MIASIS OCULAR Y BUCAL, A PROPÓSITO DE DOS CASOS / MYASIS EYE AND MOUTH, BY THE WAY OF TWO CASES

La palabra "miasis" proviene del griego, "myia" que significa mosca. La enfermedad corresponde a los daños causados por la invasión de larvas de moscas a tejidos del hombre u otros vertebrados

The term 'Myiasis' originates from the ancient Greek word 'myia', meaning 'fly'. This disease refers to tissue damage caused by the infestation of fly larvae in humans or other vertebrates

Miasis en pacientes con cáncer en el Instituto Nacional de Cancerología entre 2008 y 2018: Serie de Casos / Myiasis in cancer patients receiving medical care at a reference center in Bogotá, Colombia: 2008-2018. A case series

Resumen Introducción: La miasis puede ser considerada una enfermedad desatendida; corresponde a la infestación de larvas de dípteros en piel, heridas o cavidades naturales. La literatura para pacientes oncológicos con infestación es limitada para Colombia. Métodos: Se realizó una serie de casos de miasis en pacientes atendidos en el Instituto Nacional de Cancerología de 2008 a 2018; se obtuvieron datos de las historias clínicas con el fin de caracterizar variables sociodemográficas, oncológicas y tratamiento recibido. Resultados: Se encontraron 32 registros: 27 cumplieron con los criterios de inclusión, mediana de edad 69 años, 74% fueron hombres, 48% procedían de área rural, 33,3% de áreas con alturas superiores a 2000 msnm, 70% presentaban cáncer de cabeza y cuello, seguidos por cáncer de mama 14%; 40% ECOG 2-3; 77% visualizaron larvas antes de consultar; ningún paciente presentó sepsis al momento de consultar, 29% presentaban secreción en zona infestada, 85% recibieron ivermectina y curaciones por parte de enfermería; 70% recibió antibióticos sistémicos, y 60% otros tratamientos además de la remoción mecánica e ivermectina, la mediana de leucocitos al ingreso fue de 10280 y de eosinófilos 110. Conclusión: Ésta es la primera serie de casos informada de miasis en pacientes oncológicos para América. Es más frecuente en pacientes con neoplasias en áreas expuestas, aunque se puede presentar en zonas no expuestas; la infestación por larvas tiende a no ser purulenta. Se deben hacer estudios sobre el uso de ivermectina, otros antibióticos y las implicaciones pronósticas de esta patología en los pacientes con cáncer avanzado.

Abstract Introduction: Myiasis can be considered a neglected disease; it corresponds to the infestation of dipteran larvae in skin, wounds, or natural cavities. Literature for oncological patients with this infestation is limited for Colombia. Methods: A case series of myiasis was carried out in patients treated at the National Cancer Institute of Colombia from 2008 to 2018. Data were obtained from medical records in order to characterize sociodemographic and oncological variables and the treatment received. Results: Thirty-two records were found, 27 of them met the inclusion criteria. Median age was 69 years, 74% were men, 48% came from rural areas, 33.3% from areas with altitudes greater than 2,000 meters above sea level, 70% had head and neck cancer, followed by breast cancer in 14%; 40% had ECOG 2-3, and 77% visualized larvae before consulting. No patient presented with sepsis at the time of consultation, 29% presented with discharge in the infested area, 85% received ivermectin and treatment by the nursing staff; 70% received systemic antibiotics, and 60% other treatments in addition to mechanical removal and ivermectin. Median of leukocytes at admission was 10,280, while median of eosinophils was 110. Conclusion: This is the first reported case series of myiasis in cancer patients for Latin America. It is more common in patients with neoplasms in exposed areas, although it can occur in unexposed areas too. Larval infestation tends not to be purulent. Further studies are needed on the use of ivermectin, other antibiotics, and the prognostic implications of this pathology in patients with advanced cancer.

