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.

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.

An acetone extract of Clausena anisata may be a potential control agent for flies encountered in cutaneous myiasis.

Clausena anisata is a medicinal plant used traditionally to treat myiasis and as an insect repellent by various communities. We have previously demonstrated the effects of C. anisata extracts on blowfly feeding and development in our laboratory. The impact of C. anisata leaf extracts on populations of different fly species on farms in Mpumalanga, South Africa was investigated in this study under field conditions. Flies were exposed to liver baits treated with acetone leaf extracts of C. anisata (150 mg/mL). Fly numbers and composition on two farms, with and without C. anisata treated liver, were compared during a period of 12 weeks when fly populations were expected to be high. Observations were made on fly behaviour and development, adult sizes and numbers. The flies exposed to liver treated with the leaf extract of C. anisata had a decreased rate of development, prolonged larval period, smaller body sizes and more sluggish behaviour compared to those subjected to the control treatment. No significant differences were, however, found between the numbers and sizes of flies on the treated and on the control farm, which was most likely due to the limited nature of the baiting programme we followed. The effects of C. anisata extracts on blowfly behaviour and development observed in previous laboratory studies were confirmed in this field evaluation. Although the extracts did not have a significant effect on the overall population size in this experiment, we believe that the C. anisata leaf extract could be useful in integrated pest management based on its effect on larval development. In addition, species such as Lucilia cuprina and Chrysomya marginalis seemed to have been repelled by the C. anisata treated liver; as a result, further work should explore this aspect and how it can be used for the protection of animals.

In vitro and in vivo effects of neem tree (Azadirachta indica A. Juss) products on larvae of the sheep nose bot fly (Oestrus ovis L. Díptera: Oestridae).

Two studies were carried out in order to test the effects of neem tree extracts (Azadirachta indica A. Juss) on sheep bot fly larvae (Oestrus ovis L. Diptera: Oestridae). First, aqueous extracts from neem seeds (ASNE) at 0, 5 y 10% (w/v) concentrations were tested on larval mortality in vitro. In a second study, the effect of oral administration with neem seed meal (0, 100 y 200mg/kg) and neem leaves (1% of diet) on number of larvae found at necropsy and larval development was evaluated in experimentally O. ovis-infected sheep. Results in Experiment 1 showed a significant (P<0.05) effect of ASNE on time to L1 mortality in a dosis-dependent manner. In Experiment 2, oral administration of seeds or leaves did not affect the number of larvae found at necropsy of the sheep, but interfered with larval development and there was a tendency to reduce larval weight at the end of the infection period (55d).

Isolation of seselin from Clausena anisata (Rutaceae) leaves and its effects on the feeding and development of Lucilia cuprina larvae may explain its use in ethnoveterinary medicine.

ETHNOPHARMACOLOGICAL RELEVANCE: The leaves of Clausena anisata are used traditionally to expel maggots from wounds of animals in Zimbabwe. We have previously proved in the laboratory that the plant certainly affects the behaviour and growth of blowfly larvae. The objective of this study was to isolate and identify the active compounds responsible for this activity. MATERIALS AND METHODS: The acetone extract of Clausena anisata leaf powder was separated by solvent-solvent partition into five fractions. The n-hexane fraction was the most active in the larvicidal assay and therefore subjected to open column chromatography on silica gel. RESULTS: The isolated compound was identified by nuclear magnetic resonance (NMR) and mass spectroscopy (MS) as the pyranocoumarin, seselin, chemically known as 2',2'-dimethylpyranocoumarin. It inhibited feed intake in the first and second instars of blowfly larvae at the minimum concentration tested of 1 ppm resulting in significant lower mass pupae (13.5±0.5 mg and 22.4±0.4 mg for the first and second instar larvae respectively) compared to the solvent control group (26.19±0.8 mg) (p<0.05). CONCLUSIONS: This is the first report of the isolation of seselin from the leaves of Clausena anisata and the first report of the compound having an effect against blowfly larvae.

