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Larva Currens: Report of Seven Cases and Literature Review
ABSTRACT.
Strongyloidiasis is a frequent and often unrecognized parasitic disease because of the frequently asymptomatic nature and lack of sensitivity of diagnostic tests. Under conditions of immunosuppression (particularly systemic corticosteroid treatment), potentially fatal dissemination may occur. Thus, prevention and early diagnosis are important. Larva currens is a rare and pathognomonic cutaneous sign of strongyloidiasis, but is poorly described because of its unpredictable and fleeting occurrence. We report seven imported cases of larva currens seen in Paris between 1990 and 2020. We illustrate the clinical and biological features of this specific but uncommon sign of strongyloidiasis with clinical pictures. There were three males and four females, aged between 29 and 58 years. There were five migrants from endemic countries, one tourist and one expatriate. Digestive disorders were the main extracutaneous signs. All patients had eosinophilia above 0.5 G/L. All cases were confirmed by stool tests. All were cured with ivermectin. The rapidity and the short duration of the creeping eruption distinguish it from other parasitoses. Ivermectin is a treatment of choice. The key point is to think about preventing disseminated strongyloidiasis before giving corticosteroids not only among migrants but also among expatriates and tourists in endemic countries.
Author Notes
Author’s addresses: Yuan Tian and Gentiane Monsel, Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, Paris, France, E-mails: yuan.tian@hotmail.fr and gentian.monsel@aphp.fr. Luc Paris and Martin Danis, Laboratory of Parasitology, Pitié-Salpêtrière Hospital, Paris, France, E-mails: luc.paris@aphp.fr and martindanis21@gmail.com. Eric Caumes, Department of Infectious and Tropical Diseases, Pitié-Salpêtrière Hospital, Paris, France, and Institute Pierre Louis Epidemiology and Public Health, Sorbonne Université, INSERM, Paris, France, E-mail: eric.caumes@aphp.