Cutaneous larva migrans with pulmonary involvement

Description

After returning from a Carribean cruise, a 52-year-old woman spent an afternoon sitting on a sandy beach in Martinique with her husband. An initial burning sensation over her buttocks was followed the next day by an intensely pruritic eruption with 'red pinprick marks'. This was unsuccessfully treated on the cruise ship with antibiotics, antifungal agents, as well as topical and intramuscular steroids. Examination on day 10 revealed a serpiginous rash over her buttocks with a large number of discrete papular lesions (figure 1). The patient's husband was noted to be itching and examination revealed a rash with equivalent distribution and morphology (figure 2). A clinical diagnosis of cutaneous larva migrans was made.

Figure 1

Florid, serpiginous rash located on the buttock region of the patient.

Figure 2

Rash with identical morphology affecting the same region of patient's...

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