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Ramón-Cuellar JF, Mejía-Cordovez JA, Quiñones-Ossa GA, Leal-Isaza JP, Vargas-Osorio MP, Ramirez-Muñoz JD, Ordóñez-Rubiano EG, Ramirez AP, Amarillo DG, Hakim-Daccach F. Cerebral Myiasis, An Unexpected Intraoperative Finding - A Case Report and Systematic Review. World Neurosurg 2024; 186:138-144. [PMID: 38503402 DOI: 10.1016/j.wneu.2024.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Abstract
Postoperative complications, exemplified by surgical site infections, are commonplace in the realm of daily surgical interventions. Conversely, certain infectious entities, such as cerebral myiasis (CM), are distinctly rare. This report elucidates the clinical presentation of a 74-year-old female afflicted with a CSF fistula, within the context of a preceding surgical microvascular decompression employing a suboccipital craniotomy approach. Notably, the course of evaluation and treatment unveiled an intraoperative manifestation of severe CM. This case report underscores the critical significance of prompt identification, precise diagnostic elucidation, and comprehensive multidisciplinary management to optimize patient outcomes in instances of CM. Furthermore, a systematic literature review on CM supplements this report, contributing to the understanding of this infrequent complication.
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Affiliation(s)
| | | | - Gabriel Alexander Quiñones-Ossa
- Department of Neurosurgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Faculty of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - Juan Pablo Leal-Isaza
- Department of Neurosurgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Faculty of Medicine, Universidad El Bosque, Bogotá, Colombia
| | | | - Juan Daniel Ramirez-Muñoz
- Department of Neurosurgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia
| | - Edgar G Ordóñez-Rubiano
- Department of Neurosurgery, Fundación Santa Fe de Bogotá, Bogotá, Colombia; Department of Neurosurgery, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
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2
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Deo RC, Acharya A, Panigrahi S, Senapati SB, Mahapatra A, Puppala S. Cerebral Myiasis Secondary to Burr Hole Evacuation: A Rare Illustrative Case Report. Asian J Neurosurg 2023; 18:410-413. [PMID: 37397048 PMCID: PMC10313439 DOI: 10.1055/s-0043-1769895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023] Open
Abstract
Myiasis (maggot infestation) is a condition in which fly maggots feed off and develop in the tissues of living organisms. Most common in tropical and subtropical regions, human myiasis, is prevalent among individuals in close association of domestic animals and those inhabiting the unhygienic conditions. We, hereby, describe a rare case of cerebral myiasis (17th in the world, 3rd in India) that presented to our institution in Eastern India secondary in the operated site of craniotomy and burr hole few years back. Cerebral myiases are exceedingly rare conditions, especially in high-income countries with only 17 previously published cases with the reported mortality as high as 6 out of 7 cases dying of the disease. We additionally also present a compiled review of previous case literatures to highlight the comparative clinical, epidemiological features and outcome of such cases. Although rare, brain myiasis should be a differential diagnosis of surgical wound dehiscence in developing countries where conditions do exist in this country that permit myiasis. This differential diagnosis should be remembered, particularly when the classic signs of inflammation are not present.
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Affiliation(s)
- Rama Chandra Deo
- Department of Neurosurgery, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Abhijit Acharya
- Department of Neurosurgery, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Souvagya Panigrahi
- Department of Neurosurgery, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | | | - A.K. Mahapatra
- Department of Neurosurgery, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Sumirini Puppala
- Department of Neurology, IMS & SUM Hospital, Bhubaneswar, Odisha, India
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3
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Curzi C, Bartoletti V, Canova G, Giordan E. A Severe Case of Brain Myiasis: Treatment Rationale and Review of Literature. Asian J Neurosurg 2021; 16:582-586. [PMID: 34660373 PMCID: PMC8477821 DOI: 10.4103/ajns.ajns_521_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/01/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Cerebral myiasis is a rare condition caused by a parasitic infestation of fly larvae feeding on the host's necrotic or living tissue. Only 16 cases of cerebral myiasis have been published. We presented the case of a 72-year-old man with a neglected infestation of an extensive ulcerative cancer of the scalp. A large cranial lesion, with exposed brain and dura mater and severe Sarcophaga carnaria maggot infestation, was evident. We gently removed the maggots and covered the defect with thick gauze and sodium hypochlorite solution dressing. We additionally present a review of the literature to highlight shared features and suggestions for care management. In all cases, there was an absence of fatal meningitis and encephalitis, which is surprising given the open skull erosion with prolonged cortical exposure and points to the protective effects of larvae wound infestation.
