Larva currens, also known as cutaneous strongyloidiasis, is an itchy skin condition caused by the parasitic worm Strongyloides stercoralis during its larval stage. It is transmitted through direct contact with larvae and can recur over several years. Treatment involves anthelmintic therapy and monitoring for complete eradication.
Larva currens, also called cutaneous strongyloidiasis, is an itchy skin condition that is triggered by infection with a parasitic worm called Strongyloides stercoralis. For this reason, larva currens is sometimes referred to as strongyloidiasis. The term larva currens, however, is more specific and ultimately a more accurate description of the condition, as the parasite infects during its larval stage. The disease was first identified in 1926.
The condition is called larva currens because it identifies the worm variant when it causes the disease, in its immature, or larval stage of development. It is also characterized by the migration of larvae, burrowing deep into the tissue and creating thread-like linear lesions. Also called cutaneous strongyloidosis, larva currens is classified as a cutaneous condition, meaning it involves a skin infection.
Episodes of curren larva occur over a number of hours, with no symptoms for weeks or months at a time. In some cases, it appears not long after Strongyloides stercoralis has caused the infection. In others, it may show up much later, years after the infection has occurred.
Larva currens is the result of an autoinfection, which means that the infection is caused by direct contact with the larvae. A common cause is walking barefoot on soil that carries the infectious worms. This type of infection guarantees the recurrence of episodes over the course of several years. People with weakened or faulty immune systems can die from the condition if it develops into a hyperinfection syndrome.
The standard treatment for larva currens is anthelmintic therapy, which involves drugs that kill the parasitic worms. Examples of anthelmintic drugs include ivermectin, albendazole and thiabendazole. Cyclosporine, or cyclosporine A, a drug used to suppress the immune system after organ transplantation, has also been used for its anthelmintic properties. In case of bacterial infection, antibiotics might also be applied. The goal of treatment for larva currens is to end the infection and avoid complications.
Current maggot follow-up involves examining the patient’s stools at two to three-month intervals to make sure the worms are completely gone or to monitor treatment response. This serial sampling is done four to eight months after completion of anthelmintic therapy. Low parasite incidence or total eradication is typically achieved between six and 18 months after completion of treatment. If the worms persist, however, additional treatment may be required.
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