Reconstrução de palato com malha de polipropileno e prótese acrílica para correção de fístula oronasal adquirida em cão / Palate reconstruction with polypropylene mesh and acrylic prosthesis in dog for correcton of acquired oronosal fistulae

As fístulas oronosais adquiridas são defeitos que permitem a comunicação anormal entre as cavidades oral e nasal. Inúmeras causas podem ser atribuídas à etiologia de tal defeito. O presente trabalho visa relatar o caso de um cão com fístula oronasal adquirida que foi submetido à reconstrução cirúrgica do palato com o uso de malha de polipropileno e prótese acrílica. Após estabilização do quadro clínico e remoção manual das larvas, o paciente foi encaminhado para o desbridamento cirúrgico das lesões orais e correção do defeito no palato. A palatoplastia foi realizada com o uso da malha e resina de polimetilmetacrilato autopolimerizável. A malha foi suturada sobre o defeito palatino com pontos simples separados e fio náilon 3-0 nas extremidades da ferida. Em seguida, a resina foi preparada e, ao atingir consistência adequada, foi aplicada e modelada sobre o a malha de polipropileno com o auxílio de um descolador de Molt, sendo também suturada nas bordas da fístula com pontos simples separados e fio náilon 3-0. No mesmo tempo cirúrgico foi inserida uma sonda esofágica para alimentação enteral. Devido complicações cirúrgicas no pós operatório, o paciente foi submetido a mais duas intervenções cirúrgicas para desfecho satisfatório do tratamento. Conclui-se que associação entre a tela de polipropileno e a prótese acrílica foi uma alternativa exequível para a palatoplastia em cão.

Acquired oronosal fistulae are abnormal communication between the oral and nasal cavities. A oronasal fistula can be the result of different causes, like oral myiasis. The objetctive of these paper is to report the case of a dog with acquired oronasal fistula that underwent surgical reconstruction of the palate using polypropylene mesh and acrylic prosthesis. After stabilization of the patient ́s clinical condition and mecanic removal of the larvae, the dog was referred for surgical debridement of the oral lesions and correction of the defect in the palate. Palatoplasty was performed using a mesh and polymethylmethacrylate resin. The mesh was sutured over the palatal defect with separate simple suture and 3-0 naylon thread at the ends of the wound. Then, the resin was prepared and, upon reaching adequate consistency, it was applied and shaped over the polypropylene mesh with Molt peeler. It was also sutured on the edges of the fistula with separate simple suture and 3-0 nylon suture. At the same surgical time, an esophageal tube was inserted for enteral feeding. Due to complications, the dog underwent two more surgical interventions for a satisfactory treatment outcome. It is concluded that the association between the polypropylene mesh and the acrylic prosthesis was a practical alternative for palatoplasty in dogs after oral myiasis.

First list of parasitoids in flies of medical, veterinary, and forensic importance in Rio Grande do Sul – Brazil / Primeira lista de parasitoides em moscas de importância médica, veterinária e forense no Rio Grande do Sul - Brasil

Necrophagous flies are of great importance for human and animal health. In places where their development occurs, parasitoids can be used as a tool to control these dipterans. In Brazil, the fauna of these parasitoids has been investigated in some regions. However, in Rio Grande do Sul, it is known the occurrence of only one species. Thus, this study aimed to create the first list of parasitoids in flies of medical and veterinary importance in Southern Brazil. Collections took place in the municipality of Pelotas (31º 42' S; 52º 18' W). Three replicates consisting of a 500 g bovine liver chunk placed in a tray were exposed to open air for 20 days. Then pupae were individualized and observed until their emergence. We identified 4,882 adult flies of Calliphoridae, Fanniidae, Muscidae, and Sarcophagidae. 4,040 parasitoids emerged, belonging to eight species, of which Nasonia vitripennis, Spalangia cameroni, Spalangia chontalensis, and Tachinephagus zealandicus are new records in Rio Grande do Sul state. Also, three undescribed species of the genus Aphaereta were collected. In spite of being the first attempt to inventory the fauna of hymenopteran parasitoids, this study may help in the development of management programs of these dipterans in the region.

