Investigation of pseudo-urogenital myiasis and errors in diagnosis

Cases of genitourinary myiasis in humans caused by larvae of flies are reported from time to time. In our study, 11 patients, who reported worms in their urine and brought these worms to our laboratory, were investigated. The larvae were found to belong to the subfamily Psychodinae. By taking urine samples carefully from the patients, examining and evaluating their history, it was concluded that they did not actually have myiasis. We endeavour to describe the pitfalls in this diagnosis.

Furuncular myiasis caused by Dermatobia hominis: entodermoscopic findings

A 27-year-old male traveller returning from the Amazon forest came to our dermatology consultation with a furuncle-like nodule in the temporal region. During examination we observed an erythematous nodule with a central opening. We describe the entodermoscopic characteristics of Dermatobia hominis.

Old World Screwworm myiasis: First report of auricular Chrysomya bezziana myiasis in a dog in Singapore

A German Shepherd dog was presented to a referral practice for screwworm myiasis affecting the ear. The successful management involved killing the larvae with afoxolaner plus milbemycin oxime and using video otoscopy to completely remove dead larvae. To the best of our knowledge, this is the first case report of auricular myiasis by Chrysomya bezziana in a dog in Singapore and the first report of video otoscopic management of myiasis.

Scalp myiasis associated with soft tissue sarcoma lesion: a case report and review of relevant literature

BACKGROUND

Sarcophagidae is one of the main fly families that is attracted to open wounds, ulcers, lesions, and other injuries for depositing their larvae. The presence of larvae of flies in human tissues makes myiasis. Myiasis on the scalp could be more frightening in comparison with myiasis on the other parts of the body. It is a rare myiasis case that shows the ability of myiasis agents to attack various parts of the body. On the other hand, reporting of myiasis cases by Sarcophagidae larvae is not common due to difficulties in their identification. This study aimed to emphasize the importance of Sarcohagidae larvae in producing myiasis by describing the first case of soft tissue sarcoma infestation and provides a review of human myiasis by larvae of the Sarcophagidae family during 2010-2023 and also a review of wound myiasis cases associated with malignancy during 2000-2023.

CASE PRESENTATION

A case of sarcoma cancer myiasis is reported on the scalp of a 43-year-old man who referred to one of Tehran's hospitals for surgical treatment of cancer. Before surgery, insect larvae were observed in the area of ​​sarcoma. The larvae were isolated, examined morphologically, and identified as Sarcophaga spp.

CONCLUSIONS

Myiasis has been considered as a neglected disease. Publishing of myiasis cases could be useful to alert health policy-makers about its danger and appearance in the community. It is not usual but can be expected even on the scalp of the human head. Exact daily supervision and dressing of the wound could be recommended to prevent cutaneous myiasis.

[A case of intestinal myiasis in a bedridden elderly patient]

A 75-year-old man with type 2 diabetes and a history of previous empyema surgery was admitted to our hospital due to difficulty moving caused by chronic obstructive pulmonary disease and dehydration. During the first two days of hospitalization, intestinal myiasis was diagnosed after maggots were found in his diapers. After the maggots disappeared, he developed a fever, prompting antibiotic therapy for a suspected secondary infection, resulting in clinical improvement. Despite thorough home cleaning, no flies or maggots were found, and the source of infection and the fly species remained unknown. Recent reports suggest a higher prevalence of myiasis among the elderly, even with overall improvement in hygiene. While myiasis is typically mild, it is a condition that requires consideration in an aging society. Myiasis is a disease that should be considered in the differential diagnosis of the elderly, especially in people who are bedridden or frail.

Cutaneous myiasis caused by Dermatobia hominis (Diptera: Oestridae) in a Polish traveller to South America - a case report

Myiasis, an infestation caused by dipteran larvae, commonly known as maggots, is one of the most common parasitic skin disorders in the tropical regions. Authors report a case of cutaneous myiasis caused by Dermatobia hominis (Diptera: Oestridae) in a Polish traveller returning from a self-organized trip to South America. Species biology, prophylaxis, and medical implications of this tropical parasitosis are discussed.

