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Unusual presentations of cutaneous larva migrans in British military personnel
  1. David Michael Inglis1,2 and
  2. M S Bailey3,4
  1. 1Institute of Naval Medicine, Gosport, UK
  2. 2Department of Infectious Diseases and Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK
  3. 3Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK
  4. 4Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to David Michael Inglis, Institute of Naval Medicine, Gosport PO12 2DL, UK; d.m.inglis{at}live.com

Abstract

Cutaneous larva migrans (CLM) is one of numerous skin diseases that occur in British military personnel on deployments to the tropics and sub-tropics. It is typically managed by military primary healthcare services, but diagnostic uncertainty or unavailability of anti-helminthic medication may prompt referral to UK Role 4 healthcare services. Cases of CLM seen at the UK Role 4 Military Infectious Diseases & Tropical Medicine Service from 2005 to 2020 were identified and their case notes were reviewed to identify learning and discussion points. There were 12 cases identified, of which five came from Brunei and three were from Belize. Causes for referral were due to diagnostic uncertainty (58%) and the unavailability of anti-helminthic medication (42%). Several cases had CLM in an unusual distribution due to specific military activities performed in endemic areas. Telemedicine was very useful in making some of the diagnoses in theatre and avoiding the need for medical evacuation. Military personnel may have unusual presentations of CLM due their unique military activities. In areas that are endemic for CLM, clinicians should maintain high clinical suspicion for CLM, carry appropriate anti-helminthic medications and consider screening cases of CLM and their colleagues for other infections with similar aetiology (eg, human hookworm infection and strongyloidiasis).

  • infectious diseases & infestations
  • tropical medicine
  • dermatology
  • tropical medicine
  • parasitology
  • tropical medicine

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Footnotes

  • Twitter @MilTropMedDoc

  • Contributors DMI and MSB managed the cases, reviewed the case notes and wrote the manuscript. MSB is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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