Moscas necrófagas possuem grande importância para a sanidade humana e animal. Onde estas se desenvolvem ocorrem parasitoides que podem ser utilizados como ferramentas para o controle desses dípteros. No Brasil, a fauna desses parasitoides vem sendo investigada em algumas regiões e no Rio Grande do Sul é conhecida a ocorrência de apenas uma espécie. Portanto, o objetivo deste estudo foi criar a primeira lista de espécies de parasitoides de moscas de importância médica e veterinária ocorrentes no extremo sul do Brasil. As coletas foram realizadas no município de Pelotas (31º 42' S; 52º 18' O). Foram montadas três réplicas de bandejas contendo, cada uma, 500 g de fígado bovino, expostas ao ar livre durante 20 dias. Na sequência, as pupas foram individualizadas e observadas até a emergência. Foram identificados 4.882 adultos pertencentes às famílias Calliphoridae, Fanniidae, Muscidae e Sarcophagidae. Emergiram 4.040 parasitoides, pertencentes a oito espécies, das quais Nasonia vitripennis, Spalangia cameroni, Spalangia chontalensis e Tachinephagus zealandicus são novas ocorrências para o Rio Grande do Sul. Foram coletadas três espécies ainda não descritas do gênero Aphaereta. Apesar de ainda ser um primeiro esforço de inventariar a fauna de himenópteros parasitoides, este estudo pode auxiliar no desenvolvimento de programas de manejos desses dípteros na região.

Dermatobia hominis: una dermatosis inusual en zonas no endémicas / Dermatobia hominis: an unusual dermatosis in non-endemic areas

La miasis forunculoide es una parasitosis producida por la larva de una mosca endémica en las regiones tropicales y subtropicales de América y África. Se presenta un caso de la enfermedad en un residente de Mendoza y una breve revisión bibliográfica de esta parasitosis, poco frecuente en Argentina.

Furuncular myiasis is a parasitosis infestation caused by fly larvae, it is endemic in the tropical and subtropical regions of America and Africa. We present a case in a patient living in Mendoza. A review of the literature regarding this uncommon parasitosis in Argentina is also presented here.

Miasis foruncular causada por Dermatobia hominis en Ecuador / Furuncular myasis caused by Dermatobia hominis in Ecuador

Las miasis humanas son ectoparasitosis causadas por larvas de varias especies de moscas que producen distintas formas clínicas, afectan piel, cavidades y heridas. Estas prevalecen en regiones tropicales. Se presenta un caso de miasis foruncular en un hombre de 32 años, turista, infestado en una zona tropical húmeda de la región costera del Pacífico del Ecuador. Acude a consulta con un cuadro clínico de 30 días de evolución, y refiere picadura de insecto que creció hasta formar elevación indurada prurítica, no dolorosa, en piel de flanco izquierdo del abdomen. Al examen físico se observó una lesión foruncular de 3 x 2 cm rodeada de placa eritematosa con el centro abierto observándose un agujero central que descargaba un líquido sero-sanguinolento con movimientos. Por extracción manual se obtuvo una sola larva que por sus características externas se identificó como Dermatobia hominis. El resto del examen físico y exámenes de laboratorio fueron normales. Las actividades turísticas o de trabajo a estas zonas tropicales expone a las personas al riesgo de contraer miasis, por ende, es necesario información y medidas de prevención(AU)

Human myases are ectoparasitic infections caused by larvae of several fly species. They present various clinical manifestations, affecting the skin, cavities and wounds. Myases prevail in tropical regions. A case is presented of furuncular myasis in a male 32-year-old tourist infected in a humid tropical area from the Pacific coastal region of Ecuador. The patient presented with a clinical status of 30 days' evolution, reporting an insect bite that grew to form a painless indurated pruritic nodule on the skin of his left flank of the abdomen. Physical examination found a 3 x 2 cm furuncular lesion surrounded by erythematous plaque and an open center which discharged a serosanguineous fluid with movement. A single larva was obtained by manual extraction, which was identified as Dermatobia hominis based on its external characteristics. The remaining physical examination and laboratory tests were normal. Tourist and work activities in these tropical areas expose people to the risk of contracting myasis. Information and prevention measures are therefore necessary(AU)

Children hospitalized for myiasis in a reference center in Uruguay / Niños hospitalizados por miasis en un centro de referencia de Uruguay

