Effects of Gasterophilus pecorum infestation on the intestinal microbiota of the rewilded Przewalski's horses in China.

Horse botflies have been a threat to the Przewalski's horses in the Kalamaili Nature Reserve in Xinjiang of China since their reintroduction to the original range. As larvae of these parasites could infest the intestine of a horse for months, they could interact with and alter the structure and composition of its intestinal microbiota, affecting adversely its health. Nonetheless, there are no such studies on the rewilded Przewalski's horses yet. For the first time, this study characterizes the composition of the intestinal microbiota of 7 rewilded Przewalski's horses infected severely by Gasterophilus pecorum following and prior to their anthelmintic treatment. Bioinformatics analyses of the sequence data obtained by amplicon high throughput sequencing of bacterial 16S rRNA genes showed that G. pecorum infestation significantly increased the richness of the intestinal microbial community but not its diversity. Firmicutes and Bacteroidetes were found the dominant phyla as in other animals, and the parasitic infestation decreased the F/B ratio largely by over 50%. Large reduction in relative abundances of the two genera Streptococcus and Lactobacillus observed with G. pecorum infestation suggested possible changes in colic and digestion related conditions of the infected horses. Variations on the relative abundance of the genus groups known to be pathogenic or symbiotic showed that adverse impact of the G. pecorum infestation could be associated with reduction of the symbiotic genera Lactobacillus and Bifidobacterium that are probiotics and able to promote immunity against parasitic infection.

[Myases from here and elsewhere†: pseudo-furonculosis and Ignatzschineria larvae bacteremia]. / Myiases d'ici et d'ailleurs†: pseudo-furonculose et bactériémie à Ignatzschineria larvae.

Myiasis is an infestation by maggots. In humans, it predominates in regions with low socio-economic development. We report on two cases of myiasis acquired during a tropical travel and in Switzerland, respectively. The first one presented as a furunculous-like disease due to the invasion of subcutaneous tissues by Cordylobia sp. larvae. The second corresponded to a chronic wound infestation that resulted in a rarely reported bacteremia due to Ignatzschineria larvae, a commensal bacteria of maggots' digestive tract. Surgery was necessary in both cases, mainly for psychological reasons in the first case. Both the entomologist and molecular biology were instrumental for treatment decisions.

La myiase est une infestation par des larves de mouches. Chez l'homme, elle prédomine dans les régions à faible niveau socio-économique. Nous rapportons ici deux cas de myiase, l'un acquis lors d'un voyage sous les tropiques et l'autre autochtone : une myiase furonculaire due à la pénétration d'une larve de diptère dans la peau, en l'occurrence Cordylobia sp. ; et une myiase de plaie survenue par ponte de mouches dans des tissus nécrotiques, avec une exceptionnelle bactériémie secondaire, due à une bactérie commensale du tractus digestif de ces larves, Ignatzschineria larvae. Dans les deux situations, la chirurgie a été nécessaire, pour une indication surtout d'ordre psychologique dans la première. Dans les deux cas, l'apport de l'entomologiste et de la biologie moléculaire a été déterminant dans la décision thérapeutique.

Furuncular myiasis in Italian traveler returning from Kenya.

Myiasis has been defined as the infestation of organs and/or tissues with dipterous larvae. They are especially widespread in tropical and subtropical areas. Cutaneous myiasis is its most frequent clinical presentation. This report presents a case of furuncular myiasis caused by the larva of Cordylobia anthropophaga in a 22-year-old girl living in Bergamo, Northern Italy, who returned from Kenya (Watamu) with a big, painful furuncle in her right gluteus. The patient accidentally removed the larva from a large pimple and took it to the infectious disease ambulatory clinic at the ASST "Papa Giovanni XXIII" Hospital, Bergamo. In the Microbiology and Virology Department of the same hospital, a larva of C. anthropophaga was identified and the diagnosis of myiasis was confirmed.

Myiasis-induced sepsis: a rare case report of Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica bacteremia in the continental United States.

