traveler's pruritis - Mexico

Steve G. Kayes kayes at SUNGCG.USOUTHAL.EDU
Thu Jun 29 21:38:26 EST 1995


Kathleen:

	The large number of foci is the hang up for me.  The first thing 
that came to my mind was the association between Mexican beaches and the 
super intense pruritis.  The thing that first comes to mind is cutaneous 
larva migrans.  This is usually caused by dog hookworm larvae migrating 
through the skin.  The hall mark of this condition is the "serpiginous" 
like migration streaks.  These are due to the inflammatory cells chasing 
after the migrating larvae.  Cure is usually to freeze the organisms by 
spraying the skin with ethylene chloride which freezes the creatures in 
situ.  It should be pointed out the organisms are 1 - 2 cm ahead of the 
end of the track.  However, given the number of foci, this many not be  
cause at all, unless the patient happened to sunbathe directly on a spot 
where an infected dog deposited a large bolus of eggs.  Also worth 
pointing out is that the human is not a natural host for dog hookworm, 
and if the patient can last out the itching for 10 to 14 days, the 
organisms die of their own accord.

	Steve Kayes

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On 29 Jun 1995, Kathleen Anderson wrote:

> A friend returned from Mexican beach resort in March, and since then has 
> had persistent pruritis that's been dx'd as fleabite allergy. However, 
> the doc admits that itching severe enough to awaken the person from a 
> sound sleep (after 2-3 hours sleep) every single night is considered 
> quite unsual for this diagnosis. I suspected chiggers, since the itching 
> greatly increases in severity in the evenings, but the doc has done 
> "scrapings" to rule this out. Approximately 150 foci ("flea" bites) have 
> been counted. 
> 
> My questions:
> 
>   Would the "scrapings" technique rule out chiggers?
> 
>   Are there other parasitic (arthropods or others) from that part of the 
>   world (or here in SF Bay Area) that could cause problems of such intensity 
>   and duration?
> 
>   Is a dermatologist the best choice in such a case?
> 
>   If this is caused by something other than flea bites, is there any 
>   problem with taking the shots of Prednisone?
> 
>   Do you have any other suggestions for my friend? Questions he should 
>   ask the doctors? Or?
> 
> Thanks in advance...
> 
> --
> Kathleen Anderson
> vstr18a at mercury.sfsu.edu               
>                                                            
> 
> 



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