CUBA GEOGRAPHY TESTS SKIN
Her physical examination was notable for a dry, scaly erythematous rash that involved both of her elbows anteriorly, and skin excoriation and scratch marks on her buttocks and thighs.
The truncal rash had resolved, but the diarrhea had persisted, and pruritus ani had developed.
We examined the patient in our centre about two weeks after symptom onset. Both stool samples were negative for ova and parasites. The complete blood cell count was notable for high-grade peripheral eosinophilia (eosinophil count of 22.0 × 10 9/L), which prompted referral to our centre. The family physician ordered a complete blood cell count, and two stool samples to test for ova and parasites. About one week after symptom onset, she was taken to see her family physician who observed a pruritic, erythematous nonmigratory maculopapular rash on her upper trunk. Mild upper abdominal pain with no vomiting accompanied the diarrhea. She had no exposure to fresh water and remained well while in Cuba.įour weeks after her return, the patient complained of feeling warm, and a nonproductive cough, nonbloody diarrhea three to four times per day and a rash had developed. Her parents reported that she did not consume raw or undercooked meat, or seafood. During the trip, she spent most of her time at the beach, ate food provided at the resort and drank only bottled water. Other than having atopic dermatitis intermittently managed with topical corticosteroids, she was healthy. In Canada, ivermectin, the drug of choice for the treatment of strongyloidiasis, can be accessed through a request to the Special Access Programme at Health Canada.Ī seven-year-old girl born in Canada vacationed with her family at a beach resort in Santa Maria, Cuba, for eight days.
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