I developed swimmer’s itch after swimming in an ocean that had schistosomes/ parasites (I did not realize this at the time, but have since looked up the beach online and read about it). The rash I developed was very severe and all over my body, and finally a dermatologist prescribed me 50mg of Prednisone for 5 days. The rash is clearing up, but a few days after I finished the medication, I started to feel worse and get a bit of a new rash in spots. I had already been experiencing a sore throat and headache since I first started getting the rash, but now I have extreme headache, sore throat, light headedness, nausea, dizziness, and tiredness. My dermatologist told me that this is probably from taking the Prednisone as it weakens the immune system and not to take anything for it (I was trying Cold FX which helped), just to ride it out for a few weeks. Is this common after only taking it for 5 days? I am also a little concered about Schistosomiasis, as I swallowed a bit of the sea water when swimming. Could that be a possiblity? Should I be tested for this? Also I don’t understand why I would be getting more rashes. I live in BC Canada.

Answered by: Maria/MD Health Forum.com Team

Headache, sore throat, light-headedness, nausea, dizziness and tiredness are among the reported side effects after stopping prednisolone therapy. Like other steroids, it’s discontinuation may weaken your immune system for a few days, thus making you prone to infections. Your body may need time to adjust after stopping prednisolone therapy. The length of the adjustment period will depend on the amount of prednisolone administered and for how long it was taken. Patients who discontinued prednisolone sometimes experience recurrence of disease symptoms. Considering that you still have rashes, then I would recommend confirming with your doctor if those were indeed due to the steroid discontinuation.

Swimmer’s itch and Schistosomiasis are conditions caused by parasites known as schistosomes. Parasites need hosts to support their life cycle. Swimmer’s itch, also known as Cercarial Dermatitis is a skin condition caused by the type of schistosomes that use waterfowls as hosts. The larvae sometimes end up in the human skin by mistake. It will burrow into the skin for moisture and this will cause itchiness and rashes. Humans are not suitable hosts for cercarias, it means that they can not stay in the skin for long. The larvae will not develop and will eventually die. The genera that can cause Swimmer’s itch are Trichobilharzia and Gigantobilharzia.

People who swim in sea water may also develop sea bather’s eruption once exposed to the larval form of salt-water organisms like thimble jellyfish, sea anemone and portuguese man of war. The symptoms are identical to those of Cercaria Dermatis’.

The damage due to Cercaria Dermatitis is literally skin-deep. Schistosomiasis on the other hand, is far more dangerous because it affects the internal organs. Schistosomiasis is also known as bilharzia. This infectious disease is caused by flatworms Schistosoma mansoni, S. haematobium, and S. japonicum which are very harmful to humans. If a person is in contact with Schistosoma-infested fresh water, the parasite will enter the human body by penetrating the skin. Schistosomiasis progresses slowly, rashes may appear within days but the rest of the symptoms may be experienced by the infected person a few months later. The worms will develop in the blood vessels where they will produce eggs. The body’s reaction to the eggs will cause symptoms. When eggs migrate to the liver where it will cause scarring. Enlargement of the liver and spleen were also noted in some patients. The eggs may also go to the intestines and this may abdominal pain or diarrhea.

You mentioned that you developed rashes after swimming in the sea water. Parasites that cause Schistosomiasis can only be found in fresh water in some countries in Asia, South America and Africa. So if you didn’t travel to areas where this parasitic infection is prevalent, then I guess there is no cause for alarm.