Extracts of four plant species used traditionally to treat myiasis influence pupation rate, pupal mass and adult blowfly emergence of Lucilia cuprina and Chrysomya marginalis (Diptera: Calliphoridae).

ETHNOPHARMACOLOGICAL RELEVANCE: Aloe zebrina, Clausena anisata, Erythrina lysistemon and Spirostachys africana are used traditionally in southern Africa to combat and/or treat myiasis, the infestation of the skin of mammals by larvae of a variety of fly species belonging to the arthropod order Diptera.The objective of the study was to establish the in vitro effect of extracts of these plant species on blowfly larvae to ascertain the potential use of these extracts and validate the traditional use. MATERIALS AND METHODS: Chrysomya marginalis and Lucilia cuprina larvae cultured in the laboratory under controlled conditions were exposed to meat treated with acetone and aqueous extracts of four different plant species. In addition to solvent controls, the effects of the plant extracts were tested at concentrations of 10, 25, 50, 75, 100 and 150 mg/ml. Larval behaviour, larval development and emergence of adult flies were assessed after exposing the larvae to the treated meat. Ivermectin was used as a positive control while acetone and water served as solvent controls. Cytotoxicity of the extracts was determined using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide] assay against C3A human liver cells, bovine dermis cells and Vero African green monkey kidney cells. RESULTS: An increase in the concentration of the acetone plant extracts resulted in a decrease in the ingestion of meat by larvae, pupal mass and adult emergence rates. The R(2) values for the correlation between dose and pupal mass was 0.92, 0.74 and 0.65 for A. zebrina, C. anisata, and E. lysistemon respectively. For C. anisata and S. africana extracts the increase in the concentration was also associated with the emerging adult flies being smaller. C. anisata was the most toxic plant extract, with an average IC(50) of 39 µg/ml, while E. lysistemon was the least toxic. Vero cells were the most susceptible cell type, with an average IC(50) of less than 100 µg/ml, while the human liver cells were the most resistant to the effect of the plant extracts. CONCLUSIONS: The results suggest that the plants may contain compounds that interfere with larval feeding and the neuroendocrine control mechanisms in the blowfly. It appears that some of these plant species have the potential to deliver a product that can be used to control myiasis.

Social exclusion and myiasis of the upper lip in a Brazilian rural resident.

CONTEXT: People living in rural or remote Brazil, as in other sub-tropical or tropical nations, are vulnerable to infections that would not normally occur in urban areas or wealthier nations. Brazil is a geographically extensive nation, historically marked by vast socioeconomic inequalities. Approximately 16% of the population live in rural areas. ISSUE: This clinical case report demonstrates the vulnerability of rural residents who are underserved by Brazil's 'universal' public healthcare system, despite social and economic challenges that increase their risk for disease. Myiasis (especially oral myiasis) is a rare health condition in humans caused by fly larvae. Oral myiasis usually appears in periodontal pockets and open wounds, such as after dental extractions. It is associated with poverty, lack of access to health care, and very poor overall health status. While myiasis has a worldwide distribution, it is particularly associated with the tropical and sub-tropical regions of North and South America. LESSONS LEARNED: This article describes a rare case of myiasis in the upper lip of a rural male patient. The case report demonstrate that rural and remote residents can be socially excluded from the benefits of technology and biomedicine, making them vulnerable to rare infections.

Effectiveness of wound cleansing treatments on maggot (Diptera, Calliphoridae) mortality.