Nasal Maggot Infection in a Patient With Nasal Non-Hodgkin's Lymphoma

We describe a case of nasal non-Hodgkin's lymphoma in a 79-year-old Chinese patient accompany with nasal myiasis. The first 2 biopsies in this case were false negative. Subsequently, nasal maggots developed in this patient. After removing all maggots under nasal endoscopy, the patient continued to have recurrent fever and was transferred to a higher hospital for further treatment, in which he received a third biopsy. Unfortunately, several hours after the biopsy, the patient died for severe nasal bleeding. The final biopsy result indicated the neoplasm of the left nasal cavity was non-Hodgkin's lymphoma. This case illustrates the importance of repeated biopsies for nasal non-Hodgkin's lymphoma if necessary. Nasal myiasis is a secondary disease of nasal non-Hodgkin's lymphoma in this case.

Aural myiasis in Ancient Rome: Celsus and the ear maggots

OBJECTIVE

Although today there is extensive scientific literature on aural myiasis, a historical study of the subject has yet to appear. This short article reports the first description of aural myiasis in the Western medical literature.

METHODS

Methods involved: (1) scholarship review of ear diseases within Ancient Greek and Roman medical texts (L'Année philologique); (2) linguistic analysis for text identification through the Library of Latin Texts, the Thesaurus Linguae Latinae and the Loeb Classical Library; and (3) translation of the Latin texts that described cases of aural myiasis with commentary.

RESULTS

To our knowledge, the earliest case of aural myiasis in Latin medical literature is reported by the Roman encyclopaedist Celsus (first century CE). In his De Medicina, he describes cases of Wohlfahrtia magnifica maggot infestation of the ear and how to treat affected patients.

CONCLUSION

Despite present advances in otology, we believe that much insight can still be gained from this ancient example of medical history in ear diseases. A more comparative analysis of the subject is to be considered in the future, which will provide more data from different cultures and times.

Case Report: Outbreak of Nosocomial Myiasis by Cochliomyia macellaria (Diptera, Calliphoridae) in a Hospital in Colima, Mexico

Myiasis in humans is a disease caused by larvae of various fly families. It mainly occurs in communities with poor sanitation and low socioeconomic status. Meanwhile intrahospital or nosocomial myiasis represents a rare phenomenon but is of relevance to public health. Here, we report an outbreak of myiasis caused by Cochliomyia macellaria in five patients hospitalized for several diseases at the Service of Internal Medicine of the Hospital Regional Universitario de Colima, Mexico during June and July 2021. Three patients were males and two were females, aged 37 to 83 years. All were affected by myiasis caused by larvae of the fly C. macellaria. Three patients underwent invasive mechanical ventilation; one had cutaneous basal cell cancer and one had advanced diabetic foot. This event occurred after 4 days of hospitalization and in the same hospital pavilion. Two patients died, and the others were discharged after treatment with antibiotics and ivermectin. We believe that this nosocomial cluster represents a more frequent phenomenon than reported in tropical countries, where authorities should pay attention to its timely detection, especially in vulnerable populations.

[DROSOPHILA MELANOGASTER GASTROINTESTINAL MYIASIS: ABOUT A MOROCCAN CASE REPORT]

Introduction

Myiasis is an infestation of humans or animals by larval forms of brachycetes. Commonly observed locations are otolaryngological and cutaneous. Gastrointestinal localization remains exceptional. In this work, we report the observation of a Moroccan case of gastrointestinal myiasis caused by Drosophila melanogaster. Observation. The patient was a 56-year-old man living in a rural region of northwest Morocco. He was being followed at the National Oncology Institute in Rabat for pulmonary and renal adenocarcinoma and was put on neo-adjuvant chemotherapy with concomitant radiochemotherapy. The patient presented vomiting twice containing about forty small white, circular and hairless worms measuring 4 mm in length. This sample was sent to the parasitology and mycology laboratory for identification. Microscopic study of the larvae and adult flies obtained after rearing in the laboratory of parasitology allowed the diagnosis of myiasis caused by Drosophila melanogaster.

