[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.

The efficacy of fluazuron in the management of blowfly strike in sheep.

The blowflies Lucilia spp. and Chryomya spp. feature prominently as a leading cause of myiasis and production losses in sheep in South Africa. With chemical means of preventing and treating blowfly strike being a common manner of control, new molecules or formulations effective against blowfly strike are needed as resistance becomes more of a problem. For this study we evaluated the potential of topical application of fluazuron on sheep as an additional means to control blowflies. When pure fluazuron was applied to raw meat at the recommended dose for cattle, significant effects on adult fly development were observed. However when applied topically to post-mortally collected sheep pelts at the same dose rate, no significant effects were observed on larval repellence or larval development with fly development progressing as expected. A subsequent pharmacokinetic study showed virtually no systemic absorption together with significant wool binding. Despite demonstrating that fluazuron was effective against blowfly larvae, wool binding of the molecule preclude its use.

Effect of a novel juvenoid fenoxycarb on the pupal-adult transformation in the blowfly, Chrysomya megacephala (Fabricius, 1794) (Diptera: Calliphoridae).

Chrysomya megacephala (Fabricius, 1794) (Diptera, Calliphoridae) acts as a vector of many disease-causing pathogens. It causes myiasis in human beings and other living vertebrates. In the present study, the effect of a juvenile hormone analog (JHA), fenoxycarb, was evaluated on pupal-adult transformation by exposing pupae (0 and 1-day-old) of blowfly. Pupae were topically treated with different concentrations of the compound, viz., 20, 40, and 80 µg/µl applied on the posterior dorsum with the help of a micropipette. The effects comprised various developmental aberrations, such as delayed pupal-adult ecdysis duration, pupal mortality, formation of pupal-adult intermediates, eclosion failure, reduced adult emergence, and formation of abnormal adults. The freshly molted pupae (0 day) were more susceptible as compared to 1-day-old pupae. Pupal mortality was highest at 80 µg. Normal adult emergence was completely inhibited at day 0 pupae treated with 80 µg of the fenoxycarb. These results demonstrate that fenoxycarb was capable of successfully inhibiting the pupal-adult transformation, and thus, it can be used to control this myiasis-causing agent.

Psychoda albipennis myiasis as a rare cause of erectile dysfunction: A case report.

Urogenital myiasis occurring with the settlement of fly larvae of the order Diptera is facultative and is rarely encountered in humans. This study presents a case of urogenital myiasis caused by Psychoda albipennis in a 42-year-old male patient. The patient was admitted to our hospital with complaints of groin pain, pollakuria and erectile dysfunction and claimed that he saw motile larvae in his urine. Three larvae were collected from the patient's urine, microscopically examined and identified as fourth-stage larvae of P. albipennis. The patient's complaints ceased after the application of an antibiotic and urinary antiseptic. It was concluded that myiasis should be considered in patients with urogenital complaints.

Bloody Diarrhea Caused by Intestinal Myiasis in an Infant: A Case Report and Review of Pediatric Literature.

Intestinal myiasis caused by fly larvae parasitic in gastrointestinal tract was rare reported in children. We reported an infant with bloody diarrhea caused by intestinal myiasis. A 1 year and 7 months old boy presented with the only symptom of bloody diarrhea of unknown origin. In the second week of onset, numerous moving worms were observed in the bloody stool after bowel preparation with polyethylene glycol for colonoscopy. The bloody diarrhea disappeared after 1 week of combined therapy with albendazole and metronidazole. On follow-up after 6 months, the patient remained well without bloody diarrhea. In conclusion, intestinal myiasis being a rare disease that is very challenging to diagnose, physicians should remember it when they receive cases of bloody diarrhea with non-specific symptoms without any apparent cause.

Furuncular myiasis caused by Dermatobia hominis in five cats and efficacy of topical fluralaner for its treatment.

BACKGROUND: Dermatobia hominis (D. hominis) is a botfly that causes furuncular myiasis in several species of domestic and wild animals. However, reports of feline infestation by larvae of this dipteran are rare. OBJECTIVE: To report the natural occurrence of furuncular myiasis caused by D. hominis in five cats and the efficacy of topical fluralaner for its treatment. ANIMALS: Five adult mixed-breed cats (four males, one female) were diagnosed and treated, all living in the state of Rio de Janeiro, Brazil. RESULTS: The cats were treated with topical fluralaner. After this treatment, the larvae were dead after 24 h in three cats and after 48 h in two. There was spontaneous expulsion of larvae in two cats, and it was necessary to perform manual expression for removal of dead larvae in the other three cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Dermatobia hominis can cause furuncular myiasis in cats, although this appears to be less common than in other animal species. Topical fluralaner proved to be effective in the treatment of this parasitic disease.

High morbidity cutaneous enzootic myiasis by Dermatobia hominis (Diptera: Oestridae) in sambar deer (Rusa unicolor).