Myiasis is defined as an infestation of the organs and/or tissues of human and other animals by fly maggots. Fly species that normally breed in meat or carrion (Diptera: Calliphoridae, Sarcophagidae) may become involved in cutaneous myiasis by colonizing preexisting wounds. Reports of human wound myiasis contracted in hospitals and nursing homes, especially when patients are chronically ill or bed-ridden, are not uncommon across North America and often result in cases of neglect and civil litigation. Based on a case history dealing with this latter situation and circumstances surrounding the treatment of maggot infestation, we designed an experiment to assess the effectiveness of wound cleansing solutions on maggot mortality. Treatments, consisting of four commonly used cleaning solutions (isopropyl alcohol, Dakin's solution, iodine, and hydrogen peroxide) and a control (deionized water), were applied to experimental units (n=5), with each unit consisting of groups of actively feeding Lucilia sericata maggots (Diptera: Calliphoridae). Every 24h, treatments were applied and mortality was assessed for the duration of the study (14 days). Total mean mortality increased over the duration of the experiment, with an initial large increase (10-25%) after the first treatment application, followed by a gradual increase over the remainder of the study. General differences among treatments indicated greatest mean total mortality for Dakin's solution (sodium hypochlorite) (46%), followed by isopropyl alcohol (42%), Betadine (37%), hydrogen peroxide (33%) and lowest mortality for the control (25%); however, no statistically significant differences were observed among treatments and no treatment resulted in 100% maggot mortality. Traditional wound cleansing solutions may not be sufficient for maggot infestations of pre-existing wounds and supplemental treatments may be necessary to effectively treat cases of wound myiasis.

Lousicidal, ovicidal and repellent efficacy of some essential oils against lice and flies infesting water buffaloes in Egypt.

The lousicidal and repellent effects of five essential oils were investigated for the first time against the buffalo louse, Haematopinus tuberculatus, and flies infesting water buffaloes in Qalyubia Governorate, Egypt. For the in vitro studies, filter paper contact bioassays were used to test the oils and their lethal activities were compared with that of d-phenothrin. Four minutes post-treatment, the median lethal concentration, LC50, values were 2.74, 7.28, 12.35, 18.67 and 22.79% for camphor (Cinnamomum camphora), onion (Allium cepa), peppermint (Mentha piperita), chamomile (Matricaria chamomilla) and rosemary oils (Rosmarinus officinalis), respectively, whereas for d-phenothrin, it was 1.17%. The lethal time (50) (LT50) values were 0.89, 2.75, 15.39, 21.32, 11.60 and 1.94 min after treatment with 7.5% camphor, onion, peppermint, chamomile, rosemary and d-phenothrin, respectively. All the materials used except rosemary, which was not applied, were ovicidal to the eggs of H. tuberculatus. Despite the results of the in vitro assays, the in vivo treatments revealed that the pediculicidal activity was more pronounced with oils. All treated lice were killed after 0.5-2 min, whereas with d-phenothrin, 100% mortality was reached only after 120 min. The number of lice infesting buffaloes was significantly reduced 3, 6, 4, 6 and 9 days after treatment with camphor, peppermint, chamomile, onion, and d-phenothrin, respectively. Moreover, the oils and d-phenothrin significantly repelled flies, Musca domestica, Stomoxys calcitrans, Haematobia irritans and Hippobosca equina, for 6 and 3 days post-treatment, respectively. No adverse effects were noted on either animals or pour-on operators after exposure to the applied materials. Consequently, some Egyptian essential oils show potential for the development of new, speedy and safe lousicides and insect repellents for controlling lice and flies which infest water buffaloes.

Primer reporte en Cuba de miasis intestinal por Hermetia illucens (Diptera: Stratiomyidae) / First report of intestinal myiasis caused by por Hermetia illucens (Diptera: Stratiomyidae)

