Sometime in the middle of last week, while I was traveling through the southeast of Senegal, I contracted what I thought was a very itchy mosquito bite on the outside of my foot. I scratched it a little bit, felt it grow, and then forgot about it until I got home.
While I was taking that first shower after returning home (the one during which you gleefully wash all the visible dirt off of your body), I realized that my “mosquito bite” had grown even more, in a squiggly, branching pattern that stretched from my ankle almost to my pinky toe. It was almost worm-like. I recalled that our Assistant Program Director had warned us about contracting hatching worms from standing on wet sand, and that a student in our program had contracted what we’d colloquially called “foot worm.”
Then I began to panic.
I spent almost all of Sunday on Google. After hours of searching “sand worm,” “worm under skin,” “worm in foot,” “worm under skin on foot,” “worm foot treatment,” etc., I narrowed down my symptoms to the least-scary condition: Cutaneous Larva Migrans (CLM). If my diagnosis was correct, an animal-host hookworm larva was burrowing around in my dermal layers trying to, but unable to, penetrate my basement membrane. The raised line was fortunately not its body, but instead the irritated tissue left from the larva’s 2-4mm/day search. When I read that the most harmful consequence was secondary infection from scratching the itch, and that the larva would go away on its own in a few months, I laid back with a sigh of relief and thought of how fun it would be, if s/he lived long enough, to bring my new African friend along with me across Europe.
Saay saay laa/Je suis un joker/I am such a joker.
That thing was headed to an early death.
Thanks again to Google, I found some of the active ingredients that were most likely to kill the larva (thiabendazole, ivermectin, albendazole, taken orally or topically). I had to search through a few pharmacies before I found a white paste labeled with “LARVA MIGRANS,” with no ingredients listed. Still, I trusted in the $12 paste and will be faithfully applying it at least once a day with the following murderous sentiment in my head: Die, ************, die.
For your reference: topical applications are best because there are adverse affects associated with taking high enough doses of the medications orally. Try to get the paste pre-made for you. The other student who had gotten CLM had to crush her pills with vaseline to make her own paste (literature suggests 10-15% for thiabendazole, which is supposed to be the most effective). There is no consensus on how many times a day you are supposed to reapply the ointment.
Update: Seems like a lot of people are running into this problem; I’ve linked to some pastes that have high ratings on Amazon: ivermectin, albendazole. Best to get it checked out by a doctor, though – it’s possible you’re encountering something more serious than CLM!