This study describes the first known occurrence and treatment of enzootic cutaneous myiasis by Dermatobia hominis in a herd of sambar deer (Rusa unicolor). Sambar deer are clinically affected by enzootic cutaneous myiasis during the spring and summer in Rio de Janeiro, Brazil. Through direct inspection and clinicopathological evaluation in the herd with 80 R. unicolor, it was observed that infestation by D. hominis caused 100% morbidity. At histological exam, skin had eosinophilic and granulomatous chronic active severe necrohemorrhagic dermatitis associated with botfly and moderate surrounding fibroplasia. The systemic treatment with oral ivermectin at 0.08% was effective in 93.7% of deer with enzootic cutaneous myiasis after fourteen days. After treatment, the skin deer had eosinophilic and granulomatous chronic severe dermatitis associated with degenerated botfly and severe fibroplasia. Notable differences in leukocyte profile were observed between groups pre- and post-treatment. Decrease of relative values of neutrophils and eosinophils were significant in the treated deer group. An increase of relative values of monocytes was also confirmed in the treated group. Sambar deer was the only species affected by D. hominis, even though several other wild herbivores were kept in the same area. More studies are needed to elucidate the susceptibility of R. unicolor to D. hominis cutaneous infestations.

[Urogenital Myiasis Caused by Psychoda spp. in Female Patient with No Risk Factor for Myiasis]. / Miyaz Için Risk Faktörü Bulundurmayan Bir Kadin Hastada Psychoda spp. Kaynakli Ürogenital Miyaz Olgusu.

Myiasis is defined as follows; some flies lay their eggs and larvae on live organs and tissues or on cavities of nose, eye, ear and etc of humans or animals and the larvae develop there and cause pathological disorders. One of the rare types of myiasis is the urogenital myiasis. This condition has been associated with covering urogenital area with clothes in almost all populations and therefore, less chance for flies to reach this site and lay their eggs. Low socio-cultural level and poor hygiene conditions are stated as the most important risk factors of myiasis. On the other hand, toilets within the human living spaces are ideal environments for fly larvae that are fed on bacteria as they contain moisture and a microbial environment. It is stated that especially in case of the presence of an underlying infection, flies are more prone to lay their eggs or larvae on this area due to the bad smell. In this case report, a patient with a moderate sociocultural level with no underlying chronic disease, no open wound in the genital area and no urinary tract infection was presented. A 53-year-old female patient living with her family in an apartment flat in the city center of Konya admitted to the outpatient clinic of infectious diseases with the complaint of moving worms in her urine. The patient stated that she had seen maggots while urinating for two weeks and that she passed her urine into a container to be sure that the maggots were coming from her urine, upon seeing the maggots there she has admitted to the hospital. The Larvae were defined as the fourth stage larvae of Psychoda spp. No open lesions or wounds were seen in genitourinary area of the patient who had no complaints other than mild urinary burning. Complete blood count test results of the patient were normal and there was no growth in her urine culture. It was stated that other family members whom she lived with did not have similar complaints. The patient was diagnosed as genitourinary myiasis caused byPsychoda spp. and informed about the relationship between hygiene and the disease. And urinary antiseptics were initiated as the treatment for the patient. After the treatment, no larvae were seen in the urine of the patient. In conclusion, many regions are suitable for Psychoda type of adult flies to live in our country due to the climate conditions. It is considered that infestation may develop in patients with less risk factors in terms of urogenital myiasis, that larvae may increase in number of patients who are not treated or followed up and that the infestation may become chronic and results in more serious clinical conditions. The necessary treatment and follow-up must be performed in such cases and the patients should be educated about the relationship between infestation and hygiene.

Pin-Site Myiasis Caused by Screwworm Fly in Nonhealed Wound, Colombia.

Pin-site myiasis is an underreported complication of surgical interventions. We present a case of myiasis caused by the New World screwworm fly (Cochliomyia hominivorax) in a pin site of a chronic nonhealed wound 12 years after the intervention. This infection apparently was the result of poor perfusion of the leg.

Tissue damage and cytotoxic effects of Tagetes minuta essential oil against Lucilia cuprina.