INTRODUCCIÓN: Hermetia illucens, díptero de la familia Stratiomyidae es una especie reportada para Cuba relativamente frecuente en todo el territorio nacional. Ha sido incriminada como productora de miasis en humanos y animales. OBJETIVO: reportar por primera vez en Cuba una miasis entérica producida por esta especie. MÉTODOS: la paciente, una mujer blanca de 26 años presentó un cuadro de deyecciones líquidas posprandiales con cólicos abdominales. Al ingerir una infusión de plantas medicinales a partir de incienso (Artemisa abrotanum L.), hierba buena (Mentha nemorosa Willd.) y manzanilla (Matricaria chamomilla L.) expulsó 5 larvas (2 grandes y 3 pequeñas). Se decidió su ingreso durante una semana pero no se obtuvieron nuevas larvas, una gastroscopia realizada mostró gastritis antral crónica con focos de agudización; se determinaron otras parasitosis por lo que se le indicó mebendazol. RESULTADOS: de las larvas expulsadas una fue llevada al Departamento de Entomología Médica del Instituto de Medicina Tropical Pedro Kourí, donde fue determinada taxonómicamente como Hermetia illucens. CONCLUSIONES: este reporte junto a lo conocido en la literatura mundial muestra la posibilidad de que miasis por esta especie ocurran con cierta frecuencia, sobre todo en los meses de verano al ingerir frutas muy maduras y sin lavar; se deberá alertar a los médicos de esta posible miasis a ocurrir, promocionar las medidas higiénicas a ser tomadas al ingerir frutas y valorar el estudio de las propiedades antiparasitarias de la especie Artemisa abrotanum L.

INTRODUCTION: Hermetia illucens from Stratiomyidae family is a relatively frequent species reported in Cuba. It has been accused of causing myiasis in humans and animals. OBJECTIVE: to report for the first time in Cuba, the occurrence of intestinal myiasis caused by this species. METHODS: the patient, a white woman aged 26 years presented with a picture of postprandial fluid discharges accompanied by abdominal pain. When the patient took an infusion of medicinal plants such as incense (Artemisa abrotanum L.), mint (Mentha nemorosa Wild) and camomile (Matricaria chamomilla L.), five larvae were ejected (2 large and 3 small). It was decided to admit the patient to the hospital for a week, but not more larvae were ejected. A gastroscopy showed antral chronic gastritis with acute foci and also other types of parasitosis, so Mebendazol was prescribed. RESULTS: one of the ejected larvae was taken to the Medical Entomology Department of Pedro Kourí Institute of Tropical Medicine where it was taxonomically identified as Hermetia illucens. CONCLUSIONS: this report together with the pieces of knowledge provided by the world literature show the possibility that myasis caused by this species may occur in summer months when ripe unwashed fruits are consumed; physicians should be warned about this possible myiasis, hygienic measures should be applied when taking fruits and the study of antiparasitic properties of Artemisa abrotanum L. must be assessed.

Primer reporte en Cuba de miasis intestinal por Hermetia illucens (Diptera: Stratiomyidae) / First report of intestinal myiasis caused by por Hermetia illucens (Diptera: Stratiomyidae)

INTRODUCCIÓN: Hermetia illucens, díptero de la familia Stratiomyidae es una especie reportada para Cuba relativamente frecuente en todo el territorio nacional. Ha sido incriminada como productora de miasis en humanos y animales. OBJETIVO: reportar por primera vez en Cuba una miasis entérica producida por esta especie. MÉTODOS: la paciente, una mujer blanca de 26 años presentó un cuadro de deyecciones líquidas posprandiales con cólicos abdominales. Al ingerir una infusión de plantas medicinales a partir de incienso (Artemisa abrotanum L.), hierba buena (Mentha nemorosa Willd.) y manzanilla (Matricaria chamomilla L.) expulsó 5 larvas (2 grandes y 3 pequeñas). Se decidió su ingreso durante una semana pero no se obtuvieron nuevas larvas, una gastroscopia realizada mostró gastritis antral crónica con focos de agudización; se determinaron otras parasitosis por lo que se le indicó mebendazol. RESULTADOS: de las larvas expulsadas una fue llevada al Departamento de Entomología Médica del Instituto de Medicina Tropical Pedro Kourí, donde fue determinada taxonómicamente como Hermetia illucens. CONCLUSIONES: este reporte junto a lo conocido en la literatura mundial muestra la posibilidad de que miasis por esta especie ocurran con cierta frecuencia, sobre todo en los meses de verano al ingerir frutas muy maduras y sin lavar; se deberá alertar a los médicos de esta posible miasis a ocurrir, promocionar las medidas higiénicas a ser tomadas al ingerir frutas y valorar el estudio de las propiedades antiparasitarias de la especie Artemisa abrotanum L(AU)