Discussion/Conclusion

This observation is noteworthy for both its exceptional anatomical localization and the implicated parasite species.

An Atypical Presentation Of Cutaneous Myiasis Of The Scalp In North Punjab: A Case Report

Myiasis is an ectoparasitic infestation caused by larvae of arthropods in the group Diptera. Cutaneous myiasis is the infection of skin and includes the following types: furuncular, migratory and wound myiasis. Out of all the organisms responsible for this disease, Wohlfahrtia vigil is the most common causative agent in Pakistan, usually seen from June to September with nearly all presentations occurring at a young age. In our case, a patient without a history of trauma, skin erosion or animal exposure has a unique presentation of cutaneous myiasis. Here, an effort was made to treat a 15- year-old otherwise healthy female with a multisegmented treatment modality. A follow up visit was conducted every three days for three months at the end of which a 60% decrease in the size of the open wound was observed.

OPHTHALMOMYIASIS INTERNA WITH INVASION OF THE OPTIC NERVE

PURPOSE

To report a case of ophthalmomyiasis interna with optic nerve invasion that was treated with oral ivermectin and prednisone.

METHODS

Case report with retrospective review of medical records and multimodal imaging studies.

RESULTS

A Christmas tree farmer in his sixties presented with expanding multicolored, spiraling photopsias in the left eye. The visual acuity measured 20/50, and examination and imaging findings showed subretinal tracks consistent with ophthalmomyiasis interna. After several weeks of spontaneous improvement, the visual acuity decreased to 20/150 and fundus examination showed new optic disc edema that was treated with ivermectin and prednisone. Despite the development of optic disc pallor, the visual acuity improved to 20/25.

CONCLUSION

Subretinal fly larvae can occasionally exit the eye by invading the optic nerve. Treatment of optic nerve involvement with ivermectin and prednisone can result in an excellent visual outcome.

First record of a rare case of accidental urinary myiasis by Telmatoscopus albipunctata (Diptera: Psychodidae), with morphological description, in a human in Brazil

Telmatoscopus albipunctata is an insect of the Psychodidae family, with a worldwide distribution, particularly in tropical and subtropical countries. Although it does not have hematophagous habits, it has veterinary medical importance due to the mechanical transmission of protozoa and bacteria, many of which cause nosocomial infections. This dipteran has been reported as one of the causative agents of accidental myiasis in humans in several countries, and since it has not been registered in South America, the objective of the present report was to describe a rare case of accidental urinary myiasis caused by T. albipunctata (Diptera: Psychodidae) in humans in Brazil. In the present report, a 25-year-old female patient, resident of the central region of the state of Rio Grande do Sul, Brazil, sought medical attention after finding larvae in her urine. She complained of vaginal itching and skin dermatitis. The larvae were sent to the Veterinary Parasitology Laboratory of the Federal University of Santa Maria, where they were mounted on permanent slides for further taxonomic identification. Morphological characteristics allowed the identification of fourth-stage larvae and pupae of T. albipunctata. Therefore, the present work reports the first record of accidental urinary myiasis caused by T. albipunctata infection in Brazil and South America.

Botfly Myiasis Masquerading as Dacryocystitis

Cutaneous myiasis is an infection most commonly caused globally by Dermatobia hominus , the human botfly, which is endemic to Central and South America. In North America, the most common cause of cutaneous myiasis is infestation with the larvae of Cuterebra , the North American botfly. The authors describe a 44-year-old man who presented with a 1-month history of intermittent, severe, boring pain along the side of his nose that progressed to swelling and redness along his right inferior orbital rim and lacrimal sac. CT imaging showed a rim-enhancing collection at the right medial canthus with surrounding phlegmonous changes communicating with the skin. Pathologic evaluation revealed curvilinear pigmented material associated with a granulomatous and eosinophil-rich inflammatory infiltrate, consistent with botfly myiasis. This case describes the pathogenesis of the botfly infestation in humans, as well as the clinical, radiographic, and histopathologic features of this rare orbital infection, with an emphasis on its treatment.

