Complications
Skin lesions may become superinfected with pathogenic skin bacteria due to scratching. In returning travellers, superinfection has been reported in 0% to 8% of cases.[20][22][30] Beta-haemolytic streptococci and Staphylococcus aureus, including methicillin-resistant S aureus, are the most common causative bacteria.[52]
Symptoms include increasing pain and warmth at the site of the creeping eruption, with development of erythema spreading from the skin track. Pustules and/or abscesses may develop draining pus. Topical or oral antibiotics should be given.
Very rarely, animal hookworm larvae may penetrate deeper than the skin and invade viscera such as the lungs, causing eosinophilic pneumonitis (Loeffler syndrome).[53] This is usually associated with massive hookworm infestation.[54] Loeffler syndrome is typically mild and self-limiting; rarely, systemic corticosteroids may be indicated.
One case of erythema multiforme complicating CLM has been reported and was probably due to prior sensitisation.[55]
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