Crusted (Norwegian) scabies. Occurrence in a child undergoing a bone marrow transplant

A case of crusted (Norwegian) scabies is reported in a child who was a recipient of a bone marrow transplant. The infestation is presumed to have predated the bone marrow transplant and continued asymptomatically during chemotherapy and total body x-irradiation in preparation for transplant. The child was asymptomatic until 23 days after transplantation, when bone marrow engraftment was attained. The altered host-parasite relationship is emphasized by the observation that the onset of symptomatic pruritus coincided with successful engraftment.