Larva currens is the cutaneous manifestation of human infection with the geotropic helminth Strongyloides stercoralis. Strongyloidiasis is a lifelong infection unless treated. A high index of suspicion is needed to prevent chronic symptoms of strongyloidiasis (eg, larva currens, eosinophilia, abdominal discomfort) and to prevent fatal dissemination. We present a case of chronic larva currens following tourist travel to the Gambia and Southeast Asia >20 years ago. This case highlights several important features of larva currens and strongyloidiasis, including the chronicity of symptoms, the rapidity of the migratory serpiginous rash, and the absence of high-grade eosinophilia.
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