ABSTRACT
Myiasis is a parasitic infestation of human or animal skin, necrotic tissues and natural cavities by fly larvae or pupa. In this paper we will describe the case of a 27 years oíd woman, asymptomatic, that spontaneously eliminated from her vagina two Eristalis tenax larvae, a worldwide distributed fly specie, classified as an accidental myiasis agent. The patient lived in an urban área, she had low socioeconomic status and she had the antecedent record of use of intravaginal vegetables as sexual stimulator. Analyzing the case and the references, we concluded the patient had an accidental infestation by E. tenax, being the vaginal introduction of vegetables the most probable mechanism of transmission. This kind of infestation has not been communicated in the literature. Also, this is the first documented case of E. tenax myiasis in Chile.
Las miasis son infestaciones parasitarias de humanos o animales por larvas de mosca que infestan piel, tejidos necróticos y cavidades naturales. Presentamos el caso de una mujer de 27 años, asintomática, que eliminó espontáneamente por vía vaginal larvas de Eristalis tenax, una especie de mosca ampliamente distribuida en el mundo, la que es clasificada como agente de miasis accidental. La paciente residía en un área urbana de nivel socioeconómico bajo y entregaba como antecedente el uso de vegetales intravaginales como estimulante sexual. Analizando el caso descrito y la bibliografía existente, concluimos que la paciente presentó una infestación accidental por E. tenax, siendo el mecanismo más probable de transmisión la introducción vaginal de vegetales. Este mecanismo no ha sido comunicado previamente en la literatura. Además, este es el primer caso de miasis por E. tenax documentado en Chile.
Subject(s)
Adult , Animals , Female , Humans , Diptera/classification , Myiasis/parasitology , Vagina/parasitology , Larva/classification , Myiasis/diagnosisABSTRACT
Background: An immunological damage of beta cells in the islets of Langerhans, plays a role in the pathogenesis of type 1 diabetes. Recently, the identification of individuals in pre clinical phase and with high risk of developing type 1 diabetes, has become possible by means of the detection of immune markers such as islet cell antibodies (ICA) and the measurement of first phase response of insulin (FPRI). Subjects and methods: We studied 1,021 first degree relatives of type 1 diabetics, aged 4 to 35 years. ICA were measured using poly-IgG peroxidase in sections of human pancreas. In those subjects with positive ICA and normal oral glucose tolerance test, the FPRI was measured. FPRI was defined as the sum of insulinemias at minutes 1 and 3 after a three minutes 0.5 g/kg glucose load. Results: Thirty subjects were ICA (+), defined as having more than 20 juvenile diabetes foundation units (prevalence of 2.9 percent). No differences in age, sex and closeness of familial relationship was found between ICA (+) and ICA (-) individuals. FPRI was measured in 24 subjects with normal oral glucose tolerance test and was normal in five. Seventeen subjects had a decreased response (between percentiles 1 and 5) and two had a response below percentile 1. No relationship between ICA levels and FPRI was found. Conclusions: The early detection of populations at risk of developing type 1 diabetes should be regarded as an important tool to better understand the natural history of the disease and to develop preventive programs in the future