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Images in Clinical Tropical Medicine Bullous Leg Lesions Caused by Culicoides Midges after Travel in the Amazon Basin

By Ryan C. Maves, Erik J. Reaves and Gregory J. Martin

Abstract

Figure 2. Dissecting microscope images (40×) of a female C. paraensis collected near Iquitos, Peru in the vicinity of where the subject traveled. ( A) Thorax and legs. ( B) Head. ( C) Abdomen. ( D) Wing. This figure appears in color at www.ajtmh.org. A 36-year-old man presented with 1 day of blistering lesions on the lower extremities. Two days before presentation, he had traveled to several rural communities in the Peruvian Amazon. During that trip, he had hiked through several areas of damp soil, decaying plants, and dense grass reaching up to 50 cm in height. He awoke the next morning with numerous confluent, erythematous, pruritic, non-blanching papules that were circumferential around both ankles. Over the next day, multiple bullae up to 4.5 cm in diameter developed with surrounding edema (Figure 1). The patient was treated with prednisone (50 mg daily) by mouth for 3 days, followed by routine wound car

Year: 2013
OAI identifier: oai:CiteSeerX.psu:10.1.1.352.1320
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