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Affiliation(s)
- Christian Curzi
- Department of Neuroscience, Università di Padova, Padova, Italy
| | | | - Giuseppe Canova
- Department of Neurosurgery, Aulss 2 Marca Trevigiana, Treviso, Italy
| | - Enrico Giordan
- Department of Neurosurgery, Aulss 2 Marca Trevigiana, Treviso, Italy
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4
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Gonçalves KKN, de Araújo ESM, Barbirato DS, do Lago CAP, do Egito Vasconcelos BC. Head and neck cancer associated with myiasis. Int J Oral Maxillofac Surg 2021; 51:847-853. [PMID: 34602319 DOI: 10.1016/j.ijom.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/21/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease progression and increase its lethality due to local or systemic complications. The aim of this study was to conduct a scoping review on head and neck cancer associated with myiasis in order to answer the focal question: what are the occurrence, diagnosis, aetiology, treatment and outcomes of head and neck cancer associated with myiasis? This paper was structured based on the five-steps methodology proposed by Arksey and O'Malley (Int J Soc Res Methodol 2005;1:19-32), and followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR), OSF Registries protocol. The electronic search was performed in the MEDLINE/PubMed, Embase and SciELO.org databases for articles published up to 28 February 2021. In total, 38 articles and 56 patients were included. Most patients were male (66%), and the mean age was 66.63 years. Cases were predominantly associated with squamous or basal cell cancer. The most affected anatomical sites were the eyes, scalp, ears and oral cavity, and the most frequent type of larva was Crisomyia (13%). Manual removal of the larvae was considered the standard treatment, associated or not with antibiotics, analgesics and antiparasitic drugs.
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Affiliation(s)
- K K N Gonçalves
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - E S M de Araújo
- Faculty of Dentistry of Pernambuco, University of Pernambuco, Recife-PE, Brazil
| | - D S Barbirato
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - C A P do Lago
- Maxillofacial Surgery and Traumatology Service, Hospital da Restauração, Recife-PE, Brazil
| | - B C do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil; Department of Oral and Maxillofacial Surgery, Hospital da Restauração, Pernambuco, Brazil.
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5
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Cuestas D, Pedraza J, Herrera H, Motta A, Cuestas A, Forero Y, Porras R, Urrea F, Galvis D, Galvis I, Bernal MA, Alvarado MV, Bula R, Velasquez O, Villalba D, Lamus S, Ariza G, Bayona N, Gutierrez A, Segura A, Patiño M, Perafan A, Ramirez-Rodriguez S, Rolon M. Cutaneous myiasis in skin cancer and malignant wounds: a systematic review. Int J Dermatol 2021; 60:1529-1546. [PMID: 34363696 DOI: 10.1111/ijd.15672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/14/2021] [Accepted: 04/22/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cutaneous myiasis in patients with malignant wounds or skin cancer is a rare and undesirable event with limited epidemiological data. A subregister of reports, lack of education in the population, inadequate empirical treatments, and medical underestimation are components of a public health problem that threatens patients' lives. METHODS We conducted a systematic review of the literature of cutaneous myiasis associated with malignant wounds and skin cancer, characterizing sociodemographic variables, risk factors, clinical and histological features, and treatment. Additionally, we present a demonstrative case with the adequate taxonomic evaluation. DISCUSSION Cutaneous myiasis is an underestimated and poorly managed infestation, which can generate severe complications in oncological patients. This is the first systematic review in the literature about this clinical scenario, which provides information to the physician and clinical researcher about the epidemiological gaps and what has been published so far. CONCLUSIONS Findings from the current review have helped to display the sociodemographic, epidemiological, and clinical behavior of myiasis in skin cancer and malignant wounds. Its contribution to the greater tumor tissue destruction is clear; however, more studies are required. The therapeutic management in these patients is equally clarified.
