A <em>Strongyloides filariform</em> larva.

Enlarge / A Strongyloides filariform larva. (credit: Getty | BSIP)

Doctors in Spain diagnosed a man with an unusual roundworm infection after watching an army of larvae writhe and slither under his skin, blanketing his whole body in an ever-shifting rash.

Doctors reported the man's rare hyperinfection this week in the New England Journal of Medicine, highlighting the unusual sight of a wriggling, sliding skin rash that tracked the movements of individual parasitic prowlers. The official diagnosis was larva currens from Strongyloides.

The unfortunate patient appeared to have a perfect storm of risk factors to develop the uncommon and unpleasant infection. The 64-year-old worked in sewage management and had previously been diagnosed with metastatic lung cancer. For three years prior, doctors had noted bouts where he had eosinophilia—unusually high levels of disease-fighting white blood cells—which can be an indicator of a parasitic infection.

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