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After ivermectin therapy, he re-presented with respiratory symptoms, peripheral eosinophilia and transient pulmonary infiltrates; the classic triad of L\u00f6ffler\u2019s syndrome associated with invasive helminth infection.<jats:italic>Gnathostoma spinigerum<\/jats:italic>immunoblot was positive. After a second round of ivermectin therapy his respiratory symptoms resolved, but the patient\u2019s cutaneous disease relapsed repeatedly over months, with migratory erythematous swellings appearing and settling after a few days. He was treated with a 21-day course of albendazole and is lesion free at 40\u2009weeks post initial presentation.<\/jats:p>","DOI":"10.1136\/bcr-2017-223132","type":"journal-article","created":{"date-parts":[[2018,2,2]],"date-time":"2018-02-02T14:17:46Z","timestamp":1517581066000},"page":"bcr-2017-223132","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Imported gnathostomiasis manifesting as cutaneous larva migrans and L\u00f6ffler\u2019s syndrome"],"prefix":"10.1136","volume":"2018","author":[{"given":"William 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