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Affiliation(s)
- Daniel Cuestas
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,ESTUDIODERMA®, Bogotá, Colombia
| | - John Pedraza
- Dermatology Program, Fundacion Universitaria Sanitas, Bogotá, Colombia
| | - Hugo Herrera
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Adriana Motta
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Andrés Cuestas
- ESTUDIODERMA®, Bogotá, Colombia.,Clinical and Enginnering Research-Statistical Analysis, Predicto Artificial Intelligence Techonologies LLC, Austin, TX, USA
| | - Yency Forero
- Internal Medicine Program, Universidad de La Sabana, Chía, Colombia
| | - Ricardo Porras
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Fernando Urrea
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Dany Galvis
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Ingrid Galvis
- Special Training in Radiology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Rosa Bula
- Clinical Research, Universidad del Sinú, Cartagena, Colombia
| | - Oscar Velasquez
- Dermatology Program, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Sergio Lamus
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Gabriel Ariza
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Natalia Bayona
- Clinical Research, Universidad del Rosario, Bogotá, Colombia
| | - Ana Gutierrez
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Alexandra Segura
- Grupo de Investigación en Ciencias Biomédicas UPTC - GICBUPTC, Grupo de Investigación en Medicina Veterinaria y Zootecnia GIDIMEVETZ, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
| | - Monica Patiño
- Clinical Research, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Alejandra Perafan
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | | | - Mariam Rolon
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,Dermatopathology Department, Hospital Simon Bolívar, Bogotá, Colombia
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6
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Lo SY, Teah MK, Ho YZ, Yeap TB. Perioperative challenges in managing a patient with COVID-19 undergoing debridement for massive scalp myiasis. BMJ Case Rep 2021; 14:e241189. [PMID: 33547110 PMCID: PMC10577744 DOI: 10.1136/bcr-2020-241189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 12/25/2022] Open
Abstract
A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.
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Affiliation(s)
- Shiu Yin Lo
- Department of Anaesthesia and Intensive Care Unit, Hospital Queen Elizabeth 2, Kota Kinabalu, Sabah, Malaysia
| | - Ming Kai Teah
- Department of Anaesthesia and Intensive Care Unit, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
| | - Yan Zheng Ho
- Neurosurgical Department, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
| | - Tat Boon Yeap
- Faculty of Medicine and Health Sciences, Medicine Based Disciplines Department, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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7
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Bertone F, Cerutti M, Serusi E, Gervasio CF. Rhinomyiasis: clinical and surgical management. BMJ Case Rep 2020; 13:e236421. [PMID: 33318268 PMCID: PMC7737014 DOI: 10.1136/bcr-2020-236421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2020] [Indexed: 12/15/2022] Open
Abstract
Myiasis by Oestrus ovis, the zoonotic infestation with Diptera larvae, primarily diagnosed in goats and rams in tropical and Mediterranean countries, is an uncommon disease in humans; indeed, literature data are still lacking. Nevertheless, few cases of human myiasis have been reported, leading to benign or severe complications. Here, we report a rare case of human rhinomyiasis detected in Northern Italy. A 39-year-old Italian woman, returning from vacation in Corsica, showed several sinusal symptoms and progressive asthenia and was therefore admitted at the Otorhinolaryngology Unit of Biella Hospital, Italy. Endoscopic examination of the nasal cavity revealed some formations, morphologically identified as O. ovis larvae. The patient then underwent endoscopic sinus surgery, followed by complete resolution of symptoms. Clinical presentation, diagnostic work-up and therapeutic procedures have been compared with few other cases found in the literature.
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Affiliation(s)
- Fabio Bertone
- ENT Department, Ospedale degli Infermi, Ponderano, Biella, Italy
| | - Marta Cerutti
- ENT Department, Ospedale degli Infermi, Ponderano, Biella, Italy
| | - Elena Serusi
- ENT Department, Ospedale degli Infermi, Ponderano, Biella, Italy
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8
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Dunphy L, Sood V. Dermatobia hominis 'the human botfly' presenting as a scalp lesion. BMJ Case Rep 2019; 12:e228310. [PMID: 30852503 PMCID: PMC6424252 DOI: 10.1136/bcr-2018-228310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/03/2022] Open
Abstract
Owing to increasing international travel, physicians will encounter more infectious diseases acquired overseas, which may be bacterial, fungal or parasitic in nature. 1 Knowledge of the geographic distribution of specific diseases permits the formulation of a differential diagnosis in the context of clinical presentation. Parasitic infestations of the maxillofacial tissues can be caused by a host of different ectoparasites, for example, myiasis, a frequently misdiagnosed disease of tourists returning from exotic locations. For those natives and travellers who are subject to these 'infestations', the experience can be both alarming and very distressing.
