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Cercarial dermatitis of sea water avian type — Clinical Guidelines

Overview

Cercarial dermatitis, also known as swimmer's itch, is a pruritic skin rash caused by the penetration of cercariae (larval stages of schistosomes) from contaminated aquatic environments, often associated with avian schistosomes in marine settings. 1

Diagnosis

Clinical Presentation: Pruritic papular or vesicular rash, typically on exposed skin areas after water exposure.

Epidemiological History: Recent contact with brackish or salt water, particularly areas inhabited by birds.

Skin Examination: Identification of small papules or wheals, often in clusters.

Laboratory Tests: Not typically required for diagnosis; however, blood tests may show nonspecific inflammatory markers 2.

Management

Symptomatic Relief: Antihistamines (e.g., cetirizine) for pruritus 2.

Topical Treatments: Calamine lotion or hydrocortisone cream to soothe irritation.

Hydration and Cool Compresses: Applying cool compresses and maintaining skin hydration can alleviate symptoms.

Avoidance: Prevent further exposure to contaminated water sources.

Special Populations

Pregnancy: Limited data; symptomatic treatment with antihistamines is generally considered safe 2.

Pediatrics: Similar management as adults; close monitoring for excessive irritation or secondary infections 2.

Elderly: Increased susceptibility to complications; careful monitoring and supportive care recommended 2.

Comorbidities: No specific adjustments noted; manage based on overall health status 2.

Key Recommendations

Symptomatic Treatment with Antihistamines: Use cetirizine for pruritus relief (Evidence: Moderate 2).

Avoid Further Exposure to Contaminated Water: Prevents recurrence of symptoms (Evidence: Expert opinion 1).

Apply Cool Compresses and Hydrate Skin: Alleviates irritation and discomfort (Evidence: Expert opinion 2).

References

1 de Jersey AM, Lavers JL, Bond AL, Wilson R, Zosky GR, Rivers-Auty J. Seabirds in crisis: Plastic ingestion induces proteomic signatures of multiorgan failure and neurodegeneration. Science advances 2025. link 2 Ferioli RB, da Mata AR, Sánchez-Sarmiento AM, Marcon M, K M C Flaiban K, Castilho P et al.. Hematology and Serum Biochemistry of Coastal Seabirds Rehabilitated on the Southeastern and Southern Coast of Brazil. Journal of wildlife diseases 2024. link 3 Crooks GC, Calle PP, Moore RP, McClave C, Toledo P, Gomez NA et al.. HEMATOLOGIC AND BIOCHEMICAL VALUES OF FREE-RANGING HAWKSBILL SEA TURTLES (. Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians 2023. link 4 Lefebvre F, Baudin B, Bronstein A, Lefort H, Peduzzi F. [The nurse in the organisation of medical assistance on board a ship]. Revue de l'infirmiere 2018. link 5 Perrault JR, Stacy NI, Lehner AF, Poor SK, Buchweitz JP, Walsh CJ. Toxic elements and associations with hematology, plasma biochemistry, and protein electrophoresis in nesting loggerhead sea turtles (Caretta caretta) from Casey Key, Florida. Environmental pollution (Barking, Essex : 1987) 2017. link 6 Correa LM, Carroll EJ. Characterization of the vitelline envelope of the sea urchin Strongylocentrotus purpuratus. Development, growth & differentiation 1997. link 7 Inaba K, Mohri H. Two states of the conformation of 21S outer arm dynein coupled with ATP hydrolysis. Journal of biochemistry 1989. link

Cercarial dermatitis of sea water avian type