Considerations for Systemic and Topical Treatment of Morganella morganii Septicemia Arising from Maggot Infestation.

INTRODUCTION: Live maggot infestation (myiasis) of wounds can present a host of ailments. Loosely associated with maggot excreta, Morganella morganii is a widespread, gram-negative rod bacterium commonly found in the intestinal tracts of humans. M morganii has been observed as being pathogenic, particularly in nosocomial and postoperative environments, as well as in immunosuppressed and elderly populations. CASE REPORT: Herein, the authors present a rare, previously unreported case of M morganii septicemia (as confirmed by positive blood culture), secondary to myiasis of the lower extremities. The patient was successfully treated with both systemic and topical interventions. Posttreatment examination revealed resolution of myiasis and negative blood cultures. CONCLUSIONS: Myiasis can be invasive, leading to severe systemic infection. In these cases, a broad-spectrum antibiotic combined with systemic and topical antiparasitic therapy should be considered.

Ophthalmomyiasis in Oman: a case report and comments.

A case of external ophthalmomyiasis caused by the first instar larvae of the sheep nasal botfly (Oestrus ovis) has been reported for the first time from the Sultanate of Oman, Southern Arabia. Sixty larvae were removed from the left eye of a 21-year-old male student, who acquired the infection during a field trip. The manual removal of larvae using a swab stick was the only effective treatment. The larval characteristics are described with illustrations, and the status of O ovis ophthalmomyiasis in the Middle East is discussed. The folk treatment administered for fly-mediated ophthalmomyiasis in Oman is also reported. Ophthalmomyiasis may not be a serious public health problem in Oman, but a nationwide survey of all myiases may be worthwhile.

Persistence of human myiasis by Oestrus ovis L. (Diptera: Oestridae) among shepherds of the Etnean area (Sicily) for over 150 years.

From a study carried out in 22 townships of the Etnean area, by interviewing 112 shepherds, it was confirmed that 90 of them (80.3%), once or more in their lives, had contracted myiasis by Oestrus ovis L., habitual agent of estriasis in sheep. The most frequent sites of involvement were the pharynx (77 times), often extending to the larynx, the conjunctiva (56), followed by the nose (32) and rarely the ear (1). Multiple simultaneous sites involvement was also frequent affecting 54.4% of the shepherds. The chief symptom was pain, sometimes accompanied by fever and malaise. The shepherds go rarely to see a doctor (only 7 out of 90), the greater part preferring traditional remedies. It is curious to note that myiasis associated with Oe. ovis was already observed more than 150 years ago by a Sicilian physician, G. A. Galvagni, who had pointed out the high incidence of the myiasis in shepherds in the area. The persistence of human myiasis in the Etnean area appears to be related to the fact that in this region the conditions of sheep farming and the lifestyle of shepherds have not changed so much since then.

Ophthalmomyiasis in Kuwait: first report of infections due to the larvae of Oestrus ovis before and after the Gulf conflict.

We report for the first time four cases of ophthalmomyiasis due to the larvae of Oestrus ovis in Kuwait, before and after Operations Desert Shield and Desert Storm. The larvae were easily removed under local anaesthetic. The symptom complex of acute foreign body sensation, irritation, redness, lacrimation and photophobia resolved rapidly. Ophthalmic antibiotic and corticosteroid drops were also instilled and recovery was uneventful. The ophthalmomyiasis may not always be associated with contact with sheep-rearing per se. Medical personnel should therefore be aware that in cases of what might appear initially as acute, non-specific catarrhal conjunctivitis, patients with the persistent symptom complex should be re-examined to exclude ophthalmomyiasis due to the larvae of O. ovis in endemic areas.