Subject(s)
Diptera , Military Personnel , Scalp/injuries , Screw Worm Infection/etiology , Wounds, Gunshot/complications , Adult , Animals , Humans , Male , Panama , Travel , United StatesABSTRACT
A 67-year-old white man with human ehrlichiosis infection complicated by pancytopenia, hemophagocytic syndrome, disseminated intravascular coagulopathy and septic shock is presented. The patient had been on a three-week camping trip to California, Colorado, Utah, and New Mexico. The diagnosis of human ehrlichiosis was confirmed by sixteen-fold rise in antibody titer to Ehrlichia canis, and supported by the characteristic cytoplasmic inclusions. Human ehrlichiosis should be considered in the differential diagnosis in patients with fever and cytopenia associated with hemophagocytosis. Pancytopenia associated with ehrlichiosis is transient; however, it may be severe, and appears to be associated with destruction of normal blood elements.
Subject(s)
Ehrlichiosis/complications , Histiocytosis, Non-Langerhans-Cell/etiology , Pancytopenia/etiology , Aged , Antibodies, Bacterial/analysis , Blood Cell Count , Bone Marrow/pathology , Histiocytosis, Non-Langerhans-Cell/microbiology , Histiocytosis, Non-Langerhans-Cell/pathology , Humans , Male , Pancytopenia/bloodABSTRACT
An imported case of traumatic myiasis occurred in a soldier wounded during military action in Panama in December 1989 and evacuated to Brooke Army Medical Center, Fort Sam Houston, Texas. At the medical center, five larvae were removed from the scalp wound, reared to the adult stage, and identified as Cochliomyia hominivorax (Coquerel). Though this was the only reported case of wound myiasis of the 254 servicemen evacuated for medical treatment, this incident indicates a potential mechanism for the reintroduction of C. hominivorax into the United States.