Abstract Background: Myiasis is an emerging disease caused by tissue invasion of dipteran larvae. In Uruguay, Cochliomyia hominivorax and Dermatobia hominis are the most frequent species. This study aimed to describe the epidemiological and clinical characteristics and the follow-up of children < 15 years hospitalized for myiasis in a reference center in Uruguay between 2010 and 2019. Methods: We conducted a descriptive and retrospective study by reviewing medical records. We analyzed the following variables: age, sex, comorbidities, origin, the month at admission, clinical manifestations, other parasitoses, treatments, complications, and larva species identified. Results: We found 63 hospitalized children: median age of 7 years (1 month-14 years), 68% of females. We detected risk comorbidities for myiasis (33%), of which chronic malnutrition was the most frequent (n = 6); 84% were from the south of the country; 76% were hospitalized during the summer. Superficial and multiple cutaneous involvements were found in 86%: of the scalp 50, furunculoid type 51, secondary to C. hominivorax 98.4%, and to D. hominis in 1.6%. As treatments, larval extraction was detected in all of them, surgical in 22%. Asphyctic products for parasites were applied in 94%, ether in 49. Antimicrobials were prescribed in 95%; cephradine and ivermectin were the most frequent. About 51% presented infectious complications: impetigo was found in 29, cellulitis in 2, and abscess in 1. Conclusions: Myiasis predominantly affected healthy schoolchildren during the summer months and was frequently associated with ectoparasites. Superficial infestation of the furuncle-like scalp by C. hominivorax was the most frequent form. Infectious complications motivated hospitalizations.

Resumen Introducción: La miasis es una enfermedad emergente producida por la invasión tisular por larvas de dípteros. En Uruguay, Cochliomyia hominivorax y Dermatobia hominis son las especies más frecuentes. El objetivo de este estudio fue describir las características epidemiológicas y clínicas, y el seguimiento, de niños menores de 15 años hospitalizados por miasis en un centro de referencia del Uruguay entre 2010 y 2019. Métodos: Se llevó a cabo un estudio descriptivo y retrospectivo mediante la revisión de las historias clínicas. Se analizaron las siguientes variables: edad, sexo, comorbilidad, procedencia, mes al ingreso, cuadro clínico, otras parasitosis, tratamientos, complicaciones y especie de larva identificada. Resultados: Se encontraron 63 casos de niños hospitalizados, con una mediana de edad de 7 años (rango: 1 mes a 14 años) y el 68% de sexo femenino. Se identificó comorbilidad de riesgo para miasis (33%), siendo la desnutrición crónica la más frecuente (n = 6). El 84% eran procedentes del sur del país y el 76% fueron hospitalizados en los meses estivales. Se encontró afectación cutánea superficial y múltiple en el 86%: de cuero cabelludo en 50, de tipo forunculoide en 51, secundaria a C. hominivorax en el 98.4% y a D. hominis en el 1.6%. Se realizó extracción larvaria en todos los casos, que fue quirúrgica en el 22%. Se aplicaron productos asfícticos para parásitos en el 94%, con éter en 49 niños. Se prescribieron antimicrobianos en el 95%; los más usados fueron cefradina e ivermectina. El 51% presentaron complicaciones infecciosas: 29 impétigo, 2 celulitis y 1 absceso. Conclusiones: La miasis afectó predominantemente a escolares sanos y durante los meses estivales, y se encontró frecuentemente asociada con ectoparasitosis. La infestación superficial del cuero cabelludo de tipo forunculoide por C. hominivorax fue la forma más frecuente. Las complicaciones infecciosas motivaron las hospitalizaciones.