The blowfly Lucilia cuprina has great medico-sanitary and veterinary importance due to the ability of its larval form to develop in decaying organic matter, parasitizing vertebrates. Fly eradication is challenging and the essential oil (EO) of Tagetes minuta (TMEO) have been reported to have therapeutic properties. This study aimed to determine the activity of EO from the aerial parts of T. minuta against third instar larvae (L3) of L. cuprina. Groups of 20 L3 were placed on filter paper, which were impregnated with varying concentrations (0.19; 0.39; 0.79; 1.59; 2.38; 3.18; 4.77; and 6.36 µL/cm2) of TMEO solubilized in acetone, ethanol or Tween 20. Histological tissue damage of TMEO was measured in L3 after 24, 48 and 96 h of exposure. Dihydrotagetone (67.64%), trans-ocimene (16.23%), trans-tagetone (10.14%) and verbenone (2.98%) were obtained as major compounds of TMEO. Lethal concentrations of 50%, 24 and 48 h after TMEO exposure were 1.02 and 0.73 µL/cm2 for acetone; 3.37 and 1.75 µL/cm2 for ethanol; and 7.46 and 6.11 µL/cm2 for Tween 20, respectively. TMEO had a significant L3 mortality of 96.6% in acetone, 48 h after contact. Cuticle abnormalities were observed, as well as the loss of digestive tract architecture and vacuolization in fat bodies. TMEO presented time and concentration-dependent effects against L. cuprina. As our study demonstrated a strong insecticide activity of TMEO, we consider that it could be developed into an ecofriendly product against L. cuprina.

A formulation of neem and hypericum oily extract for the treatment of the wound myiasis by Wohlfahrtia magnifica in domestic animals.

Untreated, traumatic, or wound myiases can cause severe consequences to animal health and welfare as well as economic losses to livestock productions. For healing myiasis-caused wounds, disinfectant such as creolin is wrongly but currently used in association with insecticides. Though effective, creolin is highly toxic to the patients, is inadequate with respect to the repellent effect, and may delay the healing of treated wounds. In this uncontrolled study, the efficacy of the patented plant-derived formulation 1 Primary Wound Dressing© (1-PWD), composed of neem oil (Azadirachta indica A. Juss.) and the oily extract of Hypericum perforatum (L.) flowers, has been investigated. Forty-four domestic animals of different species suffering from wound myiasis lasting for up to 25 days, at different parts of the body, were enrolled in the study. No systemic or local antibiotic or disinfectants' treatment was administered. Larvae recovered on open wounds and adults reared from mature larvae were identified as Wohlfahrtia magnifica. All the treated wounds healed in a range of 10 to 32 days without further infestation. None of the recruited animals presented bacterial complications. Data herein presented indicate that the tested natural plant-derived formulation is able to manage the infestation caused by W. magnifica larvae and the healing process of traumatic infested wounds in several domestic animal species, without any side effect on the living tissue and without the need to use local or systemic chemical or other products.

First report on nasal myiasis in an alpaca "Vicugna pacos" - a case report.

BACKGROUND: An infestation of bot fly larvae causes myiasis which is known to cause respiratory symptoms in ruminants. There are reports of bot fly larvae in llamas, but to our knowledge there are no previous reports of nasal myiasis due to bot flies in alpacas ("Vicugna pacos"). CASE PRESENTATION: The following case report describes a neutered male alpaca showing sneezing and mild nasal discharge. Endoscopic examination of the upper respiratory tract revealed bot fly larvae in one nostril. After treatment with doramectin, there was no evidence of living bot fly larvae visible in the nostril. CONCLUSION: Bot fly larvae should be considered as a potential cause of respiratory symptoms in alpacas. In the present case, a treatment with doramectin was successful.

Oral Myiasis in a Patient With HIV Manifestations and Neurologic Toxoplasmosis Treated by Ivermectin.

Myiasis has been defined as a pathologic condition where dipterous larvae are lodged in mammalian hosts causing an infestation, which feeds on living or dead tissue for at least a certain period inside the host and develops itself as parasites. In humans, the most commonly affected sites are the nose, eyes, skin wounds, sinuses, lungs, ears, gut, gall bladder, vagina, nasal cavities, and rarely the mouth because the oral tissues are rarely exposed to the external environment. The etiology of oral myiasis is usually related to local factors such as poor oral hygiene, periodontal disease and labial incompetence, and systemic factors such as neurologic deficits.

[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.

RETROSPECTIVE EVALUATION OF A NOVEL SUSTAINED-RELEASE IVERMECTIN VARNISH FOR TREATMENT OF WOUND MYIASIS IN ZOO-HOUSED ANIMALS.

Myiasis is a major disease condition in human and veterinary medicine. Domestic, free-ranging, and zoo-housed animals can be severely affected by myiasis. Depending on case severity, multiple treatment episodes may be indicated and can lead to recurrent capturing, handling stress, and anesthetics, all of which increase the risk of adverse responses (including death) individually and also in the herd. As an insecticide, ivermectin is often used for larval control. A total of 28 individual myiasis cases were retrospectively evaluated, out of which 11 cases were also treated using an ivermectin sustained-release varnish (SRV). The clinical outcome of all cases was assessed and the results suggest that the use of a topical ivermectin SRV (with or without concurrent injectable ivermectin) can reduce handling and treatments, has no adverse effects, and has minimal recurrence of the disease when compared with cases treated without it.

