An unwanted traveller

Diagnostic Challenge

CJEM 2002;4(1):53

A 29-year-old woman presented to the emergency department with a rash on her left foot. She had returned from a holiday in Jamaica 10 days earlier. After arriving home she developed raised, erythematous, pruritic track marks distributed mainly along the sole of her left foot. She thought she had stepped on something sharp while on holiday and was concerned that she may have a foreign body in her foot. She had not sought any medical advice prior to this visit and otherwise felt well. Past medical history was unremarkable. She was not on any medications and she had no allergies.

Examination revealed raised, erythematous tunnel marks along her foot (Fig. 1). Your diagnosis is:

A. Cutaneous larva migrans

B. Larva currens

C. Gnathostomiasis

D. Cellulitis secondary to a foreign body

Fig. 1. Erythematous tunnel marks on the sole of the foot

For the Answer to this Challenge, click here.