RATIONALE: The presentation of sepsis and bacteremia in cutaneous and cavitary myiasis is uncommon. We present a patient, residing in a temperate region of the United States, with myiasis and sepsis from the emerging human pathogens Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica. PATIENT CONCERNS: A 37-year-old male patient with an 8-month history of chronic lymphedema and ulcers of the lower left extremity presented with myiasis of the left foot and leg. The patient was initially seen by his family practitioner many times and was prescribed antibiotics which he could not afford. Debridement of the myiasis was not conducted by the family practitioner due to the belief that the patient's current state of myiasis would effectively debride and eventually heal the chronic ulcers along with multiple antibiotic regimens. Over the 8-month period, the patient developed a progressive, painful, necrotizing infection of his lower left extremity. DIAGNOSES: Physical examination clearly showed myiasis of the patient's lower left extremity, believed to be caused by Lucilia sericata (green bottle fly). Blood cultures revealed the presence of Providencia stuartii, W chitiniclastica, and I indica to be the underlying cause of sepsis and bacteremia. INTERVENTIONS: All visible maggots were extracted, debridement of devitalized tissue was performed, and the leg ulcers were wrapped in pH neutral bleach. The patient was initially treated with a broad-spectrum antibiotic regimen of vancomycin, clindamycin, piperacillin, and tazobactam which, following clinical improvement, was de-escalated to cefepime. OUTCOMES: The fly larvae and maggots were removed from the extremity by scrubbing, pulse lavage, and filing away the callused tissue. Additionally, the patient's sepsis and bacteremia, caused by W chitiniclastica and I indica, were successfully treated through antibiotic intervention. Amputation was avoided. LESSONS: The use of pulse lavage and chlorhexidine-soaked brushes for the removal of cavitary myiasis is an effective and minimally invasive procedure which does not cause additional damage to surrounding tissue. W chitiniclastica and I indica are emerging bacteria that have known association to parasitic fly myiasis in humans and are capable of causing sepsis and/or bacteremia if not accurately identified and treated promptly.

[Case of pneumonia associated sepsis accompaning pulmonary myiasis]. / Pulmoner miyazisin eslik ettigi pnömoniye bagli sepsis olgusu.

Myiasis; is defined as the infestation of dead or living tissues of humans and animals by the diptera larvae. It is prevalent all over the world, especially in tropical and subtropical countries with low socioeconomic status. Myiasis of humans has been associated with low socioeconomic status, alcoholism, mental or neurological diseases, poor personal hygiene, patients with varicose veins, diabetes, malnutrition, advanced stage cancer, pediculosis, immunosuppression, sexually transmitted disease, gingivitis and other oral cavity lesions. Myiasis is most commonly seen as skin invasion in the human body, but can be observed in many areas such as eye, ear, nose, throat, urogenital, intestinal, cerebral and tracheopulmonary. Tracheo pulmonary myiasis is a very rare condition. This report presents a case of pneumonia-associated sepsis in a patient with a tracheostomy accompanied by third-stage larval Sarcophagidae. A 51-year-old male patient developed hypoxic brain injury after myocardial infarction 10 months ago before his admission to the hospital. Tracheostomy and percutaneous endoscopic gastrostomy were performed. Shortness of breath and fever were present for five days. The patient has been admitted to the emergency service with the reason for the deterioration of the general situation. The patient was unconscious. Purulent secretion in the tracheostomy area and bilateral crepitation rales in the lung bases were detected. Leukocyte level was normal with C reactive protein (CRP) 14 mg/dl. Nodular infiltration was detected bilaterally in the middle and lower zones, more prominently in the right thoracic computerized tomography. Seftriaxon, moxifloxacin and fluid therapy were initiated in the patient who was admitted with pneumonia-related sepsis diagnosis. The tracheostomy cannula has changed. On the fourth day of admission, Sarcophagidae third stage larvae were detected in deep tracheal aspiration. Treatment of piperacillin/tazobactam and teicoplanin was started by discontinuing the current antibiotherapy of the patient who had no clinical response and elevated CRP level, 18 mg/dl. The patient was discharged on the 25th day of hospitalization with improved clinical and laboratory responses. Complete healing was observed in the control performed by the home care unit. Bed-dependent, lack of self-care, and poor tracheostomy hygiene were risk factors for this patient. In this case, fluid therapy and antibiotic treatment for sepsis was given but no treatment for myiasis. Larva has been considered to have prepared a base for pneumonia due to the foreign body effect and secretion accumulation. Untreated injuries, especially those with impaired oxygenation, leave the eggs of adult flies and provide a suitable environment for larval development. Therefore, should be given importance to combat with flies and regular tracheostomy care in bedside and tracheostomized patients.

Primer reporte de pseudomiasis intestinal humana por Eristalis tenax (Diptera, Syrphidae) en zona semiárida urbana del estado Falcón, Venezuela / First report of human intestinal pseudomiasis by Eristalis tenax (Diptera, Syrphidae) in urban semiarid area from Falcon state, Venezuela

Pseudomiasis es el término empleado cuando se considera que las larvas y/o huevos de moscas se adquieren accidentalmente per os y atraviesan con inmediatez a lo largo del tracto digestivo. Se documenta un caso de una pseudomiasis intestinal por larvas de Eristalis tenax (Diptera: Syrphidae) en una paciente femenina de 39 años de edad, proveniente de un sector periférico de la ciudad de Coro, estado Falcón, Venezuela. La paciente observó inmediatamente la presencia de la larva viva en sus heces. Aunque refirió sufrir eventualmente de cólicos, al examen físico se presentó normal. La paciente aparentemente no sufre de trastornos mentales, y posee un nivel socioeconómico bajo. El presente trabajo constituye el primer reporte documentado de una pseudomiasis entérica por E. tenax en la zona semiárida del estado Falcón, en la región nor-occidental de Venezuela.

