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.

PCR Positivity of Gerbils and Their Ectoparasites for Leishmania Spp. in a Hyperendemic Focus of Zoonotic Cutaneous Leishmaniasis in Central Iran.

Background: Various arthropods, including Rhipicephalus sanguineus and Ctenocephalides felis felis have been suggested as secondary vectors of Leishmania spp. many years ago. This study was conducted to determine zoonotic cutaneous leishmaniasis (ZCL) PCR positivity of reservoir hosts and their ectoparasites for Leishmania spp. in Segzi plain in Esfahan Province from October 2016 to October 2017. Methods: Microscopic examination and nested PCR were used to detect and identify Leishmania spp. isolated from rodents' ears and ectoparasites, and then, the results were confirmed by two methods, PCR-restriction fragment length polymorphism and sequencing. Results: Totally, 93 rodents (92 Rhombomys opimus and one Nesokia indica) and nine different species of ectoparasites (n=527) including fleas, mites, and ticks were collected during different seasons in the study area. Fourteen R. opimus were positive for Leishmania spp. by microscopic examination while one N. indica and 77 R. opimus were positive by nested PCR. The infection rate of rodents with Leishmania major and Leishmania turanica was 39.79% (n=37) and 15.05% (n=14), respectively. Mixed natural infections with L. major and L. turanica were seen in rodents. Moreover, 72.22% of fleas (39/54), 75.0% of mites (5/8), and 100% of tick nymph (1/1) were PCR positive for Leishmania parasites. Conclusions: The highest rate of infection with L. major and L. turanica in R. opimus populations was observed in summer and spring, respectively. It is suggested that the role of L. turanica and the probable role of ectoparasites in the epidemiology of disease should be investigated. A Xenodiagnostic test is recommended for future study.

A Parallel Randomized Clinical Trial for Comparison of Two Methods of Maggot Therapy, Free-Range Larvae and Larval-bag, in Diabetic Ulcer (Wagner 2).

In the present study, the efficiency of two formulations of maggot therapy: free-range larvae on the wounds and larvae in a special bag (larval-bag), was compared for healing diabetic ulcers with Wagner 2 diabetic ulcer. This study was conducted as a parallel randomized clinical trial. Out of 281 patients with Wagner grade 2 diabetic ulcers referred to the wound clinic, 54 patients who met the inclusion criteria were randomly assigned to intervention groups. The disinfected larvae of Lucilia sericata were put on the wounds with 2 methods, free-range larvae and larval-bag. Follow up was done at every 48 h interval until the full appearance of granulated tissues. The main measures were wound bed preparation, removing of necrotic tissues, appearing of granulated tissues, and removing of bacterial infections in the wounds. Statistical analysis based on the Kaplan-Meier curve and the Wilcoxon (Breslow) test showed a significant reduction in wound healing time by using free-range larvae in comparison with larval-bag (P = .03). The median time to debridement was 4 days in the free-range larval group (95% confidence interval: 3-9 days) while it was 9 days in the larval-bag group (95% confidence interval: 5-16 days). Debridement rate (proportion of removed necrotic tissue surfaces) at any time in the free-ranged larvae group was 1.78 times that of the bagged larvae group (95% confidence interval 1.01-3.15, P = .036). There was no significant difference between free-range larval use and larval-bag in the acceptability of maggot therapy by patients (P = .48). It can be concluded that both of two formulations of the larval therapy (free-range larvae and larval-bag) could be recommended for cleaning out and bed preparation of diabetic ulcers. However, using free-range larvae is hardly recommended on the wounds which are eligible to use.

Reemergence of zoonotic cutaneous leishmaniasis in an endemic focus, northeastern Iran.

Zoonotic cutaneous leishmaniasis (ZCL) is a form of disease, which is mostly caused by Leishmania major (L.major) in the Old World with high incidence through early life. Recently, the high incidence of CL has been reported in Jajarm County, northeastern Iran. The aim of the present study was to investigate the epidemiological aspects of CL and to identify Leishmania spp. in the area. Between 2012 and 2018, patients with active lesions suspected of CL were examined. Diagnosis was performed by methods of clinical examination and direct smears. Conventional kDNA polymerase chain reaction (PCR) was used to identify species of Leishmania. During the seven-year study period, 629 subjects were diagnosed as CL cases by clinical and microscopic examination. Considering the population of the study area, the average incidence rate was 237.8 per 100,000 population. Most (29.4%) of the subjects with ZCL were aged <10 years. Most of the patients (58.7%) were male and the rest were female. Most ulcers were observed on the face (32.2%) and hands (23.7%), respectively. Most patients (90%) had two or more ulcers on their body. The highest incidence was in the autumn in October (32%). Our data revealed that an ongoing reemergence of ZCL focus caused by L.major has arisen in the study area. Moreover, direct PCR on the smears for identifying Leishmania showed 100% specificity, and the species was identified as L. major using species -specific kDNA PCR. The use of conventional PCR on skin smears seems to provide a valuable method for confirming the clinical diagnosis of ZCL, which is very specific and sensitive particularly for clinical correlative studies. Further investigations are needed to improve planning strategies of vectors and reservoirs populations.