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Affiliation(s)
- Louise Dunphy
- Department of Surgery, Milton Keynes University Hospital, Milton Keynes, UK
| | - Vikas Sood
- Department of Oral and Maxillofacial Surgery, Monklands Hospital, Airdrie, North Lanarkshire, UK
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9
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Patel MB, Munzer K, Dougherty M, Williams P, Loiselle A. Pleural Myiasis Associated With Pleural Angiosarcoma. Chest 2017; 149:e157-60. [PMID: 27287590 DOI: 10.1016/j.chest.2015.12.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 11/05/2015] [Accepted: 12/01/2015] [Indexed: 10/21/2022] Open
Abstract
Myiasis refers to a parasitic infestation of vertebrate mammals by dipterous larvae (maggots) of higher flies. Infections in humans typically occur in tropical and subtropical regions, regions with limited medical access, and areas with poor hygiene and living conditions. Infestations in humans have been described in subcutaneous, nasal, ocular, oropharyngeal, and orotracheal cases; however, reports of pulmonary myiasis in humans in the United States and other developed countries are extremely rare. We describe a patient with recently diagnosed primary pleural angiosarcoma who presented to our clinic for the management of a thoracostomy tube and was diagnosed with pleural myiasis.
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Affiliation(s)
- Mitesh B Patel
- Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, MO.
| | - Kurt Munzer
- Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, MO
| | | | - Peter Williams
- Department of Pathology, Saint Louis University School of Medicine, St Louis, MO
| | - Andrea Loiselle
- Division of Pulmonary and Critical Care, Washington University School of Medicine, St Louis, MO
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10
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Hoyer P, Williams RR, Lopez M, Cabada MM. Human Nasal Myiasis Caused by Oestrus ovis in the Highlands of Cusco, Peru: Report of a Case and Review of the Literature. Case Rep Infect Dis 2016; 2016:2456735. [PMID: 28116184 PMCID: PMC5220410 DOI: 10.1155/2016/2456735] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/04/2016] [Indexed: 11/18/2022] Open
Abstract
Myiasis is the infestation by dipterous larvae. The larvae can infect intact or decaying tissue including the skin or epithelial surfaces of the orbits, nose, and genitourinary and gastrointestinal tracts. We report a case of primary obligatory nasal myiasis by Oestrus ovis in a 56-year-old man from Cusco in Peru. He presented with nasal pruritus, congestion, and sneezing white "cottony" material. The material was identified as O. ovis larvae. A literature review of publications reporting nasal myiasis caused by O. ovis is presented.
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Affiliation(s)
- P. Hoyer
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - R. R. Williams
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - M. Lopez
- Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco Branch, Cusco, Peru
| | - M. M. Cabada
- Tropical Medicine Institute, Universidad Peruana Cayetano Heredia, Cusco Branch, Cusco, Peru
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
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11
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Biswas S, McNerney P. Myiasis on a Giant Squamous Cell Carcinoma of the Scalp: A Case Report and Review of Relevant Literature. World J Oncol 2016; 7:34-39. [PMID: 28983361 PMCID: PMC5624694 DOI: 10.14740/wjon966w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2016] [Indexed: 11/11/2022] Open
Abstract
Non-melanoma skin cancer is the most common malignancy amongst Caucasians worldwide with basal cell and squamous cell cancer being the most common. Giant skin cancers are a relatively rare type of skin cancer that are, by definition, greater than 5 cm. This subtype by itself is associated with a significantly increased risk of complications and mortality. Myiasis is defined as infestation of body tissues of humans by dipterous larvae. Myiasis is often associated with malignant skin conditions. We describe a rare case of cutaneous myiasis located on a giant squamous cell carcinoma of the scalp in an elderly female. Myiasis coupled with malignant skin conditions provides a unique surgical challenge. This is especially true if the malignancy is invasive, as in our case, often requiring a multidisciplinary multimodality treatment plan.
