Myiasis of the scalp due to Dermatobia hominis in a traveler returning from Brazil

Wound myiasis in Western Europe: prevalence and risk factors in a changing climate scenario

Background

Myiasis is an infestation of neglected open wounds by fly larvae. Global warming, related climate changes, and increased traveling in tropical countries may contribute to the worldwide diffusion of new fly species. Common risk factors for myiasis are advanced age, poor hygiene, malnourishment, social isolation, diabetes, cancer, and peripheral artery disease. The aim of this study was to review the characteristics of cases of myiasis reported in Europe.

Methods

A narrative review of cutaneous myiasis was performed using PubMed, EMBASE, Web of Science database, and the search terms “human,” “myiasis,” “cutaneous myiasis,” “maggot,” “Europe,” “wound,” with the combination of “AND” and “OR.” In addition, hospital charts were reviewed to add personal experience to the literature review.

Results

Overall, 52 articles, both single case reports and case series reporting cutaneous myiasis, were found in the medical literature of the past two decades. A total of 64 patients living in Europe were identified, of whom 36% had wound myiasis. In addition to the literature review, we report the case of a male patient who presented with myiasis within a deep scalp ulcer occurring after radiotherapy for basal cell carcinoma.

Conclusion

Myasis is rare and possibly under-reported in Europe. The epidemiology of this infestation may be changing in the future due to climate variability, a rise in travel to tropical areas, and the migration of fly species.

The Botfly, A Tropical Menace: A Distinctive Myiasis Caused by Dermatobia hominis

Dermatobia hominis, also known as the human botfly, is native to tropical and subtropical Central and South America and seen in travelers from endemic to temperate regions including the United States and Europe. Cutaneous infestation botfly myiasis involves the development of D. hominis larvae in the skin and is common in tropical locations. The distinct appearance of a cutaneous D. hominis infestation facilitates early diagnosis and intervention where cases are common. However, the identification of D. hominis in temperate regions may prove challenging due to its rarity. D. hominis may be misdiagnosed as folliculitis, an epidermal cyst, or an embedded foreign object with secondary impetigo. One should have a heightened suspicion in someone returning from a vacation in an endemic area, such as Belize. Here we describe the presentation, differential diagnosis, and treatment and encourage enhanced preventative measures among tourists when visiting tropical and subtropical regions. Additionally, we propose a novel classification system for assessing the various stages of infestation and suggest that patients reporting travel to Latin America and experiencing pain disproportionate to an insect bite should lead physicians to consider myiasis caused by D. hominis.

Dermatobia hominis in a dog imported from Brazil to Romania

BACKGROUND

Dermatobia hominis (Diptera: Oestridae: Cuterebrinae) is a parasite with an important zoonotic and economical impact in the cattle industry, distributed in Central and South America, inhabiting wooded areas along rivers and lowlands. It infests mammals including humans. Lately, there has been a growing trend for people to travel on holidays with their pet dog and also international trade of dogs has increased significantly in the last two decades. Hence, the risk of importation of exotic parasites, including agents of myiasis has increased. Dermatobia hominis has been commonly reported as an imported parasite to various countries, mostly as human cases and currently there are only two published cases of D. hominis imported with dogs to Europe. Herein, we report a case of D. hominis infestation in Romania in a dog recently imported from Brazil.

METHODS

Larvae were manually extracted from nodules of a 4-month old non-neutered male, Fila Brasileiro in Arad, Romania. The larvae were morphologically identified, and one specimen was characterized molecularly by amplification and sequencing of a fragment of the mitochondrial cytochrome c oxidase subunit 1 gene (cox1).

RESULTS

All larvae were morphologically identified as L3 of Dermatobia hominis. The BLAST analysis revealed a 98.81% nucleotide similarity to two D. hominis isolates from Brazil. The sequence was deposited in the GenBank database under the accession number MT364820.

CONCLUSIONS

The travel history of dogs is an important part of the veterinary anamnesis questions and should be thoroughly conducted in the daily practice. Also, prior to and after the importation of dogs from tropical regions, a thorough check of the body surface to detect the presence of nodules is recommended.

A Case of Furuncular Myiasis Due to Cordylobia anthropophaga in a Korean Traveler Returning from Uganda

A fly larva was recovered from a boil-like lesion on the left leg of a 33-year-old male on 21 November 2016. He has worked in an endemic area of myiasis, Uganda, for 8 months and returned to Korea on 11 November 2016. The larva was identified as Cordylobia anthropophaga by morphological features, including the body shape, size, anterior end, posterior spiracles, and pattern of spines on the body. Subsequent 28S rRNA gene sequencing showed 99.9% similarity (916/917 bp) with the partial 28S rRNA gene of C. anthropophaga. This is the first imported case of furuncular myiasis caused by C. anthropophaga in a Korean overseas traveler.

A rare case of digital myiasis

Cutaneous myiasis is the infestation of the skin or mucous membranes by larvae of the order Diptera. Wound myiasis affect the skin with a previous lesion, and it may consume both dead and living tissue. Finger infestation is rarely a cause of death, but it may provoke considerable morbidity. Prompt wound exploration and careful total larvae removal is essential to achieve healing. In the reported case, the patient was presented in an advanced stage of the infestation, with a large area of finger necrosis and amputation, associated with cellulitis extending from the finger's base to the hand. This diagnosis helped uncover a familiar history of severe abuse and neglect. The accurate understanding and management of such injuries are important not only for the orthopaedic treatment but also for the acknowledgment of their social and forensic implications.

Dermatobia hominis: Small Migrants Hidden in Your Skin

Myiasis is a parasitic infestation of vertebrate animal tissues due to maggots of two-winged flies (Diptera) that feed on living or necrotic tissue. Dermatobia hominis occurs widely in tropical parts of Latin America; it is the most common cause of furuncular myiasis in this region. The continuous increase in international travel has increased the possibility of observing this pathology outside endemic countries, especially in travelers returning from the tropics. If clinicians are aware of the possibility of the disease and its treatment options, this dermatosis can be easily managed. However, diagnostic delay is very common because the disease is often misdiagnosed as a bacterial skin infection. Here, we report 2 cases of furuncular myiasis caused by D. hominis in travelers returning to Italy from Latin America. Surgical and noninvasive treatment approaches are also described.

Painful, slow developing abscesses. Furuncular miyasis due to double skin infestation by Dermatobia hominis

BACKGROUND

Myiasis is defined as invasion of tissues by Diptera flies. The condition is endemic in the forested areas of Mexico, Central and South America.

MAIN OBSERVATIONS

A 61-year-old woman presented with two boil-like inflammatory and painful lesions on her back. She had been travelling in Central America. Biopsies revealed a myiasis with mature third instar larvae of Dermatobia hominis, a diptera fly endemic in this region. Complete surgical excision and systemic antibiosis led to a delayed but complete healing.

CONCLUSION

We presented a patient with a double infestation by Dermatobia hominis. Dermatologists should be aware of this disease, which has become increasingly common in travellers and is seen now also in unusual regions, other than Central and South America.