First report of Lophomonas spp. in German cockroaches (Blattella germanica) trapped in hospitals, northern Iran.

Cockroaches are considered to be important reservoirs for protozoan and helminth parasites,particularly an emerging Lophomonas spp., protozoan parasite. German cockroaches, Blattella germanica (B. germanica), are domestic pest distributed worldwide. However, little information is available regarding the burden of Lophomonas spp. infestation among domestic cockroach population worldwide. The present study investigated parasitic agents, emphasizing Lophomonas spp. infestation among B. germanica in northern Iran. During spring and summer 2018, a total of 496 adults B. germanica (265 males and 231 females) were trapped by hand and glass traps from the teaching hospitals in Mazandaran, Sari, northern Iran. All cockroaches were identified using taxonomic keys. Each cockroaches was anesthetized with chloroform and the alimentary tract removed. Each section was smeared onto a glass slide. All the smears were examined under light microscopy to determine the presence of the parasites. Ten genera of parasites were identified from the trapped B. germanica; overall, 233 (47%) were found to be positive for helminths (n = 135) and protozoa (n = 98). The helminths included Aspiculuris tetraptera egg (67/233, 28.7%), Oxiuros sp. (39/233; 16.7%), Dentostomella translucida (17/233; 7.3%), and nematodes Ova (12/233; 5.2%). The protozoan parasites identified Gregarina sp. (61/233; 26.2%), Entamoeba sp. (19/233; 8.2%), Blastocystis sp. (5/233; 2.1%), Lophomonas (4/233; 1.7%), Nyctotherus sp. (4/233; 1.7%), unclassified flagella (5/233; 2.1%). Lophomonas spp. was detected within the gut of B. germanica, for the first time, in Iran. It has previously been identified in the gut of cockroaches a long time ago, however, this is the first attempt to detect Lophomonas in cockroaches housing in hospitals. Thereby, it possibly presenting pose a serious respiratory infection risk for patients and health care personnel.

Natural host preferences of parasitoid wasps (Hymenoptera: Pteromalidae) on synanthropic flies.

Synanthropic flies are members of order Diptera and considered as medical and veterinary pests. In this study, parasitoid wasps were determined and their natural host preferences in order to select a suitable agent for biological control of flies. The pupae of three species of flies; Musca domestica, Lucilia sericata and Sarcophaga haemorrhoidalis were used as hosts for natural parasitoids. For this issue, as much as 50 pupae of each fly species put in three separate dishes with covered top by a net. These dishes were placed in the field to attract parasitoid wasps. The most parasitic rate was related to N. vitripennis (%17.2). Host preferences of N. vitripennis on M. domestica pupae were higher than observed parasitism on L. sericata and S. haemorrhoidalis. The emerging rate of two parasitoids; P. vindemmiae and S. nigroaenea were one per host pupae. According to the result, N. vitripennis can be an appropriate candidate for use as natural enemy which expected to be effective in controlling various species of synanthropic flies. Therefore, S. nigroaenea was more suitable to biological control of housefly populations.

Microbiological dataset of rural drinking water supplies in Zahedan, Iran.

The residual chlorine and microbial quality of drinking water in the Zahedan villages by a number of1221 samples from all 168 villages were collected between 2014-2015. Then the samples were evaluated using 9-tube fermentation methods and portable chlorine method test. Based on the microbial coliform and fecal coliform indices, the data indicated that the maximum and minimum controlling of the bacteria in the distribution network were in the winter (90.62%) and autumn (85.56%), respectively. Also in the reservoirs, the maximum and minimum controlling of the bacteria were in winter (93.49%) and autumn (87.35%), respectively. The residual chlorine was prepared in almost all of seasons.