Diagnosis is primarily clinical: creeping eruption and history of exposure.
Histopathological findings are generally non-diagnostic, that is, lab investigations are not helpful in the diagnosis of CLMonly useful to check for other tropical infections.
Punch biopsy of a track rarely will capture the larvae (because it is found 1-2cm beyond the leading edge of the track). Biopsy shows eosinophilic inflammation, usually without the parasite.
Larvae can occur in sputum or gastric washings with pneumonia. Peripheral eosinophilia may be present, as may Charcot-Leyden crystals in sputum.