case study: teen's rash discovered to be worms

each week we comb through science journals to explore a baffling medical issue.when 17-year-old michael dumas returned home from a trip to pompano beach, florida, he brought with him several small red bites that his family attributed to mosquitoes or chiggers — a type of mite. within days, however, the spots rapidly multiplied until the teenager’s legs and buttocks were completely covered with a red, itchy rash.a doctor soon informed him and his mother, kelli mulhollen dumas, that they were dealing with cutaneous larva migrans, a parasitic infection caused by the larvae of hookworms that had burrowed just below the surface of the young man’s skin. “i can’t stress enough how traumatic it is for a teenage boy — and his mother — to know that there are worms living in his body,”  kelli told the washington post in 2018.eight of the 17 people who made the trip to florida — which saw dumas buried in the beach sand for fun — were infected, she said, none as badly as her son who soon developed blisters and scrapes that covered the lower half of his body, in addition to a staphylococcus infection. she described his wounds as “incredibly horrible and so graphic. one of them is three inches by three inches. it’s a crater in his foot.”there are two types of hookworm: human hookworms and animal hookworms (which are referred to as zoonotic once they make the jump to humans), according to bobbi pritt, director of the clinical parasitology laboratory at the mayo clinic. both types of worms can spread to humans who come in contact with sand or soil that has been contaminated by the feces of infected humans or animals. the infected feces contain parasitic eggs that produce hookworm larvae that are capable of piercing the skin of any human unlucky enough to stroll through the area.if the larvae come from a human hookworm, they make their way into the bloodstream where they are transported to their new home in the host’s intestines. animal hookworms do not survive long in the human body, however, as they are unable to adapt to their host and make it to the intestines. instead, the larvae slither around beneath the surface of the skin leaving red, itchy marks behind. unable to mature or reproduce, these hookworms usually die within a few weeks, even without treatment. although many people don’t experience any symptoms once infected, abdominal pain, diarrhea, decreased appetite and weight loss can result, according to the cdc.doctors in this case treated dumas with an anti-parasitic coupled with an antibiotic but the mother rushed her son to a dermatologist, frustrated with the slow pace of recovery. the dermatologist tried to use liquid nitrogen to freeze the lesions away but the teenager quickly asked him to stop as he said he could feel the parasite fleeing the area. “it’s disgusting,” his mother said. “it’s beyond disgusting.”the cdc recommends not going barefoot in any areas hookworms are known to frequent or anywhere there “may be human fecal contamination of the soil,” and sitting on a towel. getting dogs and cats dewormed on a regular basis can also keep any nasty surprises from ruining the summer.dumas took to facebook to relay her son’s experiences and warn others of the dangers lying just beneath the surface of the sand. “he is in pain and this is awful,” she wrote. “never be buried in sand or allow your children to be either! i am only showing a few pictures because it is so disturbing.”she updated her page a few months later to say that, while her son’s feet and legs are permanently scarred, he no longer feels pain — even when exercising — a development that has allowed him to return to the football field where he plays tight end. “he is great!” she wrote.the experience has, unsurprisingly, stayed with them and altered the way they view the sandy shores that are a destination for millions of vacationers around the world. “i’ll never walk on the beach again without shoes,” she said.dave yasvinski is a writer with healthing.ca