Dr. Ajeet Kumar
Medical Gastroenterology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I feel like worms moving between my toes and feet with long slim white lines. They have two brown streaks and they bite with skin penetration and my skin turns white. They have penetrated my nostrils also and they have dark purple lines with two dots at the end. It looks like eyes. These lines have moved up my nose and around my eyes, inside my lower eyelids with visible black thin lines. I have attached my pictures. I think that it moves through my hair follicles also because I can see tiny black dots in my hair strands and sometimes it remains half white. I am suffering from this issue for a year. I have consulted many doctors and when I say about worm parasites, they say that it is impossible to have it without examining me. My condition is getting worse and I am scared. My vision is getting worse with stomach pain, low energy in the body, anemia, swelling in my joints and muscles. My doctor does not have any idea about my condition. Kindly help. I never had these problems like this until I traveled and bought capuchin monkeys. The liver enzymes of me, my dog, and my monkeys remain high. I have a negative result for hepatitis A, B, and C. It remains focused around my face, nose, ears, and eyes. Previously, we had a problem with black horse flies in my home. Kindly help me.
Hi,
Welcome to icliniq.com.
Your symptoms occur due to cutaneous larva migrains. It is a hookworm infection affecting skin caused by Toxocara. It comes from infected cats and dogs. It is best to do some tests to confirm it and start taking treatment according to it. You can do ELISA (enzyme-linked immunosorbent assay) antibody for Toxocara canis and Toxocara cati. I suggest you take tablet Albendazole (antihelmintic) 400 mg twice daily for five days. If it occurs as a recurring issue, then I suggest you try to identify the source of it. It can be caused by your dog or cat or any other pet in the surrounding. Kindly share some pictures to see them clearly.
Patient's Query
Thank you doctor,
I have attached some pictures. I am so scared. I took tablet Albendazole for 21 days and it helped me a lot. After stopping it, my symptoms came back again. I do not know the reason for having tiny black specks with two lines under my hair strands at the roots. My hair strands have turned grayish-white and my hair moves on its own. It is so weird. I have attached a video. When I urinate and wipe, I can see black specks and tiny red specks on the toilet paper. I saw some tiny straight lines on my clothing, skin, and even on the leather seats of my car. I will send the pictures of it. These things that bite and bury in my skin have a black shadow around it with white glowing dots. I am attaching a picture of it.
These things that eat me from outside or inside have a scariest face. I have attached their images. Kindly tell me why do I see these things with their face and body-like figures. Their grey face resemble a mouse face with two black eyes, a black nose, grey or half white with a long body, and spiky sticks all around the body. They bury my skin faster. These white lines appear to move around my body. My eyes remain red and tired. My vision is getting worse and there are white lines wrapping inside my nose, traveling up my nose and around my eyes also.
A day in the morning, I waked up with two large bites on my left inner lower leg. These bites resembled as a snake bite but it was not bitten by a snake. The first bite looked like the same bites now I have. I had another bite on the inner side of my left nostril and I was able to feel things moving inside my nose. After taking tablet Albendazole, I was able to blow and pull out worm-like things. Then I started freezing and it lasted for several weeks. I had stomach pains and diarrhea without energy. I am still dealing with this issue. I got hospitalized and found that I was anemic and so I was given blood. After having a nose bite, I felt something moving in my left nostrils up to my upper eyelid. Kindly help.
Hi,
Welcome back to icliniq.com.
I can understand your concern. I am unable to see the attached picture and so kindly attach it. Proper treatment is possible only when we diagnose it properly as several worms can cause this issue. The most common ones are Toxocara canis and Toxocara cati. As you have taken tablet Albendazole already, it has provided some relief to you. You can follow this strategy.
You can continue taking tablet Albendazole for a longer duration as it can improve your symptoms for the long term. You can follow this to have a test by taking a direct smear from the area such as eyes or skin and it can be seen under a microscope. You can do ELISA antibody testing for worms. It is available in some laboratories to do a complete panel of antibodies against various worms that infect humans.
If you are willing to take any medication, I suggest you take tablet Albendazole 400 mg twice daily for 21 days and followed by seven days off. Do this for three months. You can also apply Scablin lotion (Permethrin) 60 ml solution. Apply 30 ml on one night and another 30 ml on the second night. Apply the cream after taking bath with warm water and dry it properly before application. Apply your lotion from the neck and down and do not apply it over your face.
After using this lotion, wash your clothes, including bed sheets, pillow covers, and sofa covers using bleaching powder. It helps for mites infection. Some mites can infect humans and cause similar symptoms. I suggest you take tablet Fexet (Fexofenadine hydrochloride) 120 mg daily at night for four weeks. It is an anti-allergy medication that improves itching. You can consult an infectious disease specialist. If your doctor sees any worms, then you observe them daily and it can help you to have a definite diagnosis by taking a direct smear of the worm.
Patient's Query
Thank you doctor,
Can I have any other stronger medication other than Albendazole for three months?
Hi,
Welcome back to icliniq.com.
The dose of Toxocara injection is five days. On looking at your picture, it seems to be a Toxocara infection. But other hookworm infections like ascariasis, stronglyodosis have to be ruled out. You can do ELISA-based antibody testing for the complete worms panel. You can have a possibility of having two or three hookworm infections. Once you get the results of your tests, then you can take treatment accordingly for few days. The other parasitic medications are Ivermectin (antiparasitic) and Nitazoxanide (antibiotic). As you have taken Albendazole for some time and you have a recurrence of symptoms again, then you can use other medications such as Scablin lotion, tablet Fexet 120 mg daily for four weeks and see for improvement. I suggest you do tests and then take treatment accordingly for few days. As you have a recurrent infection, it is good to have treatment for a longer duration.
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