﻿18 BULLETIN 1369, U. S. DEPARTMENT OF AGRICULTUEE 



some stiffness and pain in the wrist. The pulse and temperature 

 and general physical condition were normal. Three weeks later the 

 child exhibited a swelling of a similar nature in the lumbar region 

 on the left side. This lasted only a few days. During the first 

 week in December the child was again brought in with a slightly 

 edematous area, about the size of the palm of the hand, on the 

 left side in the midaxillary region. Two or three days later this 

 area showed two small perforations of the skin about an inch 

 apart. A similar area next occurred on the lower border of the 

 right scapula. Pain was felt in the area and a few hours later 

 two punctures appeared. A few days later the child's father 

 saw a larva moving in a hole which appeared on the upper angle 

 of the left scapula following a similar clinical experience. Two 

 days later a larva was pressed from a puncture which appeared at 

 the base of the mastoid process of the left temporal bone.- This larva 

 was found by the writers to be TI. lineatum in the third stage. 



Another interesting case has been brought to the writers' at- 

 tention by R. A. Cooley. Dr. O. E. Patterson, who attended this 

 case, and the mother of the infested child have kindly furnished a 

 very complete history of the case. This infestation occurred in a 

 child of 5 years who lived on a stock farm near Moiese, Mont. From 

 late November, 1921, to March 1, 1923, 14 larvae were removed from 

 the patient. Seven of these appeared on the head and face, one each 

 from the neck, arm, shoulder, and chest, and one each from the 

 thigh and from the calf of the leg. The symptoms accompanying 

 the appearance of each larva were very similar but most acute 

 with those on the face. Several hours (sometimes 24) preceding 

 the appearance of each larva there was malaise and pain in the 

 stomach, accompanied later with marked fever. These symptoms 

 then gave way to retarded heart action, cold limbs, and drowsiness. 

 When these symptoms had practically disappeared a local pain 

 and swelling occurred in the region where the larva came to the 

 surface. The duration of each attack ranged from one and one- 

 half to four days. After several larvae had been expelled symptoms 

 of neuritis began to manifest themselves in stiffness of the legs, 

 weakness of the leg muscles, and finally almost complete paralysis 

 of the lower extremities, which lasted several weeks, only subsiding 

 after practicaly all larvae had come to the subdermal region. A 

 year later this paralytic condition had not completely disappeared. 

 These symptoms suggest that some of the larvse may have entered 

 the spinal canal and produced lesions there. 



The writers have examined two of the specimens from this case 

 and found them to be third-stage larvae of H. lineatum. 



Riley {8 It) has given a rather complete account of the infestation 

 of a child in Pennsylvania. A physician was called to attend this 

 child, which was supposed to be suffering from erysipelas. The 

 child, a boy of 3 or 4 years, was suffering sufficient pain from some- 

 thing working under the skin to prevent his sleeping at night. This 

 larva had been noticed five months before under the skin near the 

 sternal end of the right clavicle, and during the intervening time 

 it had traveled up and down the chest, in front down. one arm to 

 the elbow, and over one side to the back. Prior to the calling of the 

 physician no serious annoyance had been experienced. This larva 