Oftalmomiasis / Ophthalmomiasis

La oftalmomiasis es una enfermedad poco frecuente, causada por artrópodos; en este caso por la mosca adulta. Presentamos el caso de una paciente femenina, de 44 años de edad, con antecedentes de inmunosupresión severa secundaria a VIH, quien fue atendida en el Servicio de Oftalmología por molestia ocular. Presentaba un aumento de volumen circunscrito en conjuntiva que se extendía sobre la córnea nasal del ojo izquierdo, de aspecto blanco nacarado, deslustrado. Se le realizó exéresis de la lesión y crioterapia. Posteriormente se le aplicó colirio de mitomicina C. A los siete meses la paciente regresó a la consulta con un cuadro de complicación franca y severa de la lesión, con destrucción de los tejidos de la órbita y múltiples cavernas ocupadas por cientos de larvas de moscas(AU)

Ophthalmomiasis is a rare disease, caused by arthropods; in this case by the adult fly. We present the case of a 44-year-old female patient, with a history of severe immunosuppression secondary to HIV, who was treated at the Ophthalmology Service for ocular discomfort. She presented a circumscribed increase in volume in the conjunctiva that extended over the nasal cornea of ​​the left eye, with a pearly white, tarnished appearance. Excision of the lesion and cryotherapy were performed. Subsequently, mitomycin C eye drops were applied. Seven months later, the patient returned to the consultation with a frank and severe complication of the lesion, with destruction of the tissues of the orbit and multiple caverns occupied by hundreds of fly larvae(AU)

Occurrence of Gasterophilus spp. in weanling foals in southern Brazil

The occurrence of gastrointestinal myiasis caused by Gasterophilus spp. larvae (Diptera: Oestridae) in adult horses has been widely characterized, however data on natural infestation in young foals have been lacking. This observation may be related to the absence of conclusive diagnosis in these individuals, most likely due to logistical or financial constraints. Gastric ulceration is a problem and a significant cause of morbidity in foals, particularly during the weaning stage; therefore, gasterophilosis should be included in the differential diagnosis. The primary purpose of this study was to determine the prevalence of gasterophilosis in 4- to 6-month-old weanling foals. Seventy-one healthy weanling foals were enrolled in the study. Physical assessment blood sampling and was completed in all foals before the commencement of the experiment. Gastroscopy examinations were performed under sedation (Detomidine 0.01 - 0.02 mg/kg) with a flexible endoscope inserted through nasogastric via. The lumen of the stomach was examined in order to search for botflies' larvae. Following gastroscopy, foals were classified into 2 groups based on the presence of Gasterophilus spp. larvae in their stomachs: 1) Infected and 2) Not Infected. Infected foals received a single dose of commercial trichlorfon and albendazole equine oral gel and were stalled for 24 h. The passed feces were thoroughly examined, searching for elimination of larvae. A total of 64% of the foals (n = 45/71) harbored Gasterophilus spp. larvae in the stomach. Mild hyperemia in the gastric mucosa was observed in the attachment sites of the parasites. Physical assessment and hematological parameters' data were analyzed with Shapiro-Wilk normality test. Comparison between groups for clinical signs, hematological parameters and Gasterophilus spp. infection rates were evaluated using the Kruskal-Wallis test or Student's t-test. Statistical significance was set at P < 0.05. There were no statistically significant variations in physical and hematological parameters between foals that were affected and those that were not infected. The larvae found in the feces were subjected to morphological examination, which confirmed the diagnosis of Gasterophilus intestinalis. No systemic clinical indications compatible with Gasterophilus spp. infestation were seen, as described in previous studies of horses infected with the parasite. No botfly eggs were observed in the hair of evaluated foals. During gastroscopy, mild hyperemic lesions in the gastric mucosa were observed in the larvae fixation sites. Although no changes in clinical or hematological parameters were noted, the confirmation of parasite presence is a cause for concern due to horses' tolerance for low infestation levels and poor diagnosis. Additionally, the presence of this myiasis in foals may be a significant stressor during the weaning period and should be included in the differential diagnosis of recurring abdominal pain. Furthermore, infected foals might be a reservoir for the parasite and, contribute to the elimination and spread of the larvae in the environment. Thus, inclusion of young horses in deworming protocols targeted to botfly larvae is needed. This is the first report of Gasterophilus intestinalis myiasis in foals in Brazil. Further research is necessary to fully understand the epidemiology and prevalence of this condition in young horses in Brazil, based on the findings of this study.(AU)

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.

