Gigantobilharzia , Possible Cause of Cercarial Dermatitis : Case Report

Hussein M Omar,Osama H Omer,Mohammed S Al-Dhubaibi

doi:10.12816/0031224

Abstract

Cercarial dermatitis (swimmer's itch) is a worldwide, often neglected parasitic skin disease characterized by strong maculopapular skin eruption accompanied by intensive itching. A fisherman suffered from forearm dermatitis. Clinical history associated with the recovery of the avian schistosome; Gigantobilharzia from little green bee-eater (Merops orientalis najdanus) and collected Lymnaea snails supported the authors' opinion that patient clinical signs are most likely due to the invasion of avian schistosome cercariae.

Highlights

Cercarial dermatitis is a worldwide, often neglected parasitic skin disease characterized by strong maculopapular skin eruption accompanied by intensive itching
According to the available literature and due to inadequate worm material recovered from the bee-eater, the encountered schistosome parasites were generically identified as Gigantobilharzia specie
Differential diagnosis of cercarial dermatitis includes insect bites, human schistosomiasis, contact dermatitis from poison ivy, and sea bather’s eruption, which can be distinguished from cercarial dermatitis by the presence of some of the following: eruptions involving skin covered by bathing suits; skin eruptions following bathing in the sea water; larval forms of crustaceans; remnants of jelly fish tentacles.(7)

Summary

Introduction

The snail-borne avian schistosome cercarial dermatitis has been repeatedly reported from all over the world. The patient showed multiple erythematous papules and papulopustules of 2 to 3 mm in diameter on his forearms (figure 1). Seven little green bee-eaters (Merops orientalis najdanus) were hunted and brought to Parasitology laboratory, Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University. Examination of their intestines revealed that one bird was infected with long thread-like and very delicate worms (figure 2).Eggs were found in the macerated intestinal wall (figure 3&4). They were oval or subglobular, yellowish in color, measured 0.104.2±0.040 long X 0.069.6 ± 0.013 mm wide and provided with a minute polar process. Preventive measures were advised such as avoiding prolonged contact with water ponds without wearing gloves and protecting ponds from fecal contamination from all visiting birds such as Merops orientalis najdanus

Discussion

Conclusion