Myiasis on the tongue of a patient hospitalized in a psychiatric ward: A case report with a focus on diagnosis and clinical management.

INTRODUCTION: Myiasis is a disease caused by the infestation of fly larvae in the skin, which complete part of their life cycle by feeding on host tissues. OBJECTIVE: To report a rare case of tongue myiasis in a patient admitted to a psychiatric ward, focusing on clinical management. CASE REPORT: A dependent care and mentally challenged 55 years old male patient was hospitalized in a psychiatric ward. After 42 days, during the intraoral examination, it was noted numerous larvae peeking from inside of a wound on the dorsum of the tongue. The clinical diagnosis of myiasis was rendered. For the treatment, manual removal was performed initially and ivermectin (15 mg), metamizole sodium (500 mg/ml), and chlorhexidine digluconate (0.12%) were prescribed. After one week, larvae were no longer observed, and the wound was completely healed. CONCLUSION: Myiasis occurrence is uncommon in the mouth, however, its correct diagnosis and treatment are necessary to avoid further damage to patients, especially those who are hospitalized.

Efficacy of lotilaner against myiasis caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in naturally infested dogs.

BACKGROUND: The New World screwworm fly, Cochliomyia hominivorax, is widely distributed across South America. This parasitic insect is a significant cause of primary myiasis in animals, including dogs. There is an urgent need for a rapid and efficient treatment to improve the recovery of affected animals. In the present study we evaluated the potential of lotilaner for the treatment of myiasis caused by C. hominivorax larvae in naturally infested dogs. Lotilaner belongs to the isoxazoline class of chemical compounds and is marketed as Credelio™ for use against ticks and fleas in dogs and cats. METHODS: Eleven dogs with naturally acquired myiasis were enrolled in this study based on the severity of lesions and the number of identified larvae. All animals received a single oral administration of lotilaner at a minimum dose of 20.5 mg/kg body weight. After treatment, the number of expelled larvae, live or dead, was determined at 2, 6 and 24 h, and the larval expulsion rate, larvicidal effect and overall efficacy were calculated. After 24 h, the remaining larvae were removed, counted and identified. The lesions were cleaned, and palliative treatment was administered when necessary, according to the animal's health status. RESULTS: All larvae were identified as C. hominivorax. The larval expulsion rate was 80.5% and 93.0% at 2 and 6 h post-treatment, respectively. Lotilaner showed an overall efficacy of 100% at 24 h post-treatment. CONCLUSIONS: Lotilaner demonstrated a rapid onset of action and a high efficacy against C. hominivorax. We therefore recommend lotilaner for the effective treatment of myiasis in dogs.

Number of rainy days in a week influencing screwworm navel myiasis in beef calves and efficacies of injectable and topical antiparasitics.

Rainfall incidence as a risk factor for umbilical myiasis by Cochliomyia hominivorax in newborn beef cattle and the preventive and curative efficacies of injectable and topical products against its larvae were evaluated. The prevalence of navel myiasis did not differ between sex, however, it did differ between seasons of the year, independent of animal sex, with it being higher in the rainy season than in the dry season for both sexes (males 64.6%, females 62.1%). During the rainy season, rains occurred intermittently and the number of rainy days in a week had a direct influence on prevalence, with an increase (≥87%) in the number of calves with navel myiasis caused by C. hominivorax. When it rained intermittently for four, five and six days in a week during the rainy season, calves had ≈12, 24 and 11 times greater chances, respectively, of having navel myiasis compared to a week without rain during the rainy season. The injectable products did not reach preventive efficacies higher than 35%, while all treatments of topic products reached 100% preventive efficacy at 10 days post-treatment. Only the formulations with 30% dichlorfenthion and 0.32% fipronil achieved 100% curative efficacy. The results reinforce the need for intensified inspection and healing of the umbilicus during the rainy season, mainly during rainier weeks. Furthermore, topical formulations may be a better alternative as a preventive treatment than avermectin formulations. However, the curative efficacy of the topical product containing dichlorvos did not demonstrate a relationship with preventive efficacy for newborn calves.

Severe Vaginal Myiasis: Successful Management With Ivermectin.

Myiasis refers to infestation of living animals or humans by maggots or fly larvae. Urogenital myiasis is a rare condition that is linked to poor sanitary conditions and limited access to healthcare and with few published case reports. Here, we describe the case of a 67-year-old homeless woman with multiple comorbidities, who presented with extensive vaginal myiasis requiring inpatient management with ivermectin, ceftriaxone, and metronidazole and daily larvae extraction and debridement. The relevance of this case is providing a report of a successful management with ivermectin of a case of severe vaginal myiasis. Severe cases of vaginal myiasis can require repeated debridement of necrotic tissue and systemic antibiotics in addition to antiparasitic medication. People living under poor sanitary conditions and with poor hygienic practices are at increased risk for severe vaginal myiasis.

Effectiveness of sarolaner in the clinical management of furuncular myiasis in dogs naturally infested with Dermatobia hominis (Diptera: Cuterebridae).