INTRODUCTION: Hermetia illucens from Stratiomyidae family is a relatively frequent species reported in Cuba. It has been accused of causing myiasis in humans and animals. OBJECTIVE: to report for the first time in Cuba, the occurrence of intestinal myiasis caused by this species. METHODS: the patient, a white woman aged 26 years presented with a picture of postprandial fluid discharges accompanied by abdominal pain. When the patient took an infusion of medicinal plants such as incense (Artemisa abrotanum L.), mint (Mentha nemorosa Wild) and camomile (Matricaria chamomilla L.), five larvae were ejected (2 large and 3 small). It was decided to admit the patient to the hospital for a week, but not more larvae were ejected. A gastroscopy showed antral chronic gastritis with acute foci and also other types of parasitosis, so Mebendazol was prescribed. RESULTS: one of the ejected larvae was taken to the Medical Entomology Department of Pedro Kourí Institute of Tropical Medicine where it was taxonomically identified as Hermetia illucens. CONCLUSIONS: this report together with the pieces of knowledge provided by the world literature show the possibility that myasis caused by this species may occur in summer months when ripe unwashed fruits are consumed; physicians should be warned about this possible myiasis, hygienic measures should be applied when taking fruits and the study of antiparasitic properties of Artemisa abrotanum L. must be assessed(AU)

Traditional remedies used for the treatment of cattle wounds and myiasis in Amatola Basin, Eastern Cape Province, South Africa.

A questionnaire survey was carried out to document traditional remedies used in the treatment of cattle wounds and myiasis in Amatola Basin. Eighty-three cattle farmers from nine villages were interviewed. The majority of respondents (67.9%) use traditional remedies for treatment of these conditions. However, 25.9% of them use a combination of traditional remedies with conventional medicines. The survey revealed that 13 medicinal plants belonging to 11 families were used. Aloe ferox, Prunus persica and Phytolacca heptandra were, however, the most commonly used. Leaves are the most frequently used plant part, often prepared as an infusion. Other non-plant remedies used include disinfectants, antiseptics as well as diesel and petrol. Manual removal of maggots from wounds was also practise and treatment is usually continued until the wound heals.

Larvicidal effects of mineral turpentine, low aromatic white spirits, aqueous extracts of Cassia alata, and aqueous extracts, ethanolic extracts and essential oil of betel leaf (Piper betle) on Chrysomya megacephala.