Urogenital myiasis - An atypical presentation

The infestation of the human body by maggots has been reported worldwide and occurs most commonly in people of lower socioeconomic status and poor personal hygiene. Urogenital is the rarest site of myiasis presentations. Here we report the case of a 20-year-old, sexually inactive female student who presented with a necrotic growth in the paraurethral region infested with numerous maggots. The lesion involved the urethra and the bladder base. She was treated with debridement and bladder irrigation. The cystoscopy and local examination performed 2 weeks after admission, confirmed the complete healing of the urogenital lesion. Managing this patient's unique challenge was to assess the extent of the involvement and removal of all maggots from the deepest wound portion. The female internal and external urogenital myiasis is a very occasional and under-reported health hazard. Reporting such cases increases the public and physician awareness about the mode of presentation, right diagnosis, and available treatment options.

Miasis intestinal humana por Eristalis tenax en un niño de la zona urbana del municipio de Policarpa, Nariño, Colombia / Human intestinal myiasis by Eristalis tenax in a child from the urban area of the municipality of Policarpa, Nariño, Colombia

Resumen: La miasis se produce por la infestación con larvas de especies de moscas que afectan los tejidos u órganos de los vertebrados, incluido el ser humano. Puede clasificarse por caracterización entomológica o según el tropismo de las larvas en los tejidos. La miasis intestinal es poco frecuente y de difícil diagnóstico dada su sintomatología inespecífica, por lo que la única forma de confirmar el caso es mediante la identificación de las larvas expulsadas. Se presenta el primer caso reportado en el departamento de Nariño (Colombia) de miasis intestinal en un niño de seis años residente en la zona urbana del municipio de Policarpa, proveniente de una familia de nivel socioeconómico bajo, sin acceso a un adecuado tratamiento y sin disposición de aguas residuales y con insuficientes condiciones de saneamiento básico. El caso clínico se asoció con diarrea crónica, dolor abdominal y prurito anal, con la posterior expulsión de una larva cuyas características morfológicas correspondían a las de la mosca Eristalis tenax.

Abstract: Myiasis is a pathology caused by the infestation of fly larvae species which affects vertebrates' tissues or organs including humans. It can be classified entomologically or according to tissue tropism. Intestinal myiasis is rare and difficult to diagnose given its non-specific symptoms; the only way to confirm a case is by identifying the expelled larvae. This is the first case of intestinal myiasis reported in the department of Nariño (Colombia) in a 6-year-old child from a low-income family in the urban area of the municipality of Policarpa where there is no adequate treatment and no disposition of wastewater and basic sanitation conditions are insufficient. The clinical case was related to chronic diarrhea, abdominal pain, and anal pruritus with the subsequent expulsion of a larva identified by its morphological characteristics as Eristalis tenax fly larva.

Desenvolvimento pós-embrionário de Chrysomya putoria (Calliphoridae) em carne equina e sua importância para a entomologia e veterinária forenses / [Post embryonic development of Chrysomya putoria (Calliphoridae) using horse meat and its importance for forensic entomology and veterinary]

Devido à importância médica, veterinária, ambiental e forense do califorídeo Chrysomya putoria (Diptera), foi avaliado o desempenho apresentado por estágios imaturos criados em carne de cavalo. Os espécimes foram colocados em câmaras aclimatizadas reguladas a 30 ºC, 60 ± 10% UR e 14 horas de fotofase. Os estágios larval e pupal concluíram seu desenvolvimento em 4,16 e 4,12 dias, respectivamente. As larvas pós-alimentação e pupas com 24h de idade pesaram, em média, 58,06 e 40,10mg, respectivamente. As taxas de emergência registradas foram de 65% nas condições experimentais propostas. Como os compostos orgânicos voláteis são diferentes na decomposição de um animal para outro, este trabalho e outros realizados com a mesma dieta são os mais apropriados para estimativa de intervalo post mortem envolvendo cavalos.(AU)

