2nd August 2023

A 46 year old man presents with fever, severe itching, muscle pains and diarrhoea.

A 46 year old man presents with fever, severe itching, muscle pains and diarrhoea. He returned from Cameroon 4 weeks ago, where he went on holiday, and partook in regular ‘skinny dipping’ and scuba diving. He recalls the itch starting a few days after the last time he went skinny dipping. On examination,n there is evidence of an urticarial rash with marked excoriations. Blood tests reveal a raised eosinophil count.

What is the most likely cause?

Select the SINGLE most appropriate option from the list below. Select ONE option only.