Pseudomyiasis is the term used for the accidental entrapment of swallowed fly maggots and/or eggs immediately passing through the digestive tract. We report a case of intestinal pseudomyasis caused by the larvae of the cosmopolitan drone fly Eristalis tenax (Diptera: Syrphidae) in a 39 year old woman, resident in a suburban sector from Coro city, Falcon state, Venezuela. The patient immediately noticed a living larva in her stool. Although patient referred eventually became colic, her physical examination was normal, with no mental disturbance. She was in a low socioeconomic level. This is the first report of an enteric pseudomyasis by E. tenax in the semiarid zone of Falcon state, in the northwestern region of Venezuela.

Miasis cutánea: reporte de un caso y revisión de la literatura / Cutaneous myiasis: case report and review of the literature

Se denomina miasis a la patología ocasionada por la infestación de larvas de moscas en el hombre, la cual puede presentar cuadros de gran severidad al producir lesiones cutáneas destructivas e invasivas. Se presenta el caso de una paciente de 30 años de edad, que adquirió la larva de Dermatabia hominis en la zona selvática del departamento de Cusco; además se describe el ciclo biológico del patógeno, las características clínicas de la enfermedad y opciones terapéuticas.

Myiasis is a disease caused by fly larvae infestation in humans, which could be severe, producing destructive and invasive skin lesions. We present the case of a 30 years-old female patient, who got infected by Dermatobia hominis larva in Cusco's jungle area; we also describe the life cycle of the pathogen, the clinical features of disease and treatment options human fly vital cyele, clinical features and treatment options.

Cutaneous human myiasis due to Dermatobia hominis / La miasis cutánea humana debido a Dermatobia Hominis

This is a case report of cutaneous myiasis due to Dermatobia hominis in a female physician who had travelled to Belize. Cutaneous myiasis is endemic in Central and South America but is seldom reported from the Caribbean islands.

Éste es un reporte de caso de miasis cutánea debido a Dermatobia hominis en una mujer médico que había viajado a la Belice. La miasis cutánea es endémica en América Central y América del Sur, pero rara vez se reporta en las islas del Caribe.

Cutaneous human myiasis due to Dermatobia hominis.

This is a case report of cutaneous myiasis due to Dermatobia hominis in a female physician who had travelled to Belize. Cutaneous myiasis is endemic in Central and South America but is seldom reported from the Caribbean islands.

Nasal myiasis in an intensive care unit linked to hospital-wide mouse infestation.

A large city hospital experienced an infestation of mice combated in part by broadcasting poisoned baits. Months later there was an invasion of flies into the hospital, and 2 comatose patients in an intensive care unit contracted nasal maggots. Adult flies were trapped and maggots removed from the nares of the second patient. These were identified as the green blowfly (Phaenicia sericata). Recent downsizing of hospital personnel had led to the unintended and unrecognized loss of housekeeping services in the canteen food storage areas. A mouse infestation of the hospital occurred, with the epicenter in the canteen area. This was initially addressed by scattering poisoned bait and using rodent glue boards. The result of such treatment was the presence of numerous mouse carcasses scattered throughout the building attracting the green blowfly. Adult gravid female flies trapped in the new intensive care unit (where mice were not present) laid eggs in the fetid nasal discharge of 2 comatose patients. Live trapping of mice and removal of carcasses led to an abatement of the fly infestation. The cause-and-effect nature of the mouse carcasses and flies was underscored a year later when an outbreak of P. sericata occurred in the operating department and was linked to the presence of mouse carcasses on glue boards not removed the previous fall. Hence, the disruption or loss of 1 vital link in hospital organization (in this case, housekeeping support) may lead to an unintended and bizarre outcome.

Fly-attracting volatiles produced by Rhodococcus fascians and Mycobacterium aurum isolated from myiatic lesions of sheep.

Bacterial strains isolated from the healthy breech mucosa and myiatic wounds of ewes were tested for their volatile production as fly attractants towards Wohlfahrtia magnifica (Diptera: Sarcophagidae). Cultures were studied as fly baits in field experiments, and strains performing with the best chemotropic effect were selected for further analysis. Static and dynamic headspace samples from shaken cultures were examined by gas chromatography-mass spectrometry (GC-MS). Strains identified as Rhodococcus fascians and Mycobacterium aurum produced various volatile sulfur compounds and benzene, and proved to be the best fly attractants.

