Clinical study of Maggot therapy for Fournier's gangrene.

Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture-directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.

Larvicidal effect of Clinopodium macrostemum essential oil extracted by microwave-assisted hydrodistillation against Culex quinquefasciatus (Diptera: Culicidae)

Abstract INTRODUCTION: In the present study, we determined the chemical composition of Clinopodium macrostemum essential oil obtained by microwave-assisted hydrodistillation and its effect on the growth and development of Culex quinquefasciatus mosquito larvae. METHODS: The essential oil compounds were identified by gas chromatography-mass spectrometry analysis, and bioassays were conducted to evaluate the influence on the developmental stages of early second instar larvae of Cx. quinquefasciatus until the emergence of adults, using essential oil concentrations of 50, 100, 200, 400, and 800mg/L. RESULTS: The gas chromatography-mass spectrometry analyses revealed that the leaf essential oil of C. macrostemum contained 32 compounds and the major chemical compounds identified were linalool (55.4%), nerol (6.4%), caryophyllene (6.25%), menthone (5.8%), geraniol acetate (4.1%), terpineol (3.7%), and pulegone (2.8%). The essential oil yield obtained by microwave-assisted hydrodistillation was 0.8% at 20 min. The treatments showed lethal concentrations (LC50 and LC90) of 22.49 and 833.35mg/L, respectively, after the final measurement of the total number of dead larvae (second, third, and fourth instars), and LC50 and LC90 of 6.62 and 693.35mg/L, respectively, at the end of the experimental period. The essential oil inhibited the growth and development of the mosquito larvae by 32% (relative growth index = 0.68) at 50mg/L, and up to 47% (relative growth index = 0.53) at 800mg/L. CONCLUSION: The present study demonstrated the larvicidal effect of C. macrostemum essential oil on Cx. quinquefasciatus, which can be attributed to the oxygenate compounds obtained by the extraction method.

Inhibition of the growth and development of mosquito larvae of Culex quinquefasciatus (Diptera: Culicidae) treated with extract from leaves of Pseudocalymma alliaceum (Bignonaceae).

OBJECTIVE: To determine larvicidal activity of the essential oil, hydrolat and botanical extracts derived from leaves of Pseudocalymma alliaceum on mosquito larvae of Culex quinquefasciatus. METHODS: Groups of twenty larvae were used in the larvicidal assays. The mortality, relative growth rate, the larval and pupal duration and viability was estimated. The essential oil was analyzed by solid phase microextraction using gas chromatography coupled to mass spectrometry. RESULTS: Essential oil at 800 ppm showed larvicidal activity at 24 h with lethal values of LC50 and LC90 of 267.33 and 493.63 ppm. The hydrolat at 20% and 10% on 2nd stage larvae showed 100% effectiveness after 24 h. The aqueous extract at 10% had a relative growth index of 0.58, while the ethanolic and methanolic extract obtained values of 0.76 and 0.70 and control reached 0.99. Larvae treated with 10% of methanol, ethanol and aqueous extract showed a reduction in larval duration of 5.00, 2.20 and 4.35 days; ethanol extract at 1% provoke decrease of 2.40 days in the development and exhibited an increment of 3.30 days when treated with 0.01%. Aqueous, ethanol and methanol extracts at 10% reduced in 6.15, 3.42 and 5.57 days pupal development. The main compounds were diallyl disulfide (50.05%), diallyl sulfide (11.77%) and trisulfide di-2-propenyl (10.37%). CONCLUSIONS: The study demonstrated for the first time, the larvicidal activity of the essential oil and hydrolat of Pseudocalymma alliaceum; aqueous, ethanol and methanol extracts inhibited the normal growth and development of mosquito larvae, prolonging and delaying larval and pupal duration.