By Gary M. White, MD
Larva currens represents cutaneous infection by the Strongyloides stercoralis larvae.
- S stercoralis is a tiny nematode worm which lives in the small bowel of humans. Infection usually occurs through contact with contaminated soil. Larvae penetrate the skin, enter the blood stream, reach the lungs and are coughed up and swallowed. Female worms can produce larvae which penetrate the perianal skin or intestinal, mucosa and reinfect the patient. This cycle may persist for decades.
- See also strongyloidiasis.
Linear, red, urticarial, inflammatory lesions that migrate rapidly are :characteristic (racing larvae).
Often, the larvae are not seen in the biopsy specimens. The diagnosis may be confirmed by stool analysis for Strongyloides larvae.
Typically, oral thiabendazole or albendazole are recommended although each therapy ::has disadvantages. Oral ivermectin (e.g. 12-24 mg. as ia single dose or repeated in 24 hours) has been reported to be successful. The absence of cutaneous symptoms, a normal blood count, a normal eosinophil count and a negative stool test indicate successful treatment.
Case Rep Dermatol Med. 2013;2013:381583
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