Chronic ulcers and myasis as ports of entry for Clostridium tetani

Evaluating tetanus immune status is not yet the usual clinical practice regarding patients with chronic ulcers or myasis. However, of 858 tetanus patients at Hospital Couto Maia (Salvador, Bahia, Brazil) aged 1 year or above, 2 had pressure ulcers and 17 had chronic ulceration of the lower limbs where these skin lesions were the ports of entry for Clostridium tetani. In these 19 cases, the following predisposing factors were described: venous insufficiency (n=6), sickle cell anemia (n=2), Hansen s disease (n=1), malnutrition (n=1), diabetes mellitus (n=1), trauma (n=1) and unknown factors (n=7). In 6 other cases, in addition to the Hansen s disease patient, the port of entry for tetanus was the site of extraction of Tunga penetrans larvae. In these 25 cases, the majority of patients (68) were over 40 years old (17/25) and all of these patients stated that they had either not followed a tetanus toxoid vaccination regimen (19/25), or had partially completed such a regimen, or did not give precise information (6/25). Among the same series studied, over half (52) of the patients died (13/25). We conclude that tetanus prevention must be included in the treatment of chronic skin ulcer patients, vaccination coverage should be increased among older people, and strategies aimed at improving coverage for all age groups must be reviewed.

Chronic ulcers and myasis as ports of entry for Clostridium tetani.

Evaluating tetanus immune status is not yet the usual clinical practice regarding patients with chronic ulcers or myasis. However, of 858 tetanus patients at Hospital Couto Maia (Salvador, Bahia, Brazil) aged 1 year or above, 2 had pressure ulcers and 17 had chronic ulceration of the lower limbs where these skin lesions were the ports of entry for Clostridium tetani. In these 19 cases, the following predisposing factors were described: venous insufficiency (n=6), sickle cell anemia (n=2), Hansen s disease (n=1), malnutrition (n=1), diabetes mellitus (n=1), trauma (n=1) and unknown factors (n=7). In 6 other cases, in addition to the Hansen s disease patient, the port of entry for tetanus was the site of extraction of Tunga penetrans larvae. In these 25 cases, the majority of patients (68%) were over 40 years old (17/25) and all of these patients stated that they had either not followed a tetanus toxoid vaccination regimen (19/25), or had partially completed such a regimen, or did not give precise information (6/25). Among the same series studied, over half (52%) of the patients died (13/25). We conclude that tetanus prevention must be included in the treatment of chronic skin ulcer patients, vaccination coverage should be increased among older people, and strategies aimed at improving coverage for all age groups must be reviewed.

Bacteriological investigations on wound myiasis of sheep caused by Wohlfahrtia magnifica (Diptera: Sarcophagidae).

The aim of the present investigation was to get further information about obligate aerobic and facultatively anaerobic bacterial communities of the intact and Wohlfahrtia magnifica infested vulval region of sheep. The numbers of aerobic and facultatively anaerobic microorganisms were lower in samples taken from uninfested mucous membrane and myiatic wounds as well as in the wound fluid as compared to samples originating from the uninfested skin surface. Gram-negative bacteria belonging to the family Enterobacteriaceae were isolated only from the skin and mucous membrane of uninfested sheep. Gram-positive microorganisms dominated in all samples. The ratio of facultatively anaerobic bacteria was higher than 80% in the sample taken from a lesion containing third instar Wohlfahrtia larvae and in the wound discharge collected from a vulval wound free of maggots. It is suggested that there is a shift in the composition of the bacterial communities of vulva as staphylococci disappear from the wounds due to the presence of Wohlfahrtia larvae.

Isolation and identification of bacteria associated with the screwworm fly Cochliomyia hominivorax, coquerel and its myiasis.

We studied eight different myiasis of sheep caused by screwworm flies under laboratory conditions. Swabs were taken from the wound, before, during, and after the myiasis. Seven hundred and thirty-one samples were streaked on different bacteriological media. All samples were identified by Api System (bioMerieuex). We found thirty-eight different bacterial species in the exudates from the myiasis (before, during, and after the parasitic cycle). The analysis of bacterial flora of the screwworm showed, on larvae stage 1, 10 different bacterial species, on larvae 2, 12 bacterial species; larvae 3, 15 bacterial species; crawl off, 15 bacteria species, pupa, 9 bacterial species; and adults, 2 bacterial species and on the pioneer fly, 14 different bacterial species were isolated and identified.