Experimental skin lesions from larvae of the bot fly Dermatobia hominis

Imported and Autochthonous Cases of Myiasis Caused by Dermatobia hominis: Taxonomic Identification Using the Internal Transcribed Spacer Region

Dermatobia hominis is a fly endemic to and widely distributed throughout the Americas; it is found from the southern regions of Mexico to Argentina. However, because of widespread travel, myiasis has become common in countries where neither the disease nor the species that cause this infection are endemic. Central Mexico, for instance, is not a region where myiasis is endemic. We, thus, describe three cases of D. hominis myiasis: two autochthonous cases from the southern part of Mexico and one imported from Costa Rica. In addition, morphological and genetic identification was performed on the maggots extracted from the patients.

Myiasis caused by Dermatobia hominis: countries with increased risk for travelers going to neotropic areas

Here, we review the human botfly (Dermatobia hominis), which belongs to a group of Diptera generically known as "myiasis-causing flies," characterized by the ability of their larvae to develop in animal flesh. In addition to its medical and economic importance, there is an academic interest in this botfly because of its peculiar biology, particularly because a phoretic diptera is needed to complete the life cycle. The larvae penetrate the host's skin, causing furuncle-like lesions that are pruritic, painful, and resemble subcutaneous nodules, producing irreversible perforations in the skin. Although D. hominis is distributed from Mexico to Argentina, a review performed by our working group from 1999 to 2015 determined that the countries with the highest infection rates in travelers are Belize, Bolivia, and Brazil. Interestingly, infected men show a higher variation in the distribution of the lesions than in women. Many treatment schemes have been suggested, including the application of highly dense liquids to the lesion to cause anoxia in the D. hominis larvae. We showed, for the first time, a Bayesian inference between D. hominis and other myiasis-causing flies. The flies grouped into two main clusters according to their capacity to produce facultative and obligatory myiasis, and D. hominis was phylogenetically close to Cuterebra spp.

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.

Histopathology of experimental myiasis in mice as a result of infestation and experimental implantation of Dermatobia hominis larvae

A laboratory model of myiasis as a result of Dermatobia hominis (L.) larvae was developed using mice as hosts. Mice in three groups were each infested with one newly hatched larva and skin biopsies processed for histopathology at 4, 12, and 20 d postinfestation (dpi). Mice in three other groups were each subjected to implantation of one larva collected from an infested (donor) mouse at 4, 12, and 20 dpi. Skin lesions of these receptor mice were then assessed at 10, 14, and 6 d postimplantation (dpimp), respectively. The inflammatory process in infested mice at 4 dpi was discrete, consisting of a thin necrotic layer around the larva, edema, many neutrophils, few eosinophils, mast cells, and proliferation of fibroblasts. At 12 dpi, there was a thicker necrotic layer, edema, many neutrophils and eosinophils, few mast cells, neoformation of capillaries, proliferation of the endothelium and fibroblasts, and early stages of fibrosis. These histopathological characteristics together with fibrosis were observed over a large area of the lesion at 20 dpi. Mice submitted to larval implantations demonstrated similar skin histopathology to that seen in the infested rodents, 10 dpimp corresponding to 12 dpi and 6 or 14 dpimp to 20 dpi. In all mice, the progressive acute inflammatory process followed a sequence linked to factors such as size of larvae and presence of secretory-excretory products. Both infested mice and those implanted experimentally with D. hominis larvae were shown to be suitable models for the study of the parasite-host relationship in this important zoonotic myiasis.

Lymphadenopathy and expression of nodal mast cells and eosinophils in the myiasis by human bot fly

Wistar rats (Rattus norvegicus) infested with Dermatobia hominis (L. Jr., 1781) had their axillary lymph nodes removed and histopathologically processed. Follicular hyperplasia in the germinal center was noted from 2 d postinfestation (dpi), exhibiting a high number of centerblasts, mitotic and apoptotic cells, and a thin parafollicular area. The paracortex showed hyperplasia rich in dendritic cells, immunoblasts, and endothelial venules, with diapedesis seen from 4 dpi onward. Hyperplasia of the medullar sinus also was first observed at this point, as well as dilated lymphatic sinus, lymph, macrophages, neutrophils, mast cells, and eosinophils. Medullar strings were expanded and filled with immunoblasts, mitotic cells, and plasmocytes. Lymphadenitis was not observed. The expression of mast cells was similar for both myiasis-affected and control rats but increased significantly (mastocytosis) at 7 and 15 d postlarval emergence (dple). Eosinophilia was observed at 4, 10, 15, 20, and 28 dpi as well as at 2, 7, and 15 dple, particularly on the last three observations of dpi and the earliest dple. This experimental approach allowed progressive tissue reactions in the lymph nodes to be monitored during myiasis, particularly those involving mast cells and eosinophils. These reactions abated and complete repair was observed at 60 dple.

