Teen's Hand Rots After Catching Flesh-Eating Parasite on Organic Farm

A teenager who visited Ecuador caught a "flesh-eating," parasitic disease which caused a huge ulcer to form on the back of his hand.

The ulcer, on the right hand of the unnamed 19-year-old, got bigger and bigger over a period of three months, according to a case study published in the New England Journal of Medicine. Several tender nodules had also developed under the skin of his right forearm and elbow, his doctors explained in the journal.

The teenager visited a dermatology clinic in the city of Saint Paul, Minnesota, to get his hand checked out. Doctors learned he had travelled to Ecuador and worked on an organic produce farm for five months prior to visiting them.

The ulcer measured 1.1 inches in diameter and was "tender with a firm border." A biopsy showed it was infected with the Leishmania panamensis parasite.

The patient was diagnosed with Leishmaniasis disease, which is found in some tropical and subtropical regions, as well as parts of southern Europe. The parasite is spread by the bite of phlebotomine sand flies, which are around a quarter of the size of mosquitoes, on average.

Cutaneous leishmaniasis that affects the skin—as seen in this case—is among the most common forms. Symptoms include one or more sores on the skin, which can change in size and appearance, and turn into ulcers.

The condition is classed as a neglected tropical disease, the umbrella term for parasitic and bacterial diseases that "cause substantial illness for more than one billion people globally," according to the U.S. Centers for Disease Control and Prevention.

Cutaneous Leishmaniasis, NEJM,
The ulcer which formed on the 19-year-old patient's hand. NEJM

"Affecting the world's poorest people, NTDs impair physical and cognitive development, contribute to mother and child illness and death, make it difficult to farm or earn a living, and limit productivity in the workplace. As a result, NTDs trap the poor in a cycle of poverty and disease," the CDC explains on its website.

The CDC states its difficult to track cases of the disease, but there are thought to be approximately 700,000 to at least 1.2 million new cases of cutaneous leishmaniasis each year.

The condition is sometimes described as "flesh-eating," although the parasite doesn't eat the flesh, but instead damages the tissue.

The patient was prescribed with drugs, which healed the ulcer after 10 days, leaving behind a scar. The number and size of the nodules were also "were markedly reduced," his doctors wrote.

Jonathan Alpern of Health Partners Travel and Tropical Medicine Center and Alexia Knapp of its Department of Dermatology told Newsweek there was a delay in diagnosing and treating the patient.

Although it was a typical presentation of the disease, leishmaniasis affecting the skin is not commonly seen in the U.S., "and the disease was not immediately recognized."

The pair added doctors need to be aware of this "important cause of skin lesions in travellers returning from endemic areas, including short-term travellers."

"Recent data suggests that significant risk exists even when the exposure period is under two weeks," they said.

potato, vegetable, stock, getty, farm, produce,
A stock image shows a farmer holding some potatoes, unrelated to the case study. Getty