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Affiliation(s)
- Saptarshi Biswas
- Department of Acute Care Surgery, Allegheny Health Network, Pittsburgh, PA, USA
| | - Patrick McNerney
- Department of Acute Care Surgery, Allegheny Health Network, Pittsburgh, PA, USA
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12
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Navarro JN, Alves RV. Postoperative cerebral myiasis: A rare cause of wound dehiscence in developing countries. Surg Neurol Int 2016; 7:69. [PMID: 27413581 PMCID: PMC4926550 DOI: 10.4103/2152-7806.184581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/26/2016] [Indexed: 11/10/2022] Open
Abstract
Background: Cerebral myiasis is a rare parasitic disease, especially in postoperative neurological surgery. Case Description: We report a case of postoperative myiasis in a patient who underwent a craniotomy for resection of metastatic melanoma, evolving with wound dehiscence due to myiasis in the operative wound. Conclusion: Myiasis infestation should be a differential diagnosis of surgical wound dehiscence, particularly when the classic signs of inflammation are not present and computed tomography of the brain shows signs suggestive of this disease entity.
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Affiliation(s)
- Juliano N Navarro
- Department of Neurosurgery, Hospital Municipal Pimentas Bonsucesso, Guarulhos, São Paulo, Brazil
| | - Raphael V Alves
- Department of Neurosurgery, Hospital Municipal Pimentas Bonsucesso, Guarulhos, São Paulo, Brazil
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13
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Giri SA, Kotecha N, Giri D, Diyora B, Nayak N, Sharma A. Cerebral Myiasis Associated with Artificial Cranioplasty Flap: A Case Report. World Neurosurg 2015; 87:661.e13-6. [PMID: 26409084 DOI: 10.1016/j.wneu.2015.09.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/02/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cranioplasty is a commonly performed procedure for the repair of cranial defects. Various materials have been used for this procedure and have a good safety profile. Human cerebral myiasis is an exceedingly rare condition. It involves the invasion of live or dead human tissues by larvae of the insect species dipterous. CASE DESCRIPTION We describe the first case of cerebral myiasis associated with an artificial cranioplasty bone flap. There was delayed cerebral cortex infestation of the species dipterous after cranioplasty with polymethyl methacrylate bone flap. The patient initially presented with an acute subdural hematoma and contaminated, comminuted frontal bone fracture that required craniectomy with interval cranioplasty at 3 months. Two years after the index procedure, the patient presented for neurosurgical follow-up because of 2 months of nonhealing ulcers and a foul smell emanating from the cranioplasty site, as well as acute onset of unilateral arm and leg weakness. Surgical exploration found live larvae invading the dura and cerebral cortex, an area that was thoroughly debrided with good outcomes for the patient. CONCLUSIONS Cerebral myiasis can be managed via surgical and antibiotic therapy to obtain a good clinical outcome.
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Affiliation(s)
- Sachin Ashok Giri
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India
| | - Nitin Kotecha
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India
| | - Deepali Giri
- Department of General Medicine, Zynova Heart Hospital, Mumbai, India
| | - Batuk Diyora
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India.
| | - Naren Nayak
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India
| | - Alok Sharma
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India
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14
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Clarke KJ. Myiasis (fly disease) and insectal disease generally are causing mental illness. Med Hypotheses 2013; 81:360-5. [PMID: 23726691 DOI: 10.1016/j.mehy.2013.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/02/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
Mental illness by which psychosis is meant here is known to be caused mainly by imbalances of certain neurotransmitters in the brain. But, what is causing these imbalances? There has been a recent flurry of interest focusing on the possibility of parasitical disease. The appropriateness of this is based on the fact that organisms of the animal kingdom produce the same neurotransmitters. In fact stinging insects release them in their venoms. The proposal here is that insect larval parasites acting on the human brain and body may release such neurotransmitters and cause imbalances and altered mental states and is supported by the occurrence of previously unexplained physical symptoms such as; diarrhoea, constipation, spasms, anaemia, bloating, insomnia, headache, migraine, weight loss, low blood pressure, low grade fever, amnesia and signs of allergy which may accompany mental illness. Some of these symptoms have been previously attributed to the medications prescribed to alleviate the psychotic symptoms but, many are also parasitical signs. It is proposed that the minute larvae may make sudden movements and may be highly motile and may move from pressure, hence evading the phlebotomist's needle. There is also the testimony of those with delusional parasitosis and related addictions, I propose the regularity with which humans are bitten, stung and have their foods infected with insects at all stages as a demonstration of how insectal disease may have the potential for common infection and disease; mental and physical.
