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.

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.

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.

First case of Furuncular Myiasis due to Cordylobia anthropophaga in a Latin American resident returning from Central African Republic

ABSTRACT Myiasis is a temporary infection of the skin or other organs with fly larvae.1 The larvae develop into boil-like lesions. Creeping sensations and pain are usually described by patients. Following the maturation of the larvae, spontaneous exiting and healing is experienced. Herein we present a case of a traveler returning from Central African Republic. She does not recall insect bites. She never took off her clothing for recreational bathing, nor did she visit any rural areas. The lesions appeared on unexposed skin. The specific diagnosis was performed by morphologic characterization of the larvae, resulting in Cordylobia anthropophaga, the dominant form of myiasis in Africa. To our knowledge, this is the first reported case of C. anthropophaga in Latin America.

Miasis foruncular por Dermatobia Hominis: un diagnóstico emergente en Chile / Foruncular myiasis due to Dermatobia Hominis: a diagnosis emerging in Chile

Las lesiones cutáneas son causa frecuente de consulta en viajeros siendo las picaduras de insectos unas de las más prevalentes. Damos a conocer un caso de paciente que presenta una lesión dolorosa en cuero cabelludo, tras viaje a la selva boliviana, refractario a tratamiento antibiótico empírico y con estudio complementario inconcluyente. Finalmente, se realizó estudio macroscópico de la costra, que determinó que se trataba de una larva de Dermatobia Hominis. Este caso demuestra la importancia de tomar en cuenta estos agentes no presentes en Chile y que son causantes de patologías dermatológicas del viajero.

Cutaneous lesions are frequent cause of consultation in travelers, being insect bites one of the most prevalent. We present a case of a patient with a painful lesion on the scalp, after a trip to the Bolivian jungle, refractory to empirical antibiotic treatment and with an inconclusive complementary study. Finally, macroscopic study of the crust was carried out, which determined that it was a larva of Dermatobia Hominis. This case demonstrates the importance of taking into account these agents not present in Chile and that are the cause of dermatological pathologies of the traveler.

Miíase na topografia de saco lacrimal / Lacrimal sac topography myiais

RESUMO A miíase é a infestação dos tecidos humanos por larvas Diptera. O comprometimento ocular é raro. Os autores apresentam um caso de miíase na topografia do saco lacrimal e discutem as modalidades terapêuticas para o tratamento desta doença.

ABSTRACT Myiasis is the invasion of human tissues by Diptera larvae. Ocular involvement is rare. The objective of this paper is to report a case of myiasis in the topography of the lacrimal sac and discuss current treatments for this disease.

Oestrus ovis infection of grazing sheep during summer in southern Chile

Oestrus ovis is a botfly whose larvae cause nasal myiasis, an environmental-dependent disease in small ruminants, generating acute and chronic injuries in the cranial cavities of sheep. Chile is a country of the southernmost worldwide distribution of this parasite, and there is few information about. Whence, the objective of this study was to approximate the epidemiological situation of O. ovis infection in Chilean sheep. From December 2009 to March 2010, a total of 87 samples were obtained by necropsy for skull inspection. The larvae were collected, and microscopically identified. The prevalence in the sampled sheep was 60.9%. From those that were infected, 85.7% (18/21) of sheep were 1 to 3 years old, constituting the stratum with the highest prevalence. The difference of infection in females and males was not significant. The high risk of infection seems to be dependent upon the environmental conditions of this southern region, especially during summer when the first larval stage (L1) could be found as the evidence. Therefore, the disease should be considered as a significant problem for this kind of livestock production.

Traumatic Myiasis Caused by an Association of Sarcophaga tibialis (Diptera: Sarcophagidae) and Lucilia sericata (Diptera: Calliphoridae) in a Domestic Cat in Italy

We describe here a rare case of traumatic myiasis occurred in August 2014, caused by an association of 2 Diptera species, Sarcophaga tibialis Macquart (Diptera: Sarcophagidae) and Lucilia sericata (Meigen) (Diptera: Calliphoridae), in a domestic cat in northern Italy. Species identification was based on adult male morphology. The present case is the first report of S. tibialis as an agent of myiasis in Italy, and also the first ever report of myiasis caused by an association of S. tibialis and L. sericata. The cat developed an extensive traumatic myiasis in a large wound on the rump, which was treated pharmacologically and surgically. The biology, ecology, and distribution of S. tibialis and L. sericata are also discussed. A literature review is provided on cases of myiasis caused by S. tibialis, and cases of myiasis by L. sericata involving cats worldwide and humans and animals in Italy.