Chrysomya bezziana (Diptera: Calliphoridae) infestation: case report of three dogs in Malaysia treated with spinosad/milbemycin.

BACKGROUND: Infestation of wounds with the larvae of Callophorid flies is relatively common in countries where these parasites are found. The most common species associated with infections in Southeast Asia is Chrysomya bezziana (Ch. bezziana), the Old World screw worm. Treatment consists of either subcutaneous injection of ivermectin or oral administration of nitenpyram combined with aggressive tissue debridement under general anaesthesia. OBJECTIVES: To describe the treatment of cutaneous myiasis in three dogs caused by the larvae of Ch. bezziana in Malaysia and their treatment with spinosad plus milbemycin. RESULTS: In all dogs, a single oral dose of spinosad plus milbemycin at the recommended dosage of 31-62 mg/kg and 0.5-1.0 mg/kg, respectively, was able to kill all larvae within 8 h. Most dead larvae fell off the host and those remaining on the host were dead and easily removed with simple saline flushing and gentle debridement. Neither general anaesthesia nor aggressive mechanical debridement were needed in any patient. CONCLUSIONS AND CLINICAL IMPORTANCE: Oral spinosad plus milbemycin is a safe, licensed and effective treatment at the recommended dose for the rapid elimination of Ch. bezziana myiasis, with no need for sedation or anaesthesia.

[Cutaneous myiasis due to Cochliomyia hominivorax associated with seborrheic dermatitis]. / Miasis cutánea por Cochliomyia hominivorax asociada a dermatitis seborreica: Case report.

Myiasis is an infestation of tissues and organs of humans and animals by Diptera larvae (flies, horseflies, mosquitoes). They are located at different body sites, and classified clinically as cutaneous, visceral and cavitary. We report a 26-year-old woman with a history of seborrheic dermatitis and recent trip to Brazil. She presented with a seven days history of suppurating wounds in the parieto-occipital area of the scalp. At physical examination we found three ulcers of approximately 1.5 cm each, with multiple mobile larvae inside. The obtained larvae were analyzed, identifying Cochliomyia hominivorax larvae at L2 and L3 stages. The patient was managed successfully with oral antimicrobials and local cleansing. The screwworm Cochliomyia hominivorax in our country is rare. Known risk factors are wounds, poor personal hygiene, extreme ages, psychiatric disorders, presence of specific dermatosis such as psoriasis and seborrheic dermatitis, among others.

An Unexpected Guest: A Case of Cutaneous Furuncular Myiasis: The 2013 PEMpix Photo Competition Winner.

Dermatobia hominis, also known as the botfly, is a parasitic infestation commonly found in Central and South America. In humans, this usually presents as cutaneous furuncular myiasis, after the larvae become embedded in the skin. This produces a local inflammatory reaction, which may mimic cellulitis; however, definitive treatment requires removal of the botfly larvae. This infestation is uncommon in the United States but should remain high on the differential diagnosis of returning travelers presenting with cutaneous lesions, as seen in the reported case of a teenager after return from Central America.

Clinical applications of topical ivermectin in dermatology.

Ivermectin (IVM) is a broad-spectrum anti-parasitic drug with significant anti-inflammatory properties. The emergence of treatment resistance to lindane, permethrin, and possibly malathion complicates the global strategy for management of common parasitic skin diseases such as scabies and head lice. In this regard. IVM has been safely and effectively used in the treatment of these common human infestations. In addition, IVM may be useful in inflammatory cutaneous disorders such as papulopustular rosacea where demodex may play a role in pathogenesis. Herein, we review the current applications of topical IVM in dermatology.

The first imported human infestation with Furuncular myiasis in man in the Slovakia and current knowledge of myiasis.

INTRODUCTION: Furuncular myiasis is caused by the genus of botfly Dermatobia hominis. It belongs to the family Cuterebridae and is indigenous to Central and South America. OBJECTIVE: to present a case report of the first case of this disease in Slovakia. CURRENT STATE OF PROBLEM SOLUTION: The term myiasis refers to infestation of the host (animal, man) by botfly larvae. Its larvae burrow under the skin. They feed on the host's living tissues and fluids. MateriAl and methods: Patient's history analysis, parasitological examination. RESULTS: A 58-year-old woman after returning from Central America found in the skin above her m. gluteus mayor 2 indurations, which contained three botfly larvae. DISCUSSION: Infestation with botfly larvae Dermatobia hominis is for man annoying and from a health point of view dangerous. CONCLUSION: With proper diagnosis, it is possible to remove the larvae safely from furuncles. The authors point to the first case of imported infestation with Furuncular myiasis caused by botfly Dermatobia hominis in man introduced to Slovakia. They note that increasing tourism spread to the countries with the endemic occurrence of Furuncular myiasis will cause its higher prevalence also in Central European countries (Fig. 5, Ref. 45).