Cranial osteomyelitis as a complication of furuncular myiasis / Osteomielite craniana como complicação de miíase furuncular

ABSTRACT Objective: To report the case of an infant with infrequent cranial osteomyelitis as a complication of furuncular myiasis. Case description: The patient was a 4-month-old male who presented to the emergency department with a nodular skull lesion with edema, tenderness, pain, and purulent drainage, as well as progress of the ulcerated lesion and evidence of larvae inside. Antibiotic treatment was initiated, and the patient was taken to the operating room to remove the larvae, but he had no symptomatic improvement. A skull radiograph was taken to visualize the osteolytic lesion, and a 3D computed tomography scan showed osteomyelitis of the external parietal surface. Antibiotic management readjustment continued for a total of six weeks, and a skin flap was used with clinical improvement. Comments: Myiasis is defined as the infestation of vertebrates with fly larvae. In mammals, larvae can feed on host tissue and cause a wide range of infestations depending on their location in the body. The cranial osteomyelitis as a complication of myiasis described in this report seems to be an exceptional case.

RESUMO Objetivo: Relatar um caso de criança com osteomielite craniana infrequente como complicação da miíase furuncular. Descrição do caso: Paciente do sexo masculino, com quatro meses de idade, que se apresentou no pronto-socorro com lesão nodular no crânio com edema, sensibilidade, dor e drenagem purulenta, com evolução da lesão ulcerada e evidência de larva no interior. O tratamento com antibióticos foi iniciado e o paciente foi levado à sala de cirurgia para remover as larvas, mas não houve melhora. Uma radiografia do crânio foi realizada para visualizar a lesão osteolítica e uma tomografia computadorizada em 3D mostrou osteomielite da superfície parietal externa. O reajuste do tratamento com antibióticos foi mantido por um total de seis semanas e um retalho cutâneo foi realizado com melhora clínica. Comentários: Miíase é definida como a infestação de vertebrados com larvas de moscas. Nos mamíferos, as larvas podem se alimentar do tecido hospedeiro e causar uma ampla variedade de infestações, dependendo da sua localização no corpo. A osteomielite como complicação da miíase, apresentada nesse caso, parece ser uma forma não usual de complicação dessa doença.

Sarcoma cardiaco con metástasis a encéfalo y miasis / Cardiac sarcoma with encephalon metastasis and myiasis

Los sarcomas cardíacos, son una entidad muy rara que a menudo son asintomáticos hasta que están avanzados, y aun así producen síntomas inespecíficos e imitan otras patologías. El pronóstico sombrío resulta de una invasión local extensa y / o metástasis a distancia en la presentación. Se presenta una paciente de sexo femenino, de 24 años de edad, preveniente del área rural de Paraguay, que fue diagnosticado con sarcoma cardiaco primario. Un año después de la intervención quirúrgica, la paciente regresa al servicio, donde se detecta metástasis a encéfalo, concomitantemente se aprecia miasis, por lo que es ingresada a la unidad de cuidados intensivos, para seguimiento. Se puede apreciar la falta total de seguimiento a esta paciente, por lo que ha ingresado en este estado al servicio, por lo que es fundamental la implementación de programas de seguimiento a estos pacientes para evitar complicaciones prevenibles(AU)

Cardiac sarcomas are a very rare entity that are often asymptomatic until they are advanced, and even so produce nonspecific symptoms and mimic other pathologies. The somber prognosis results from extensive local invasion and / or distant metastasis in the presentation. We present a 24-year female patient from the rural area of Paraguay, who was diagnosed with primary cardiac sarcoma. One year after the surgical intervention, the patient returns to the service, where metastasis to the brain is detected, concomitantly myiasis is seen, and therefore, she is admitted to the intensive care unit for follow-up.The total lack of follow-up to this patient can be appreciated, which is why she has entered the service in this state, so it is essential to implement follow-up programs for these patients to avoid preventable complications(AU)

A case of imported furuncular cutaneous myiasis and cytochrome oxidase Ⅰ gene sequence analysis of the pathogenic Cordylobia anthropophaga / 中华皮肤科杂志

To report a case of imported furuncular cutaneous myiasis,and to analyze the sequence of the mitochondrial cytochrome C oxidase subunit Ⅰ (CO Ⅰ) gene of the pathogenic Cordylobia anthropophaga.A 33-year-old female patient had a travel history to Ghana and Cameroon in Africa 1 month prior to the presentation.No anti-mosquito measures were taken during her stay,and she hung up the laundries outside to dry for several times.Skin examination showed furuncular protuberances with diameters of 1-2 cm on the inner side of the left upper arm as well as on the outer side of the left chest,which were bright red and hard on palpation with irregular borders and a small hole on their central surface.Morphological identification revealed that the larva squeezed from the lesion was suspected as myiasis.After PCR amplification of the CO Ⅰ gene of the larva,an about 650-bp PCR product was acquired.Sequencing and BLAST analysis showed that this product was most closely related to the CO Ⅰ gene (GenBank accession number:FR719158.1) of Cordylobia anthropophaga isolated in Cameroon in 2010 with the sequence similarity being 99.84％,and they were grouped together on the phylogenetic tree.According to the clinical features and travel history of the patient and the sequencing results of the pathogenic Cordylobia anthropophaga,this case was confirmed as imported furuncular cutaneous myiasis caused by Cordylobia anthropophaga.

Excision of furuncular myiasis larvae using a punch: a simple, practical and aesthetic method

Abstract: Myiasis refers to Diptera larvae infesting vertebrate animals. There are two forms of the disease: primary and secondary. In primary myiasis, fly larvae invade and develop in healthy tissue; in secondary myiasis, flies lay their eggs in skin ulcerations, and the larvae develop in tissue necrosis products. Furuncular myiasis is a type of primary myiasis. Treatment for it consists of techniques such as the production of localized hypoxia to force the emergence of the larvae, and mechanical or surgical removal of the maggots. These techniques, however, are painful and often unsuccessful. We propose a new technique for extraction of myiasis larvae, which might facilitate the surgical procedure and constitute a virtually painless and aesthetic option for the patient.