Miíases humanas: Atualidades para a prática clínica / Human myiasis: updates to the clinical practice

Miíase é uma infestação ectoparasitária, que tem as espécies Cochliomyia hominivorax, Dermatobia hominis e Cochliomyia macellaria como maiores destaques. Os principais fatores de risco são baixo nível socioeconômico, padrões inadequados de higiene, enfermidades psiquiátricas, diabetes mellitus, imunodepressão, etilismo, desnutrição e úlcera varicosa. Os autores abordam a importância epidemiológica da miíase humana em regiões endêmicas, discorrendo sobre manifestações clínicas, diagnóstico, tratamento e medidas profiláticas...

The myiasis consists of a parasitic infestation, the species having Cochliomyia hominivorax, Dermatobia hominis and Cochliomyia macellaria as most prominent. The main risk factors are low socioeconomic status, inadequate hygiene standards, psychiatric disease, diabetes mellitus, immunosuppression, alcoholism, malnutrition and varicose ulcer. There may be asymptomatic or systemic cases with serious complications. The purpose of this article is to address the epidemiological importance of human myiasis in endemic regions, discussing clinical manifestations, diagnosis, treatment and prophylactic measures...

Primer reporte de miasis hospitalaria por Lucilia cuprina (Diptera: Calliphoridae) en Costa Rica / First report of nosocomial myiasis by Lucilia cuprina (Diptera: Calliphoridae) in Costa Rica

Introducción. Las miasis hospitalarias son entidades con una importancia manifiesta en salud pública. La documentación de este tipo de casos es escasa en la literatura biomédica regional y mundial. Objetivo. Informar un caso de miasis hospitalaria en Costa Rica, donde el agente etiológico implicado fue Lucilia cuprina (Diptera: Calliphoridae). Este caso de miasis hospitalaria figura como el primer informe para Latinoamérica asociado con este agente etiológico. Presentación del caso. Una paciente de 91 años de edad, con signos de inmunosupresión, afectación grave de la función pulmonar y asistencia respiratoria mecánica, presentó larvas en ambas fosas nasales al séptimo día después del ingreso hospitalario. Varios ejemplares fueron recolectados y procesados para su identificación. La identificación taxonómica de los ejemplares recolectados estableció que la especie de los muscomorfos correspondía a L. cuprina. Conclusión. El presente constituye el primer caso de miasis hospitalaria por L. cuprina en la literatura biomédica de Costa Rica y el primero registrado en Latinoamérica.

Introduction. Nosocomial myiases can be an important condition from a public health perspective. However, cases of this condition reported in regional and worldwide biomedical literature are scarce. Objective. A case of nosocomial myiasis is reported from Costa Rica, where the species involved was Lucilia cuprina (Diptera: Calliphoridae). Materials and methods. A 91-year-old patient with signs of immunosuppression, severe impairment of lung function, and mechanical ventilation presented larvae in both nostrils on the seventh day after admission. Five specimens were collected and processed for identification. Results. The taxonomic identification of the specimens established that the muscoid fly species was L. cuprina. Conclusion. This is the first case of nosocomial myiasis reported from Costa Rica and in Latin America for which the etiological agent is L. cuprina.

Miíase na cavidade bucal em paciente geriátrico: relato de caso / Myiasis in the oral cavity in the geriatric patient: case report

Pacientes geriátricos que apresentam comprometimento sistêmico severo muitas vezes necessitam de cuidados especiais. A limitação da atividade motora pode estar relacionada com as diversas condições médicas que acometem esses pacientes. O acidente vascular cerebral pode causar sequelas graves como, por exemplo, o comprometimento da motricidade do indivíduo. Neste relato, apresentamos um caso clínico de um paciente geriátrico com importante comprometimento da atividade motora, decorrente de um acidente vascular cerebral, acometido por miíase oral, devido à falta de cuidados específicos.

Geriatric patients who have severe systemic involvement often require special care. The limitation of motor activity may be related to several medical conditions that affect thesepatients. Stroke can be cause serious sequelae, such as motor impairment of the individual. Here we report a case of a geriatric patient with a significant impairment of motor activity, resulting from a stroke, affected by oral myiasis due to lack of specific care.

