What is Larva Currens?

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, larvae currens are sometimes called strongyloidiasis. However, the term larva currens 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 signals the variant of the worm when it causes the ailment, in its immature or larval stage of development. It is also characterized by the migration of the larvae, burrowing deep into the tissue and creating linear thread-like lesions. Also called cutaneous strongyloidiasis, larva currens is classified as a skin condition, meaning it involves skin infection.

Larva currens episodes occur over several hours, with no symptoms for weeks or months at a time. In some cases, it appears shortly after Strongyloides stercoralis causes the infection. In others, it can manifest much later, years after the infection has occurred.

Larva currens is the result of autoinfection, which means that the infection is caused by direct contact with the larvae. A common cause is walking barefoot on the ground with the infectious worms. This type of infection ensures that episodes recur 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 larvae currens is anthelmintic therapy, which involves drugs that kill the parasitic worms. Examples of anthelmintic drugs include ivermectin, albendazole, and thiabendazole. Cyclosporine, or cyclosporin A, a drug used to suppress the immune system after organ transplantation, has also been used due to its anthelmintic properties. In cases of bacterial infection, antibiotics can also be applied. The goal of treatment for larva currens is to end the infection and prevent complications.

Follow-up for worms involves examining the patient's stool at two to three-month intervals to ensure that the worms have completely disappeared or to monitor therapeutic response. This serial sampling is done between four and eight months after the completion of anthelmintic therapy. Low parasite occurrence or total eradication is generally achieved between six and 18 months after completion of treatment. If the worms persist, however, further treatment may be necessary.

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