Larva Currens and Systemic Disease

Abstract

Of 26 patients infested with Strongyloides stercoralis 10 (38.5%) were asymptomatic without systemic or cutaneous signs. Nine patients (34.6%) presented with systemic complaints only and seven patients (26.9%) had systemic and cutaneous manifestations. Further observations of the skin lesions on four of those with systemic and cutaneous manifestations revealed linear urticarial bands, extending to several centimeters within 1 hour and persisting up to many days, waiting and waning. Blood examination showed eosinophilia in all patients. These findings confirm the concept that larva currens even alone should be considered a cutaneous sign of systemic disease.

Disseminated strongyloidiasis in immunocompromised patients – report of three cases

“…The characteristic cutaneous manifestation of strongyloidiasis is larva currens, characterized by a serpiginous eruption that provokes an intensely itchy wheal along its tortuous tract. 8,9 There is also an absence of larvae in biopsy specimens, chronicity, and recurrence. 10 In disseminated strongyloidiasis, the most commonly described cutaneous manifestation is a rapidly progressive petechial, purpuric eruption that usually occurs on the abdomen and proximal extremities.…”

“…Von Kuster and Genta 7 reviewed the cutaneous manifestations of strongyloidiasis. The characteristic cutaneous manifestation of strongyloidiasis is larva currens, characterized by a serpiginous eruption that provokes an intensely itchy wheal along its tortuous tract 8,9 . There is also an absence of larvae in biopsy specimens, chronicity, and recurrence 10 …”

Periumbilical Purpura in Disseminated Strongyloidiasis

“…During this process, filariform larvae penetrate the perianal skin and produce a serpiginous, urticarial eruption called "larva currens" (running larva) because of the speed in which the larvae migrate through the skin. 5,6 Recent studies of experimentally induced S stercoralis infection in dogs and monkeys have shed light on the mechanism of hyperinfection in hu¬ mans.7"9 When chronically infected ani¬ mals are given high-dose steroid thera¬ py, fulminant fatal hyperinfection oc¬ curs with vague clinical signs. The immunosuppressive therapy appears to alter the host-parasite relationship in favor of the parasite.…”

Case 4

“…It is frequently asymptomatic in immunocompetent individuals 2 or associated with minor complaints mainly of skin and gastrointestinal tract but can be chronic with persisting infection for many years 1 . Chronic strongyloides infection, presenting many years later, has been found in ex‐prisoners of war from the Far East 2 …”