RESUMEN
Surgical maggots have been used successfully for wound debridement over the past millennium. At Johns Hopkins University in 1929, Baer introduced maggots into the wounds of 21 patients with chronic intractable osteomyelitis. The development of methicillin-resistant Staphlococcus aureus has been a major impetus to resurgent interest in maggot debridement. In January of 2004, the US Food and Drug Administration gave Dr. Ronald Sherman permission to produce and market surgical maggots for debriding non-healing necrotic skin and soft tissue wounds. Given an uncooperative patient with non-healing wounds, our medical team obtained insectary-reared sterile surgical maggots, Phaenicia sericata, to promote debridement of necrotic tissue and development of granulation tissue.
RESUMEN
Se entiende por miasis a la infestación de vertebrados vivos por larvas de dípteros, que por lo menos durante un corto período, se alimentan de los tejidos vivos o muertos del hospedador, de sus sustancias corporales líquidas o del alimento por él ingerido. El objetivo del presente trabajo fue determinar las especies bioagentes de miasis humanas ocurridas en la ciudad de Bahía Blanca, Argentina, durante el período comprendido entre el 01/03/2000 y el 31/05/2005. Se estudiaron 17 casos clínicos. Las larvas extraídas de las lesiones fueron remitidas de laboratorios y hospitales públicos y privados de dicha ciudad. Parte de las larvas se fijó en alcohol 70° y se procesó según la técnica de Mazza & Jõrg (1939). El resto se crió en condiciones de laboratorio hasta la obtención de los adultos. Se observaron las características diagnósticas de las larvas III y de los ejemplares adultos y se clasificaron taxonómicamente. Las especies bioagentes fueron: Cochliomyia hominivorax (Coquerel) en trece de los casos y Phaenicia sericata (= Lucila sericata) (Meigen) (Diptera: Calliphoridae) en los cuatro restantes. Las miasis fueron traumáticas y aurales, se presentaron durante los meses de Diciembre a Marzo, en la franja etaria de 4 a 86 años, siendo el 76,5 por ciento de los casos de presentación en pacientes masculinos. Teniendo en cuenta la voracidad de las larvas, principalmente las de C. hominivorax, resulta claro que el diagnóstico rápido de miasis y la aplicación del tratamiento adecuado son decisivos para que esta parasitosis se resuelva sin consecuencias graves para el paciente.
Myiasis is the infestation of live human and vertebrate animals with dipterous larvae which, at least for a short period, feed on the host's dead or living tissue, liquid body-substance, or ingested food. The objective of this study was to identify the flies producing myiasis in Bahía Blanca city, Argentina, from 01/03/2000 to 31/05/2005. Seventeen clinical cases were studied. The larvae obtained from lesions were forwarded from laboratories and from public and private hospitals. Part of the larvae were fixed in alcohol 70° and processed according to the Mazza & Jõrg technique (1939). The other part continued growing in flasks with meat in laboratory conditions to obtain the adults. The etiological agents of myiasis were identified by observing the diagnostic characteristics of the larvae III and of the adults, and by using taxonomic keys. Myiasis was produced by Cochlyiomia hominivorax (Coquerel) in thirteen of the cases and by Phaenicia sericata (= Lucila sericata) (Meigen) (Diptera: Calliphoridae) in the other four. The cases were traumatic and aural myiasis and happened from December to March. The ages of patients were four to eighty-six years and 76.5 percent of the cases occurred in male patients. Given the aggressiveness of these larvae, mainly C. hominivorax, in causing human myiasis, the importance of specific and quick diagnosis and of adequate treatment must be acknowledged.