Ophthalmomyiasis externa caused by Oestrus ovis

This report describes the case of a woman in her early 20s who presented with a 3-day history of mobile foreign bodies and watering from her right eye. She had recently returned from vacation on a Greek island and presented to an ophthalmology unit in London, UK. A sample taken demonstrated Oestrus ovis infestation and confirmed the diagnosis of ophthalmomyiasis externa. She was treated with prophylactic topical antibiotics and subsequently made a full recovery. This was only the sixth presentation of O. ovis ophthalmomyiasis externa documented within the UK and the only case documented within the last 20 years. This is the fifth documented case found to have been transmitted within Greece.

Case of Wound Myiasis in a Squamous Cell Carcinoma Lesion of the Scalp

Myiasis refers to the infestation of living humans and vertebrate animals by dipterous larvae. Many organs can be infested by fly larvae, but cutaneous and wound myiases are the most frequently encountered clinical forms. Persistent ulcer or non-healing wound is one of the symptoms of squamous cell carcinoma which is the second most common skin cancer in the world. Here we report a case of an elderly man with a severe wound myiasis in a squamous cell carcinoma lesion of the scalp. The maggots were confirmed to be Lucilia sericata which are widespread flies in Japan. Human myiasis is rarely reported in Japan, but patients with necrotic, hemorrhaging, or pus-filled wounds are susceptible to infestation. It is necessary for doctors and nurses to ensure that their patients change their dressings daily and keep their wounds clean.

Elephantoloemus indicus Austen, 1930 (Diptera: Calliphoridae) as the cause of cutaneous myiasis in captive Indian elephants from Assam, India

Elephantoloemus indicus Austen, 1930, a dipteran calliphorid fly is known to cause by its larval stage obligatory cutaneous myiasis in Indian subspecies of Asian elephants (Elephas maximus indicus Cuvier, 1798) in Myanmar and Thailand. The present study was undertaken on morphological identification of some specimens of fly larvae which were recovered from the warbles detected on the skin of captive Indian elephants at the Nameri National Park and Kaziranga National Park both situated in the state of Assam, India. The larval specimens were whitish to creamy white in colour and body conformation varied from cylindrical to barrel shaped depending on their measured size (Av 6.12 ± 0.28 × 2.35 ± 0.12 mm). Microscopic examination of processed larvae revealed presence of numerous single pointed spines uniformly distributed on entire body surface, well developed mouth hooks and cephalopharyngeal skeleton at the anterior end and posterior spiracles each with lightly sclerotized peritreme enclosing three short and straight respiratory slits. Based on geographical distribution of the fly, host relation, larval parasitism and morphological characters, the larvae were determined as of the genus Elephantoloemus which is represented by E. indicus as the only species described so far. This finding seems to be the first record in India after its report from Myanmar and Thailand.

Severe Vaginal Myiasis: Successful Management With Ivermectin

Myiasis refers to infestation of living animals or humans by maggots, or fly larvae. Urogenital myiasis is a rare condition that is linked to poor sanitary conditions and limited access to healthcare and with few published case reports. Here, we describe the case of a sixty-seven year old homeless woman with multiple comorbidities who presented with extensive vaginal myiasis requiring inpatient management with ivermectin, ceftriaxone and metronidazole, and daily larvae extraction and debridement. The relevance of this case is providing a report of a successful management with ivermectin of a case of severe vaginal myiasis. Severe cases of vaginal myiasis can require repeated debridement of necrotic tissue and systemic antibiotics in addition to antiparasitic medication. People living under poor sanitary conditions and with poor hygienic practices are at increased risk of presenting it.

