemic areas, CLM might represent a challenge for physicians in terms of diagnosis, treatment, and prevention, particularly in workplaces. The multidisciplinary approach in the diagnosis of CLM with the involvement of different scientific competences (i.e., dermatologists, veterinarians, and occupational physicians) may contribute to further assess the distribution of human CLM and associated risk factors, toward reducing the risk for the infection.

Author summary
Cutaneous larva migrans (CLM) is a parasitic zoonosis caused by multiple types of hookworms, characterized by creeping migration of larva through the skin. Humans are infected through accidental penetration of their skin by free-living larvae at the filariform stage. CLM is typically acquired in warm tropical or subtropical areas, although reports of autochthonous cases have increased in Western European countries. There is little evidence on the prevalence of CLM as an occupational disease, although workers exposed to potentially contaminated soil or to animals that are the definitive hosts of these nematodes, as dogs and cats, could be considered at higher risk of infection. We report a case of autochthonous CLM in a dog breeder in southern Italy (Apulia) to highlight how the collaboration among specialists in a One Health perspective (e.g., dermatologists, occupational physicians, veterinarians, and parasitologists) is essential for the correct diagnosis of zoonotic infection.