Spleen cell proliferation during and after skin myiasis by human bot fly Dermatobia hominis

Spleen cells from mice were examined at 5, 10, 15, 20 and 25 days post-infection (dpi) with Dermatobia hominis larva and at 5, 10, 15, 30 and 60 days post-larval emergence (dple). Cell proliferation in vitro assays were carried out with RPMI-1640 medium and larval secretory product (LSP) of D. hominis at 5, 10, 15, 20 and 25 days. When each group of mice was tested against each medium, significance was only seen for 25 dpi, with increasing order: LSP-10 d, -25 d, -5 d, -20 d, -15 d and RPMI. Significant results were also observed when each medium was tested against mice at each dpi or dple. Each dple group vs. each medium produced significant results only for 10 dple, with increasing order: LSP-5 d, -20 d, -25 d, -10 d, -15 d and RPMI. Comparative tests were also carried out between groups to refine certain observations. The LSPs were also analyzed using SDS-PAGE. The results prove that myiasis caused depletion of spleen cells, particularly under the effect of the LSP-10 and -15, but the cells tended to increase up to 60 dple. This in vitro assay may represent the real systemic immune response in the relationship LSP-D. hominis-host.

Expression of circulating leucocytes before, during and after myiasis by Dermatobia hominis in experimentally infected rats

Expression of circulating white blood cells was investigated in rats (Rattus norvegicus) experimentally infected with larvae of Dermatobia hominis, the human bot fly. Leucocytes were counted prior to infection (control group) as well as at 6, 10, 15, 20 and 28 days post-infection (dpi) and at 7, 15, 30 and 60 days post-larval emergence (dple). Total leucocyte numbers did not differ markedly among the groups. Significant differences were registered when values from control and animals harboring each larval stage of D. hominis were compared; with crescent rank: L1-, L2-, control and L3-infected groups. Leucocyte numbers were significantly higher in the control, 15, 20 or 28 dpi groups than in the 6 dpi animals. Higher counts were observed in control, L2- or L3-infected rats than L1-infected animals. Neutrophils, eosinophils and both large and small lymphocytes were also counted and analyzed. Basophils and monocytes were insufficient in number to permit statistical studies. These results stimulate the continuity of the studies about the host-parasite relationship in the dermatobiosis.

Salivary glands of second and third instars of Dermatobia hominis (Diptera: Oestridae)

Salivary glands of Dermatobia hominis (L., Jr.) (Diptera: Oestridae) larvae were studied under light and electron microscopy. The salivary glands of second (L2) and third instars (L3) are similar and consist of pairs of translucent tubules. The individual efferent ducts unite to form a single deferent duct, which inserts dorsally into the cephalopharingeal skeleton. Each gland has a monolayer of epithelial cells surrounded by basement membrane and connective tissue. The cellular plasma membrane is enfolded at its base, forming a labyrinthine area. The cell surface is linked to the basement membrane (BM) by hemidesmosomes and to adjacent cells by septet junctions and desmosomes. Irregular channels with several vesicles occur between the cytoplasm and BM. Golgi complex, rough and smooth endoplasmic reticulum, ribosome, lysosomes, multivesicular bodies, and myelin figures are usually present in the cells. The nucleus is large, with diffuse chromatin. The connective tissue circling the BM contains collagen fibrils, muscle fibers and tracheal tubes. Lined cuticle encloses the efferent and deferent ductal cells, which have few, widely dispersed mitochondria, free ribosomes, microtubules, and a large nucleus with diffuse chromatin.

Insect/mammal associations: effects of Cuterebrid bot fly parasites on their hosts

The effect of parasites on their hosts has implications for basic and applied ecology (e.g., species' population dynamics and distributions, biological control, and threats to at-risk species) and coevolution. Cuterebrid bot flies comprise one of the most-studied groups of insect parasites of mammals. Interest in their impact dates from at least 1857, when Cuterebra emasculator was so named because of the erroneous belief that its larvae castrate their hosts. This review addresses the effects of cuterebrid larvae on host biochemistry, physiology, behavior, and ecology. Despite high prevalence (peak values commonly range from 30% to 70%), at average intensities (one to three larvae per host) these parasites generally have little effect on the fitness or population dynamics of their typical hosts. This outcome likely reflects parasite/host coevolution favoring parasites that minimize harmful effects on hosts required for their survival and hosts that best tolerate perennial parasites they cannot avoid. In contrast, aggravated effects occur at higher intensities and with atypical hosts. Additional field studies involving experimental manipulation of infestation and spanning more than a few seasons are required to confirm these conclusions.

Dermatologic infectious diseases in international travelers

Skin lesions provide an important clue to the diagnoses of many infections in returned travelers. New information related to epidemiology, recognition, diagnosis, or management is described for the systemic infections--dengue fever, several of the rickettsial infections, African trypanosomiasis, and coccidioidomycosis. Many pathogens cause focal skin findings. Recent findings are presented for cutaneous leishmaniasis, Buruli ulcer, gnatho-stomiasis, cutaneous larva migrans, myiasis, tungiasis, and scabies. This paper describes the most common skin problems in returning travelers and outlines the types of infections that cause skin lesions, as defined by morphologic characteristics.