BACKGROUND: Many methods have been employed, with variable success, in the treatment of cutaneous myiasis caused by Chrysomya species. AIMS: Experiment 1: to assess the larvicidal effect of mineral turpentine (MT) and the main ingredient of MT, low aromatic white spirits (LAWS), on Chrysomya megacephala larvae in vitro. Experiment 2: to assess the larvicidal effects of aqueous extracts of winged senna (Cassia alata), and aqueous extracts, ethanolic extracts and essential oil of betel leaf (Piper betle). METHODS: In experiment 1, two samples of LAWS were obtained from two industrialists (samples 1 and 2). Adult flies of C. megacephala were bred in the insectory of the Department of Parasitology, Faculty of Medicine, University of Colombo. Petri dishes were prepared with pads of cotton wool. These cotton pads were soaked separately in MT, LAWS samples 1 and 2, and normal saline as a control. Ten larvae were placed in each Petri dish. The activity of the larvae was observed and recorded half-hourly. MT and the two samples of LAWS were analyzed by chromatography. In experiment 2, volatile essential oil of betel was prepared using a standard steam distillation process. An ethanolic extract of betel was obtained after boiling the crushed leaf with water, and mixing the stock with ethanol. Betel oil dilutions of 1-4% were prepared using 1% Tween 80 (v/v aq) as a solvent, with 0.05 g/100 mL sodium lauryl sulphate (as stabilizer) and 0.01 g/100 mL methyl paraben (as a preservative). Cotton wool swabs soaked in 1, 2, 3 and 4% essential oil of betel in 1% Tween 80 (v/v aq) prepared as above, 1, 2, 3 and 4% ethanolic extract of betel, 50 and 25% aqueous extract of C. alata, and 50 and 25% aqueous extract of betel were placed in separate Petri dishes. Ten larvae were placed in each Petri dish. 1% Tween 80 solvent with the stabilizer and the preservative, but without betel essential oil, was used as a negative control and MT was used as a positive control. Larval motility was assessed as before. RESULTS: MT and the two LAWS samples killed the larvae in vitro within 4 h. Chromatography showed more unidentified constituents in MT than in pure LAWS, indicating additional substances in MT. The 4 and 3% preparations of the essential oil of betel were effective in killing 100% of the larvae of Chrysomya within 3 h 30 min. The 2% extract of betel essential oil killed 96.7% of larvae in 4 h. Ethanolic and aqueous extracts of betel, the aqueous extract of C. alata, normal saline and the Tween 80 solvent were not larvicidal. CONCLUSIONS: MT and LAWS, the main ingredient of MT, were effective in killing Chrysomya larvae. Essential oil obtained from betel leaves also showed a dose-dependent larvicidal effect on Chrysomya larvae. This natural product may be effective in the treatment of wound myiasis.

A study of cutaneous myiasis in Sri Lanka.

BACKGROUND AND OBJECTIVES: Cutaneous myiasis (CM) due to Diptera fly larvae shows different patterns in different regions. Many modalities of treatment have been described. The objectives of our study were to identify the species causing CM in Sri Lanka, the common sites of infestation, and the contributory factors, and to assess some treatment modalities, in particular mineral turpentine and certain herbal preparations. METHODS: All patients with CM admitted or referred to the Dermatology Unit at the General Hospital, Kalutara, over 18 months starting from July 1997, and all patients with CM from the orthopedic and surgical wards of the National Hospital of Sri Lanka in Colombo over 6 months from July 1997, were studied. Details of the history and examination were recorded on specially designed forms. Maggots extracted were identified at the Department of Parasitology, Faculty of Medicine, University of Colombo. The modalities of treatment employed in the patients were recorded. In the Department of Parasitology, a colony of Chrysomya megacephala was maintained. Homogenized leaf extracts of Azadirachta indica (neem) and Pongamia pinnata (Indian beech) and mineral turpentine (active ingredient--low aromatic white spirits) were tested for efficacy in killing C. megacephala larvae in vitro. Leaf extracts were not used directly on patients. RESULTS: There were 16 patients (10 males and five females; the sex of one patient was not recorded). The mean age was 58.5 years (range, 11-94 years). Identification of larvae revealed C. bezziana in 14 (87.5%) and C. megacephala in two (12.5%) patients. The foot was affected in 15 (93. 7%) and the scalp in one patient. The immediate predisposing factor for CM in dermatology patients was infected dermatitis. The other relevant associated factors were: diabetes mellitus, psychiatric illness, leprosy, and mental subnormality. Turpentine was a useful adjunct in the removal of maggots manually. There were no side-effects to turpentine. In the in vitro testing, turpentine was 100% effective in killing maggots. Some patients required surgical removal under anesthesia. Indian beech and neem leaf extracts were not effective against Chrysomya larvae in vitro. CONCLUSIONS: All cases of CM were due to larvae of Chrysomya species. The commonest was C. bezziana. C. megacephala larvae causing CM have been reported for the first time in Sri Lanka. The foot was the site of predilection. Dermatitis, psychiatric illness, leprosy, diabetes, and mental subnormality were some contributory factors. Topically instilled mineral turpentine, followed by manual removal of maggots, was effective in most cases. The plant extracts tested in vitro were ineffective. As C. bezziana is an obligatory parasite capable of penetrating deeply, the importance of preventive measures is emphasized.