This week's interesting case is generously donated by Dr. Justin Juskewitch. Hopefully all of you have been able to avoid this so far this summer!
The patient is a young girl who developed this very itchy rash about 30 minutes after a swim in a fresh water lake in Maine (Northeastern United States). The rash developed to what is shown below over a period of several hours.
Her two siblings had a similar presentation. All three children had resolution of itching with benadryl, corticosteroid cream, and oatmeal body wash baths over the next few hours, but the rash lasted for 5-7 days.
What is the most likely diagnosis? Is any additional therapy recommended?
8 comments:
Looks and sounds like swimmer's itch. Not much more to do than what she already did
Typical swimmer’s itch, also known by other names depending on the activity of the patient like “clam digger’s itch” or “duck itch”.
All is caused by cercaria larvae in most freshwater bodies of water frequented by ducks and/or water birds. The cercaria penetrate the skin and cause a cercaria dermatitis.
This summer is so hot even in the Northern most states that a quick plunge into the lake is certainly very appealing. We may expect to see more cases like this one.
Thank you Dr. Pritt for a timely reminder of an often neglected seasonal condition.
Florida Fan
Swimmer’s itch
Swimmer's itch due to cercarial dermatitis
Swimmer's itch is an allergic condition that occurs when trematode cercariae, the motile and infectious stage of avian schistosomes (eg Trichobilharzia spp), penetrate the skin of humans. They utilize a variety of different species of birds as definitive hosts (humans are no suitable hosts), and rely on different snail species as intermediate hosts.
PS If any, only symptomatic therapy is needed (anti-itch lotions, antihistamine), the cercaria die quickly without causing a severe trematode infection.
Also called Pelican itch in Australia, specifically east coast of Australia from Northern NSW upwards (warmer waters).
Trematode cercaria are many to sereach for the host when enter human cause itching and treated by antihistmane
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