Case 191. 
Spiruroid nematode larva migrans (creeping disease) (38 y-o M)
         
    Biopsy from vesicle-forming creeping disease (cutaneous larva migrans) of the abdominal skin, seen after eating firefly squid (Watasenia scintillans)    
         
   
Key words : spiruroid nematode larva, creeping disease, larva migrans
   
     
 
     
Bullous creeping disease is characteristic of this parasitosis. The life cycle and final host of this larva is unknown, hence term of spiruroid nematode larva type-X.   The larva, 100 μm in width, is seen just beneath the epidermis. Note a pair of basophilic clover-shaped lateral chords. Eosinophilic reaction is seen.
     
 
     
Reference case 191A
Another case of spiruroid nematode larva migrans. The larva is seen in the subcutaneous tissue in this case (HE). Firefly squid from Toyama bay is on the market in March through August. Larva migrans into the gut and eye ball may associate serious clinical manifestation. Refer to case 25.
  Reference case 191A
Cross section of spiruroid nematode larva, showing multinucleated gut epithelium and cross-striated cuticle (HE, higher power). The transmission can be avoided by freezing of the squid or preservation under high salt concentration. The incidence of this disease is thus decreasing.