Due to medical, veterinary, environmental and forensic importance of the calliphorid Chrysomya putoria (Diptera), the performance presented by immature stages, reared on horse meat, was evaluated. The specimens were placed in acclimatized chambers regulated at 30 ºC, 60 ± 10% RU and 14 hours of photo phase. The larval and pupal stages completed their development in 4, 16 and 4, 12 days, respectively. Post-feeding larvae and aged 24h pupae weight on average 58, 06 and 40, 10 mg, respectively. The emergence rates recorded were 65% under the experimental conditions proposed. As volatile organic compounds are different in the decomposition of one animal to another, this work and others carried out with the same diet are the most appropriate for estimating post-mortem interval involving horses.(AU)

Miasis por Cochliomyia hominivorax en la Argentina / Myiasis by Cochliomyia hominivorax in Argentina

Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.

Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.

Caracterización clínica de los pacientes ingresados por miasis en el Hospital del Niño Dr. Francisco de Icaza Bustamante, Guayaquil, Ecuador / Clinical characterization of patients admitted for myiasis at Dr. Francisco de Icaza Bustamante Children's Hospital in Guayaquil, Ecuador

Introducción: La miasis constituye un importante problema de salud pública. En el Ecuador se atribuye su causa con mayor frecuencia a Cochliomyia hominivorax. Objetivo: Describir las características clínicas y el tratamiento de los pacientes ingresados por miasis en el Hospital del Niño Dr. Francisco de Icaza Bustamante, Guayaquil, Ecuador. Métodos: Se realizó un análisis retrospectivo de la información clínica de 84 pacientes con diagnóstico de miasis, ingresados entre 2011 y 2018. Las variables analizadas fueron: sexo, edad, número de casos por mes y año, forma de presentación, sintomatología y tiempo de hospitalización, además de factores meteorológicos. La base de datos fue procesada con el software MS Excel 2013. Resultados: La mediana de edad fue de 6 años (5 meses-14 años); 27,4 por ciento correspondía al sexo masculino y 72,6 por ciento al femenino. Se encontró mayor número de ingresos en la temporada de verano, de julio a diciembre. Se registró miasis cutánea (79,8 por ciento), ótica (17,9 por ciento) y oral (2,3 por ciento). El tiempo de hospitalización general tuvo una mediana de 6 días (1-36 días). Conclusiones: Es necesario realizar actividades encaminadas a la prevención de la enfermedad en la comunidad y la elaboración de adecuados protocolos de manejo en las unidades de salud. El personal de salud debe registrar adecuadamente la información clínica para elaborar información estadística pertinente que lleve a fundamentar la implementación de adecuadas políticas de salud(AU)

Introduction: Myiasis is an important public health problem. In Ecuador its cause is mainly attributed to Cochliomyia hominivorax. Objective: Describe the clinical characteristics and the treatment of patients admitted for myiasis at Dr. Francisco de Icaza Bustamante Children's Hospital in Guayaquil, Ecuador. Methods: A retrospective analysis was conducted of the medical data of 84 patients diagnosed with myiasis admitted from 2011 to 2018. The variables analyzed were sex, age, number of cases per month and year, form of presentation, symptoms, hospital stay duration, and meteorological factors. The database was processed with the software MS Excel 2013. Results: Mean age was 6 years (5 months-14 years); 27.4 percent were male and 72.6 percent were female. The largest number of admissions occurred in the summer season, from July to December. Records were found of cutaneous (79.8 percent), aural (17.9 percent) and oral (2.3 percent) myiasis. Mean hospital stay duration was 6 days (1-36 days). Conclusions: It is necessary to perform activities aimed at preventing the disease in the community as well as develop appropriate management protocols in health facilities. Health care providers should adequately record the clinical data required to develop relevant statistical information leading to the implementation of effective health policies(AU)

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)

Miasis genital como complicación de circuncisión debido a fimosis: reporte de caso / Genital myiasis as complication of circumcision due to phimosis: case report