Primer reporte de pseudomiasis intestinal humana por Eristalis tenax (Diptera, Syrphidae) en zona semiárida urbana del estado Falcón, Venezuela / First report of human intestinal pseudomiasis by Eristalis tenax (Diptera, Syrphidae) in urban semiarid area from Falcon state, Venezuela

Pseudomiasis es el término empleado cuando se considera que las larvas y/o huevos de moscas se adquieren accidentalmente per os y atraviesan con inmediatez a lo largo del tracto digestivo. Se documenta un caso de una pseudomiasis intestinal por larvas de Eristalis tenax (Diptera: Syrphidae) en una paciente femenina de 39 años de edad, proveniente de un sector periférico de la ciudad de Coro, estado Falcón, Venezuela. La paciente observó inmediatamente la presencia de la larva viva en sus heces. Aunque refirió sufrir eventualmente de cólicos, al examen físico se presentó normal. La paciente aparentemente no sufre de trastornos mentales, y posee un nivel socioeconómico bajo. El presente trabajo constituye el primer reporte documentado de una pseudomiasis entérica por E. tenax en la zona semiárida del estado Falcón, en la región nor-occidental de Venezuela.

Pseudomyiasis is the term used for the accidental entrapment of swallowed fly maggots and/or eggs immediately passing through the digestive tract. We report a case of intestinal pseudomyasis caused by the larvae of the cosmopolitan drone fly Eristalis tenax (Diptera: Syrphidae) in a 39 year old woman, resident in a suburban sector from Coro city, Falcon state, Venezuela. The patient immediately noticed a living larva in her stool. Although patient referred eventually became colic, her physical examination was normal, with no mental disturbance. She was in a low socioeconomic level. This is the first report of an enteric pseudomyasis by E. tenax in the semiarid zone of Falcon state, in the northwestern region of Venezuela.

Caso de miasis orbitaria / A case of myasis orbitalis

Se presenta un caso de un paciente masculino de ochenta y tres años de edad, de raza blanca con antecedentes de la enfermedad del Parkinson con una miasis orbitaria derecha profunda producida por el gusano barrenador de la mosca Cochlimyia hominivorax. Se realizó un reporte de caso con el objetivo de describir el cuadro médico que presentaba el anciano. Presentó abundantes larvas en una zona necrótica en el párpado superior derecho, con fetidez y ninguna sensación en la zona que permitió realizar la toilette de urgencia sin el uso de ningún anestésico. Se interconsultó por un conjunto de especialistas de diferentes materias y se determinó que la mejor opción era la enucleación del globo ocular y necrectomía de la zona afectada junto a una etmoidectomía con el objetivo de eliminar la mayor cantidad de larvas posible. El paciente luego de operado evolucionó favorablemente.

A case of an eighty three year-old, white race, masculine patient, with antecedents of Parkinson´s disease is presented with a deep right myasis orbitalis produced by the borer worm of the Cochlimyia hominivorax fly. The clinical picture is described, abundant larvae in a necrotic area of the right upper eyelid, with fetidity and no sensation that allowed to carry out the toilette of urgency without the use of any anesthetic. He was interconsulted by a group of specialists of different matters and it was determined that the best option was the enucleation of the eyeball and necrectomy of the affected area next to an ethmoidectomy with the objective of eliminating the biggest quantity of larvae. The patient after been operated evolved favorably.

Miasis genital accidental por Eristalis tenax / Accidental genital myiasis by Eristalis tenax

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.

Primer reporte en Cuba de miasis intestinal por Hermetia illucens (Diptera: Stratiomyidae) / First report of intestinal myiasis caused by por Hermetia illucens (Diptera: Stratiomyidae)

INTRODUCCIÓN: Hermetia illucens, díptero de la familia Stratiomyidae es una especie reportada para Cuba relativamente frecuente en todo el territorio nacional. Ha sido incriminada como productora de miasis en humanos y animales. OBJETIVO: reportar por primera vez en Cuba una miasis entérica producida por esta especie. MÉTODOS: la paciente, una mujer blanca de 26 años presentó un cuadro de deyecciones líquidas posprandiales con cólicos abdominales. Al ingerir una infusión de plantas medicinales a partir de incienso (Artemisa abrotanum L.), hierba buena (Mentha nemorosa Willd.) y manzanilla (Matricaria chamomilla L.) expulsó 5 larvas (2 grandes y 3 pequeñas). Se decidió su ingreso durante una semana pero no se obtuvieron nuevas larvas, una gastroscopia realizada mostró gastritis antral crónica con focos de agudización; se determinaron otras parasitosis por lo que se le indicó mebendazol. RESULTADOS: de las larvas expulsadas una fue llevada al Departamento de Entomología Médica del Instituto de Medicina Tropical Pedro Kourí, donde fue determinada taxonómicamente como Hermetia illucens. CONCLUSIONES: este reporte junto a lo conocido en la literatura mundial muestra la posibilidad de que miasis por esta especie ocurran con cierta frecuencia, sobre todo en los meses de verano al ingerir frutas muy maduras y sin lavar; se deberá alertar a los médicos de esta posible miasis a ocurrir, promocionar las medidas higiénicas a ser tomadas al ingerir frutas y valorar el estudio de las propiedades antiparasitarias de la especie Artemisa abrotanum L.