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Abstract
Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. In mammals (including humans), dipterous larvae can feed on the host's living or dead tissue, liquid body substance, or ingested food and cause a broad range of infestations depending on the body location and the relationship of the larvae with the host. In this review, we deeply discuss myiasis as a worldwide infestation with different agents and with its broad scenario of clinical manifestations as well as diagnosis techniques and treatment.
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16
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Posttraumatic human cerebral myiasis. World Neurosurg 2010; 73:557-9. [PMID: 20920942 DOI: 10.1016/j.wneu.2010.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 01/14/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Only eight cases of cerebral myiasis in humans have been reported worldwide and only one in the United States. Presented here is a case of cerebral myiasis in the setting of head trauma in suburban Los Angeles. METHODS The article includes chart review and description of a clinical case presentation. RESULTS A 42-year-old HIV-positive man was found in a ditch after 2 weeks, the victim of apparent assault. He had multiple facial fractures along with open depressed bifrontal sinus fractures with necrotic bone, eroded dura, exposed cortex, and extensive maggot infestation of the left frontal lobe. The patient was taken urgently to the operating room, where the maggots where evacuated by irrigation and suction. Debridement of necrotic bone, dura, and brain was performed, the frontal sinuses were exenterated, and skull defects plated with titanium mesh. Intraoperative cultures revealed a polymicrobial meningitis/encephalitis, which was treated postoperatively with antibiotics. The patient's neurologic exam stabilized and the patient was transferred to a rehabilitation facility for further care, ultimately achieving functionality and holding a job. CONCLUSION This is the first published case of cerebral myiasis secondary to trauma, and to our knowledge, the first documented long-term survivor of extensive cerebral myiasis. Wide debridement to normal brain followed by 6 weeks of broad-spectrum antibiotic treatment is effective in managing this condition. A well-functioning outcome can be expected with prompt recognition and treatment of the disease. Larval infestation may have a protective effect against bacterial infection and may allow for greater tolerance of treatment delay.
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17
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Abstract
Most cases of myiasis in association with cancer are reported in patients with squamous cell carcinoma of the head and neck region. They are not emergencies. We report a case of massive myiasis of the scalp with bleeding in a patient with an ulcerated squamous cell carcinoma of the scalp, haematological and colorectal malignancies. Treatment of myiasis is based on local disinfection and mechanical removal of larvae. Other options of treatment are discussed.
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Affiliation(s)
- Uwe Wollina
- Dermatology and Allergology, Academic Teaching Hospital Dresden, Dresden, Germany.
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18
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Patient With Persistent Wound Drainage. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2009. [DOI: 10.1097/ipc.0b013e3181934320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Marco de Lucas E, Díez C, Gutiérrez A, Montiaga F, Arnáiz J, Mandly AG, Sánchez E, Valle N. Unusual MRI findings in a patient with history of frontal fracture and skin infestation by fly larvae, as a possible sign of intracerebral myiasis. Clin Neurol Neurosurg 2008; 110:725-8. [PMID: 18471957 DOI: 10.1016/j.clineuro.2008.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Revised: 03/20/2008] [Accepted: 03/26/2008] [Indexed: 10/22/2022]
Abstract
We report a case of an 11-year-old columbian immigrant with mild non-specific cephalalgia. He had a previous history of frontal fracture and skin infestation caused by Dermatobia hominis larvae. MRI performed revealed multiple subependymal and intraventricular lesions with concentric blooming artifacts and moderate hydrocephalus. Based on his previous history, intracerebral myiasis diagnosis was suggested. His mother denied any kind of diagnostic surgery or treatment. To the best of our knowledge, this is the first MRI report of a possible intracerebral myiasis, an exceedingly rare entity.
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Affiliation(s)
- Enrique Marco de Lucas
- Servicio de Radiodiagnóstico, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
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