Resumen La circuncisión es un procedimiento quirúrgico de baja complejidad; el riesgo de complicaciones oscila entre el 0,2 a 5%, siendo la miasis un hecho poco frecuente. Para su tratamiento, principalmente se extraen las larvas, y se administran antiparasitarios y antibióticos para prevenir la infección secundaria. El objetivo del artículo es reportar el caso de un adulto masculino, quien presentó miasis genital posterior a una circuncisión y biopsia. En la mayoría de los casos, la miasis es accidental en humanos, y su verdadera incidencia es difícil de establecer debido al subregistro. La mala higiene, el bajo nivel socioeconómico y el hacinamiento son factores de riesgo importantes para adquirirla, además de la excesiva exposición del hospedero potencial a las moscas. Es fundamental realizar un correcto tratamiento de heridas y un seguimiento estricto del paciente que recibe manejo quirúrgico. MÉD.UIS.2019;32(2):41-6

Abstract Circumcision is a non complex surgical procedure, but is not a harmless option. Risk of complications may fluctuate between 0,2% and 5%, being myiasis a low often situation, for its treatment mainly the larvae are extracted, antiparasitics and antibiotics are administered to prevent secondary infection. The objective of the article is to report the case of a male adult, who presented genital myiasis after a circumcision and biopsy. In most of cases myiasis is accidental in humans and its true incidence is very hard to establish due to underreporting. Poor hygiene, low socio-economic level and overcrowding, are risk factors to obtain it, besides an excessive exposure to flies. A right wounds treatment and a strict monitoring of patient in surgical management is essential. MÉD.UIS.2019;32(2):41-6

Oftalmomiasis por Oestrus ovis en un área urbana al sur del Perú / Oestrus ovis ophthalmomyiasis at an urban area in Southern Peru

Resumen La oftalmomiasis es la infestación ocular por larvas de dípteros. Ha sido descrita en pacientes provenientes de áreas rurales, higiene deficiente o por contacto con animales. Sin embargo, existen reportes esporádicos de esta infestación en áreas urbanas. Presentamos el caso de un varón joven, sin factores de riesgo, proveniente de un área urbana al sur del Perú, que presentó 10 larvas en la conjuntiva ocular. Las larvas fueron identificadas como Oestrus ovis, una mosca que suele infestar ovejas y cabras como parte de su ciclo de vida. Realizamos una breve revisión del tema, resaltando la importancia de identificar adecuadamente la especie causante de la miasis, así como su ciclo de vida.

Ophthalmomyiasis is the ocular infestation by dipterous larvae. It has been described in patients from rural areas, poor hygiene, or contact with animals. However, there are sporadic reports of this infestation in urban areas. We present the case of a young man without risk factors, from an urban area in southern Peru, in whom we found 10 larvae at ocular conjunctiva. The larvae were identified as Oestrus ovis, a fly that usually infests sheep and goats as part of their life cycle. We made a brief review of the case, highlighting the importance of adequately identifying the species that cause myiasis as well as its life cycle.

Otomyiasis: Systematic Review

Abstract Introduction Myiasis is a disease causedby fly larvae that growinthetissues of animals and humans. It can cause a variety of local symptoms, like erythema or pain, depending on its location, and generalized symptomatology, such as fever andmalaise.Myiasis can generate severe complications, for instance sepsis, or directly impact vital tissues. Its management varies depending on the location, and on the preferences of the doctor that faces this challenge. Myiasis usually occurs in tropical countries, and, in many places, it is not a rare condition. The cases are rarely reported, and there are no publishedmanagement protocols. Objective To review the literature regarding the most common agents, the predisposing factors and the treatment alternatives for otic myiasis, a rare form of human myiasis caused by the infestation of fly larvae in the ear cavities. Data synthesis We present a systematic review of the literature. The search in five databases (Medline, Embase, Cochrane Database of Systematic Reviews, LILACS and RedALyC) led to 63 published cases from 24 countries, in the 5 continents. The ages of the patients ranged fromnewborn to 65 years old. Themost common agents belong to the Sarcophagidae or Calliphoridae families. Chronic otitis media, previous otic surgical procedures, mental deficit, alcohol or drug abuse, sleeping outdoors, prostration, and malnutrition were predisposing factors. The treatment alternatives are herein discussed. Conclusion The results highlight the need for monitoring, follow-up and standardization of medical approaches. (AU)