INTRODUCTION: Hermetia illucens from Stratiomyidae family is a relatively frequent species reported in Cuba. It has been accused of causing myiasis in humans and animals. OBJECTIVE: to report for the first time in Cuba, the occurrence of intestinal myiasis caused by this species. METHODS: the patient, a white woman aged 26 years presented with a picture of postprandial fluid discharges accompanied by abdominal pain. When the patient took an infusion of medicinal plants such as incense (Artemisa abrotanum L.), mint (Mentha nemorosa Wild) and camomile (Matricaria chamomilla L.), five larvae were ejected (2 large and 3 small). It was decided to admit the patient to the hospital for a week, but not more larvae were ejected. A gastroscopy showed antral chronic gastritis with acute foci and also other types of parasitosis, so Mebendazol was prescribed. RESULTS: one of the ejected larvae was taken to the Medical Entomology Department of Pedro Kourí Institute of Tropical Medicine where it was taxonomically identified as Hermetia illucens. CONCLUSIONS: this report together with the pieces of knowledge provided by the world literature show the possibility that myasis caused by this species may occur in summer months when ripe unwashed fruits are consumed; physicians should be warned about this possible myiasis, hygienic measures should be applied when taking fruits and the study of antiparasitic properties of Artemisa abrotanum L. must be assessed.

External Ophthalmomyiasis Caused by Oestrus ovis: A Rare Case Report from India

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of external ophthalmomyiasis caused by the larvae of a sheep nasal botfly, Oestrus ovis, for the first time from Meerut city in Western Uttar Pradesh, India. A 25-year-old farmer presented with severe symptoms of conjunctivitis. The larvae, 3 in number, were observed in the bulbar conjunctiva, and following removal the symptoms of eye inflammation improved within a few hours.

Primeiro registro de larvas de Chironomus inquinatus Correia, Trivinho-Strixino & Michailova (Diptera, Chironomidae) vivendo no casco do cágado Phrynops geoffroanus Schweigger (Testudines, Chelidae) na região Neotropical / First record of Chironomus inquinatus larvae Correia, Trivinho-Strixino & Michailova (Diptera, Chironomidae) living on the shell of the side-necked turtle Phrynops geoffroanus Schweigger (Testudines, Chelidae)

Neste estudo reportamos pela primeira vez a ocorrência de larvas de Chironomus inquinatus Correia, Trivinho-Strixino & Michailova vivendo no casco do cágado Phrynops geoffroanus Schweigger, possivelmente em função da intensa acumulação de sedimento, em um rio poluído da região Neotropical.

In this study we report for the first time the occurrence of Chironomus inquinatus larvae Correia, Trivinho-Strixino & Michailova living on the shell of the side-necked turtle, Phrynops geoffroanus Schweigger, possibly by the intense accumulation of sediment, in a polluted river of the Neotropics.

A Laboratory-Based Study for First Documented Case of Urinary Myiasis Caused by Larvae of Megaselia scalaris (Diptera: Phoridae) in Saudi Arabia

Megaselia scalaris (Diptera: Phoridae) is one of the medically important insects. Maggots from a urine sample of a 5-year-old Saudi girl were examined microscopically for identification. These maggots were cultured to become adult flies. Larvae and adults were identified using standard keys. Protozoan flagellates were obtained from the gut of the larvae. This is the first report of M. scalaris as a causative agent of urinary human myiasis in Saudi Arabia.

A Laboratory-Based Study for First Documented Case of Urinary Myiasis Caused by Larvae of Megaselia scalaris (Diptera: Phoridae) in Saudi Arabia

Megaselia scalaris (Diptera: Phoridae) is one of the medically important insects. Maggots from a urine sample of a 5-year-old Saudi girl were examined microscopically for identification. These maggots were cultured to become adult flies. Larvae and adults were identified using standard keys. Protozoan flagellates were obtained from the gut of the larvae. This is the first report of M. scalaris as a causative agent of urinary human myiasis in Saudi Arabia.