External Ophthalmomiasis Cases in Şırnak

Dermatological cases caused by myiasis make up approximately 20% of travel diseases. Ocular involvement occurred in approximately 5% of these myiasis cases. The conjunctival involvement of Oestrus ovis (O. ovis) larvae, which is the active agent in most ocular infestation cases in humans, causes external ophthalmomyiasis. External ophthalmomyiasis was diagnosed because of O. ovis first-stage larvae that were removed from the conjunctiva of three patients who applied to the Şırnak State Hospital Eye Clinic with complaints of foreign body sensation, burning, stinging, watering, and redness in the eyes and swelling of the eyelids in July and October. All symptoms of the patients disappeared within a few days after the removal of the larvae. Ophthalmomyiasis due to O. ovis must be kept in mind in the differential diagnosis of patients presenting with similar eye complaints in areas where sheep and goat husbandry is performed intensely.

Point-of-care ultrasound utilized for foreign body in a toe: A case report of botfly larvae

BACKGROUND

Myiasis, as defined by the Centers for Disease Control and Prevention, is infection with fly larvae commonly occurring in tropical and subtropical areas. Whereas the presentation of skin infection with organisms such as Dermatobia hominis (human botfly) is more easily recognized in these regions, identification of myiasis in the United States is difficult due to its rarity. Due to unspecific signs and symptoms, myiasis may initially be mistaken for other conditions, like cellulitis.

CASE REPORT

This case details a patient with pain, swelling, drainage, and erythema of the right second toe. The patient recently returned from Belize and reported an insect bite to the area approximately 1 month prior. She had been seen by health care professionals twice prior to presenting to our Emergency Department (ED) due to increasing pain. At those visits, the patient was prescribed antibiotics, failing to improve her symptoms. In the ED, point-of-care ultrasound (POCUS) of the soft tissue was performed and showed evidence of a foreign body consistent with cutaneous myiasis. Given the patient's history of travel to Belize and known insect bite, it is prudent to have an increased suspicion for cutaneous myiasis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To prevent a delay in diagnosis and unnecessary antibiotics, clinicians should have a high level of suspicion for botfly if a patient reports recent travel in an endemic region and pain disproportionate to an insect bite. POCUS contributes to a more efficient recognition of the disease.

Myiasis in Ulcerated Breast Carcinoma: First Case Record in Myanmar

Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.

A Rare Case of Oral Myiasis Caused by Phormia regina (Meigen) (Diptera: Calliphoridae) in an Intubated Patient

Myiasis is the infestation of tissues with living larvae. Oral myiasis is an extremely rare form of the disease, with open mouth, unconsciousness, and poor oral hygiene being the predisposing factors. It is generally observed in the tropics or subtropics, as well as rural places with low socio-economic income. Mechanical removal and ivermectin are frequently used as treatments. Herein, we present a case of oral myiasis in a 69-year-old male intubated patient with myocardial infarction. Multiple larvae were observed in the mouth and mechanically removed. With the microscopic investigation, the larvae were identified as Phormia regina (Meigen) (Diptera: Calliphoridae), which is extremely rare globally. For preventing oral myiasis, good patient care, good sanitary practice for oral health, efficient treatment of dental diseases, and fly population control, usage of masks for the risk groups are recommended.

Feline ophthalmomyiasis externa caused by Cuterebra larvae: four cases (2005-2020)

CASE SERIES SUMMARY

Described are four cats diagnosed with ophthalmomyiasis externa caused by Cuterebra larvae. Medical records were retrospectively reviewed to identify cats with ophthalmomyiasis externa between 2005 and 2020 at Cornell University Hospital for Animals. Signalment, history, clinical and diagnostic findings, treatment and outcome were recorded. All cats were young (< 3 years of age), had outdoor access and were initially examined during the summer months. All cases had unilateral disease with the right eye affected. Two cases had nictitating membrane lesions and two had orbital disease. Concurrent superficial corneal ulceration was present in three cats. Two cats suffered from pyrexia, suspected secondary to inflammation from the larval infestation. Successful larval removal was performed in all cats, which resulted in improvement of discomfort and clinical signs. A corneal ulcer persisted in one cat, which was lost to follow-up prior to ulcer resolution. Parasite identification confirmed Cuterebra species infestation in all cases.