Inflammatory reaction to the human bot-fly, Dermatobia hominis, in infested and reinfested mice

Two groups of mice were infested with first stage larvae of the human bot-fly, Dermatobia hominis (Linnaeus Jr) (Diptera: Oestridae). In the first group, skin biopsies were carried out 1, 3, 5, 7, 10 and 18 days after infestation. The second group was also infested but had all the larvae removed 5 days after infestation. The mice in the latter group were reinfested 4 weeks later and skin biopsies were carried out 1, 3, 5, 7, 10 and 18 days after reinfestation. In the first group, an inflammatory reaction began slowly, the neutrophils being the main inflammatory cells, eosinophils being scarce. The reaction progressed with time, developing a necrotic halo around the larvae containing inflammatory cells surrounded by fibroblasts. The inflammation invaded the adjacent tissue. In the second group, the inflammatory reaction was intense on the day immediately after reinfestation, the pattern being changed by the presence of a large number of eosinophils. Activated fibroblasts surrounding the necrotic area around the larvae appeared 3 days after reinfestation in the second group and 7 days after infestation in the first group. The results demonstrated that the previous contact with the antigens elicited the early arrival of eosinophils, probably through the chemotactic factors liberated by mast cells in the anaphylactic reaction.

Midgut ultrastructure of the third instar of Dermatobia hominis (Diptera: Cuterebridae) based on transmission electron microscopy

The midgut ultrastucture of the third-instar of Dermatobia hominis (L., Jr.) was investigated using transmission electron microscopy (TEM). The tubular midgut bears a monolayer of epithelial cells with the plasma membrane showing multiple folding where it adjoins the basement membrane. Septate junctions bound the epithelial cells on each side. These cells have electrolucent cytoplasm containing mitochondria, vacuoles, rough and smooth endoplasmic reticula, lamellar bodies, and a prominent nucleus with dispersed chromatin. The peritrophic matrix is close to elongate microvilli, which are sometimes forked. Regenerative cells, in an undifferentiated state when closest to the basement membrane, are scattered throughout the epithelial cells. A thick basement membrane, surrounded by thick connective tissue including muscle, tracheal tubes, and extracellular matrix is linked to epithelial cells by hemidesmosome-like structures. Entero-endocrine, goblet or cuprophilic cells were not observed.

Activated host neutrophils in the larval midgut lumen of the human bot fly Dermatobia hominis

Light microscopy (LM) and transmission electron microscopy (TEM) were used to observe activated polymorphonuclear neutrophils from mammalian hosts as well as invading bacteria in the midgut lumen of larvae of the human bot fly Dermatobia hominis. Other resident or recruited cells associated with dermal myiasis were fed on by larvae and digested more rapidly than neutrophils. The latter were observed moving towards bacteria and particles of food, extending the filopodia and engulfing material to be digested within phagosomes. The larval midgut lumen, thus, appears to be a suitable environment to produce neutrophil activation at least for short periods, as seen in mammalian hosts. Although interactions between phagocytes and bacteria in the midgut lumen may be important in bot fly larval development, further studies are required to confirm this.

Cellular immune response to parasite infection in the Drosophila lymph gland is developmentally regulated

The mechanisms by which an organism becomes immune competent during its development are largely unknown. When infected by eggs of parasitic wasps, Drosophila larvae mount a complex cellular immune reaction in which specialized host blood cells, lamellocytes and crystal cells, are activated and recruited to build a capsule around the parasite egg to block its development. Here, we report that parasitization by the wasp Leptopilina boulardi leads to a dramatic increase in the number of both lamellocytes and crystal cells in the Drosophila larval lymph gland. Furthermore, a limited burst of mitosis follows shortly after infection, suggesting that both cell division and differentiation of lymph gland hemocytes are required for encapsulation. These changes, observed in the lymph glands of third-instar, but never of second-instar hosts, are almost always accompanied by dispersal of the anterior lobes themselves. To confirm a link between host development and immune competence, we infected mutant hosts in which development is blocked during larval or late larval stages. We found that, in genetic backgrounds where ecdysone levels are low (ecdysoneless) or ecdysone signaling is blocked (nonpupariating allele of the transcription factor broad), the encapsulation response is severely compromised. In the third-instar ecdysoneless hosts, postinfection mitotic amplification in the lymph glands is absent and there is a reduction in crystal cell maturation and postinfection circulating lamellocyte concentration. These results suggest that an ecdysone-activated pathway potentiates precursors of effector cell types to respond to parasitization by proliferation and differentiation. We propose that, by affecting a specific pool of hematopoietic precursors, this pathway thus confers immune capacity to third-instar larvae.