A roundworm infection caused a man to develop a curious rash that migrated all over his body. Having started near her anus, the mysterious red lesions began to move rather quickly, leading doctors to a diagnosis of Strongyloides hyperinfection syndrome.
the parasite Strongyloides stercoralis was to blame for the patient’s symptoms, which are detailed in a case report published in The New England Journal of Medicine. The affected patient was a 64-year-old man living in Spain who had a diagnosis of metastatic lung adenocarcinoma, a type of cancer.
While in hospital for a malignant mass compressing her spine, she was prescribed high-dose glucocorticoids. A type of steroid, it is sometimes used in cancer treatment to supplement treatments and treat some of the side effects.
However, within a few days, a rash appeared near the man’s anus and began to spread all over his body. Doctors were able to follow the progress of the lesions by drawing around them with a pen; when they looked again 24 hours later, the wavy, red marks were no longer within the ink outline (which you can see here).
Spread was rapid, involving the trunk and extremities, but after examination of the stool, the identity of the traveling lines became apparent. The man was infected with roundworms and had developed Strongyloides hyperinfection syndrome.
The “rash” was actually larva currens. which is the body’s response to larvae migrating into the skin earlier in their life cycle. Fortunately, doctors treated the infection with a dose of the wonder Nobel Prize-winning antiparasitic drug Ivermectin (no, it doesn’t treat COVID-19).
The patient may have contracted the parasites as a result of his work as a wastewater management worker, where Strongyloides stercoralis it could probably be found in sewage contaminated with human fecal matter. In fact, avoiding sewage is the second top tip from the Centers for Disease Control and Prevention (CDC) for avoiding such an infection.
Strongyloides stercoralis is a rhabditid nematode known to most people as roundworms. They typically parasitize humans and dogs by penetrating their skin as larvae (some brave scientists volunteer to be parasitized this way for research purposes). Once in the body, they migrate to the small intestine where they become adults and reproduce to give rise to the next generation of parasites that penetrate the skin.
It is the circle of life, and it moves (through) all of us.