External ophthalmomyiasis caused by Oestrus ovis misdiagnosed as bacterial conjunctivitis

Ophthalmomyiasis Externa and Importance of Risk Factors, Clinical Manifestations, and Diagnosis: Review of the Medical Literature

OBJECTIVE

This review aims to describe and compare the risk factors, clinical course, diagnosis, and parasitologic features of external ophthalmomyiasis. We also discuss the different preventive measures and the effect of global warming in a large case series reported from January 2000 to December 2022.

METHODS

We perform a literature review of reported cases of external ophthalmomyiasis to determine the clinical characteristics, therapeutic management, and information on the organisms that most commonly cause external ophthalmomyiasis.

RESULTS

A total of 312 cases of external ophthalmomyiasis were recorded. The most common causative organism was Oestrus ovis (Linnaeus) (Diptera: Oestridae), accounting for 72.1% of cases, followed by Dermatobia hominis (Linnaeus Jr. in Pallas, 1781) (Diptera: Oestridae) at 5.4%, Lucilia sericata (Meigen) (Diptera: Calliphoridae) at 0.96%, and Chrysomyia bezziana (Villeneuve) (Diptera: Calliphoridae) at 0.96%. Before experiencing symptoms, 43.6% of cases reported having direct contact with flies or being hit in the eye, 33% reported no associated risk factors, 9.3% reported living with sheep and goats, and 7.7% reported a history of foreign objects entering the eye. The most common symptoms for those affected by O. ovis were sudden onset, including a foreign body sensation and movement, redness, tearing, itching, swelling, irritation, photophobia, burning, and ocular secretion. In cases caused by D. hominis, symptoms included eyelid edema, pain, redness, itching, movement within the lesion, ocular irritation, and discharge. Regarding occupational or recreational activity, agriculture, and livestock had the highest incidence, followed by trades and technical activities, being a student, and having traveled to an endemic region for work or recreation.

CONCLUSION

Patients with red eyes may suffer from external ophthalmomyiasis, which requires a thorough examination to diagnose and treat it early. Moreover, as the temperature increases due to climate change, it is essential to consider how this will affect the spread of different pathogens.

EXTERNAL OPHTHALMOMYIASIS CAUSED BY OESTRUS OVIS (A CASE REPORT)

The work deals with atypical conjunctival infection of Czech patient with Oestrus ovis larvae. Ophthalmomyiasis is infestation of mammalian eyes by the larvae or worms of some flies. The most common cause of human myiasis is the Sheep. Shepherds are infected in habitats, but human eye disease outside the areas of abundant hamsters is rare. We describe a case of eye disease in a middle-aged man from the Czech Republic who spent a summer holiday seven weeks before examination in the north of Greece. During the first examination he was completely treated and no further problems were reported. Ophthalmomyiasis externa should be considered as a possible infection of travelers to the southern endemic regions when returning with an acute causeless onset of a one-sided foreign body sensation in the eye.

Human ophthalmomyiasis caused by Oestrus ovis-first report from Croatia and review on cases from Mediterranean countries

Oestrus ovis is the most common cause of human ophthalmomyiasis. So far, majority of ophthalmomyiasis cases have been reported from Mediterranean countries, but not from Croatia. In current study, we present first two cases of human ophthalmomyiasis in Croatia, caused by O. ovis larvae. Reviewing a PubMed database, additional 259 cases of human ophthalmomyiasis in countries of Mediterranean basin have been reported. A total of 260 (99.62%) cases had external, while 1 (0.38%) had internal form of ocular myiasis. In all cases, O. ovis larvae were identified as the causative agent. O. ovis infestation is usually reported in shepherds and farmers although there is a high prevalence of infection in urban areas as well. Various climatic factors influence O. ovis larvipositional activity. Air temperature is the most important factor affecting O. ovis larviposition, while humidity, wind speed, and time of the day play only a moderate role. Most common symptoms of ophthalmomyiasis are irritation and redness, and in more than half of cases infestation is multiple. Ophthalmomyiasis interna is eye-compromising condition. Since there is reduced awareness among patients and medical professionals, the real number of ophthalmomyiasis cases is probably significantly higher than published. Global warming predisposes future increase of O. ovis prevalence in humans, which emphasizes the need for mandatory reporting and surveillance of disease.

Report of a rare case of severe allergic reaction due to nasal myiasis and a brief review of the literature in Turkey

Myiasis is defined as infestation of a mammal by fly larvae. It may occur on either living tissues (primary myiasis) or dead tissues (secondary myiasis). In this report, we present a patient with myiasis with an extremely rare clinical manifestation and severe allergic reaction, and we review the literature in order to reveal the current status. A 20-year-old female patient was admitted to our emergency department due to rush on face, cough and shortness of breath. The maggot came out of her nose was identified as Oestrus ovis. With a diagnosis of severe allergic reaction due to myiasis, she was treated diphenhidramine, prednisone and inhale albuterol in the emergency department. After treatment and further investigation, she was discharged with full recovery. Myiasis is a rare cause for severe allergic reaction in patients with definite diagnosis. Immediate diagnosis and treatment are milestones in preventing bad outcomes.

External ophthalmomyiasis: a case series and review of ophthalmomyiasis in Turkey

Ophthalmomyiasis externa is the infestation of the superficial external ocular structures by fly larvae. This is a particularly rare condition, which has nevertheless been reported in several countries worldwide. It is common in sheep-farming areas, especially in Mediterranean countries. The patients may present with classic conjunctivitis, pseudomembranous conjunctivitis, conjunctival hemorrhages, punctuate keratitis, keratouveitis, and eyelid edema with erythema. Herein, we present three cases of external ophthalmomyiasis caused by Oestrus ovis larvae and review ophthalmomyiasis cases reported from Turkey.

Ophthalmomyiasis externa: three cases caused by Oestrus ovis larvae in Turkey

Ocular involvement of parasitic infections includes external, internal and orbital ophthalmomyiasis. Oestrus ovis (sheep botfly) is the most common cause of ophthalmomyiasis externa. Living in warm climates, particularly in agricultural districts, is a risk factor. Although external ophthalmomyiasis can be treated by removal of the infecting larva(e) and topical drug treatment, the risk remains of its presence leading to further contamination for other people. We describe three cases of external ophthalmomyiasis due to infestation with the first instar larvae of O. ovis An awareness of larval conjunctivitis in endemic areas may avoid misdiagnosis and allow immediate management to prevent complications.