• Lisa Meffert, Friederike Schmitz, and Jana Ziob.
• Universitätsklinikum Bonn, Medizinische Klinik und Poliklinik III, Abteilung für Onkologie, Hämatologie und Rheumatologie.
• Dtsch. Med. Wochenschr. 2021 Aug 1; 146 (15): 1005-1008.

IntroductionDiagnosis of a polysymptomatic, rare parasitosis requires collaboration of internal specialists, tropical disease specialists, parasitologists and dermatologists.HistoryThe course of disease is shown in a 66-year-old woman who regularly travels to Cameroon and presented with remarkable hypereosinophilia and pruritus with urticarial swellings.Findings And DiagnosisUsing interdisciplinary diagnostics based on travel history, symptoms and laboratory results an occult amicrofilaraemic Loa loa infection with immunological hyperreaction to the parasite antigen, reactive hypereosinophilia and high antibody titers was diagnosed.Therapy And CourseAnthelmintic therapy was inducted with ivermectin and diethylcarbamazine. Treatment with ivermectin alone resulted in a prompt regression of symptoms and decrease of eosinophil levels and antibody titers.ConclusionsParasitic diseases like L. loa infections are extremely rare in Europe but should be considered as differential diagnosis at an early stage when patients present with appropriate travel history and clinical findings. There is a lack of standardized therapy and follow-up recommendations. A precise recording of all new diagnoses with therapy progress/response should be established in an international registry.Thieme. All rights reserved.

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