RELEVANCE AND NOVEL INFORMATION

To the authors' knowledge, this is the first report of feline ophthalmomyiasis externa caused by Cuterebra species. Parasite removal was successful in restoring comfort and resolving clinical signs in all cats with adequate follow-up information.

A Rare Case of Oral Myiasis Caused by Lucilia sericata in an Intubated Patient from Southeast Turkey

The infestation of human and animal tissues or organs by the larvae of flies is collectively termed as myiasis. The occurrence of oral myiasis is analogously low compared with cutaneous myiasis as oral tissues are not habitually exposed to the external environment. Oral myiasis predominantly affects the periodontium, buccal and/or palatal mucosa, lips, and tongue. The prevalence of myiasis is substantially higher in tropical and subtropical regions, especially in developing countries. This research adduces a case of oral myiasis related to palatal gingiva in a young boy who was intubated due to pneumonia.

Aspiration as a Novel Technique to Address Facial and Periocular Myiasis

Suction aspiration, which has not yet been described in the treatment for myiasis in the periorbital and facial regions, was used to achieve rapid resolution of maggot burden in a 78-year-old patient who presented with a large ulcerated squamous cell carcinoma of the face. This technique also facilitates submission of parasite samples for further analysis. Suction aspiration had no complications, such as significant residual ruptured maggots in the wound or eye injury. Suction aspiration is a safe and efficient technique to reduce maggot burden that has advantages over classic myiasis treatments, especially near the eyes and airway.

Characterization of New Molecular Markers of Three Botflies Parasitizing Cervid Hosts

Specific identification of oestrid larvae is usually problematic not only when using morphobiometric features, but also when applying molecular criteria, since very few molecular markers have been described for this group of flies. New molecular markers for oestrid are needed for more reliable species identification, diagnostic purposes, and epidemiological surveys; moreover, they can help in phylogenetic reconstruction. Here, we report the characterization of COI, 28S rDNA, ITS1, and ITS2 in Cephenemyia stimulator from roe deer and in Cephenemyia auribarbis and Pharyngomyia picta from red deer. The COI and 28S rDNA are very uniform in length, while the ITSs sequences are highly variable at both intraspecific and interspecific levels. The described ITSs sequences were longer than those described for other dipteran species by the presence of simple repeats and tandem repeat sequences. In C. auribarbis both ITS1 and ITS2 appeared as two variants, one short and the other long. In general, the analyzed markers present low intraspecific genetic variation and high interspecific variation. ITSs showed the greatest amount of intraspecific and interspecific variation. Phylogenetic analysis demonstrated that the characterized sequences differentiate the species and genera of Oestridae.

Rabbit Bot Fly Furuncular, Tracheopulmonary, and Human Bot Fly Infestations in Connecticut (Oestridae: Cuterebrinae)

Endemic and tropical human bot infestations are relatively uncommon or unreported in the United States. We report two cases in Connecticut: an unusual furuncular and respiratory myiasis by the rabbit bot Cuterebra buccata (Fab.) (Diptera: Oestridae) in a 74-yr-old male and a case of human bot fly, Dermatobia hominis (L.) (Diptera: Oestridae), myiasis in a 4-yr-old female with a tropical travel history with her family. Identification of C. buccata was based morphologically, in part, on spinal armature and further corroborated by DNA sequencing of the mitochondrial COI gene and comparison to the National Center for Biotechnology Information GenBank DNA sequence database. The resulting annotated sequence data were deposited into the National Center for Biotechnology Information GenBank. The unique medical aspects, and limitations and specifics on bot fly larval habits and identification are discussed.

Accidental Nasal Myiasis Caused by Megaselia rufipes (Diptera: Phoridae) in a Child

A case of a nasal myiasis in a 3-yr-old Italian girl who was referred to Bambino Gesù Hospital in Rome, Italy, is reported. Larvae discharged with the nasal mucus were microscopically identified as Megaselia spp.; DNA barcoding analysis showed that they belonged to the 'scuttle fly' species Megaselia rufipes (Meigen). Based on the patient's history, she became infected when she played outside. This is the first report of myiasis in humans due to M. rufipes (Diptera: Phoridae).