BACKGROUND: The human botfly, Dermatobia hominis, is a common cause of furuncular myiasis in dogs in Latin America. Lesions can be single or multiple, each harboring an individual larva, presented as an erythematous nodule that causes pruritus and pain. Typical treatment consists of sedation for removal of larvae by surgical incision or manual pressure. Medications to kill the larva before its extraction can reduce inflammation and discomfort and provide a less traumatic larval removal. Isoxazolines are broad-spectrum ectoparasiticides with larvicidal activity previously reported in the treatment of screwworm myiasis in companion animals. The aim of this study was to evaluate the effectiveness of sarolaner as part of the clinical management of furuncular myiasis in dogs caused by D. hominis larvae. METHODS: Ten short-haired mixed breed dogs naturally infested with D. hominis were enrolled. Clinical diagnosis was achieved by observation of skin nodules and visualization of larval motility through the lesion orifice. Sarolaner was administered at manufacturer recommended dose for fleas and ticks. Lesions were reexamined 24 h post-treatment and assessed for viability of larvae. Larvae were removed by digital compression and identified as D. hominis. RESULTS: Seventy-five D. hominis larvae were retrieved from ten dogs. No live larvae were observed, demonstrating 100% larvicidal efficacy of sarolaner. Skin lesions were healed 30 days post-treatment and new lesions were not observed. CONCLUSIONS: Sarolaner seems to be effective as larvicidal treatment for dogs with furuncular myiasis, reducing discomfort caused by the presence of the larva in the skin and facilitating its safe removal.

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.

Dermatobia hominis in a dog imported from Brazil to Romania.

BACKGROUND: Dermatobia hominis (Diptera: Oestridae: Cuterebrinae) is a parasite with an important zoonotic and economical impact in the cattle industry, distributed in Central and South America, inhabiting wooded areas along rivers and lowlands. It infests mammals including humans. Lately, there has been a growing trend for people to travel on holidays with their pet dog and also international trade of dogs has increased significantly in the last two decades. Hence, the risk of importation of exotic parasites, including agents of myiasis has increased. Dermatobia hominis has been commonly reported as an imported parasite to various countries, mostly as human cases and currently there are only two published cases of D. hominis imported with dogs to Europe. Herein, we report a case of D. hominis infestation in Romania in a dog recently imported from Brazil. METHODS: Larvae were manually extracted from nodules of a 4-month old non-neutered male, Fila Brasileiro in Arad, Romania. The larvae were morphologically identified, and one specimen was characterized molecularly by amplification and sequencing of a fragment of the mitochondrial cytochrome c oxidase subunit 1 gene (cox1). RESULTS: All larvae were morphologically identified as L3 of Dermatobia hominis. The BLAST analysis revealed a 98.81% nucleotide similarity to two D. hominis isolates from Brazil. The sequence was deposited in the GenBank database under the accession number MT364820. CONCLUSIONS: The travel history of dogs is an important part of the veterinary anamnesis questions and should be thoroughly conducted in the daily practice. Also, prior to and after the importation of dogs from tropical regions, a thorough check of the body surface to detect the presence of nodules is recommended.

[Myiasis by Cochliomyia hominivorax in Argentina]. / Miasis por Cochliomyia hominivorax en la Argentina.

Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.

Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.

Miasis por Cochliomyia hominivorax en la Argentina / Myiasis by Cochliomyia hominivorax in Argentina

Miasis es la infestación de humanos y animales por larvas de dípteros ciclorrafos con invasión y destrucción tisular. Cochliomyia hominivorax es responsable del 80% de las miasis en la Argentina. Es importante realizar el diagnóstico etiológico específico debido a la agresividad de las larvas de esta especie, las que pueden provocar cuadros clínicos graves. Presentamos cuatro casos de miasis por C. hominivorax. Dos de los pacientes residían en la ciudad de Buenos Aires y trabajan en zona rural, y los otros dos residían en el Gran Buenos Aires.

Miasis is the infestation of man and animals by larvae of flies belonging to the order Diptera, suborder Cyclorrapha. Eighty percent of miasis in Argentina is caused by Cochliomyia hominivorax, a species that induces pronounced tissue invasion and destruction, and results in severe clinical forms. Because of the aggressiveness of its larvae, it is important to reach a specific etiological diagnosis. We present four cases of miasis by C. hominivorax in two patients living in the city of Buenos Aires but working in a rural area and two patients living in the Greater Buenos Aires.

Efficacy of sarolaner on the treatment of myiasis caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in dogs.

The aim of this study was to evaluate the larval expulsion, larvicidal effect, retention rate of dead larvae and overall efficacy of sarolaner on the treatment of myiasis caused by New World screwworm Cochliomyia hominivorax in naturally infested dogs. Eight Beagle dogs received a single dose of saroalner 40 mg, with dosage ranging from 2.7 mg/kg to 3.7 mg/kg. Evaluations occurred every 15 min in the first hour, every hour for up to 6 h, and after 24 h of treatment. At 24 h post-treatment, total wound cleaning was performed, including removal and counting of remaining live and dead larvae. The animals received antibiotic, analgesic and wound cleaning support until complete wound healing. The average expulsion of the larvae was 50.9 % occurring mainly after 4 h of treatment. The larvicidal effect was 70.6 % at 6 h after treatment and 100 % at 24 h. The mean retention rate of dead larvae of sarolaner was 33.9 %, The overall efficacy was 100 %, thus making sarolaner an excellent treatment option in myiasis caused by C. hominivorax larvae in dogs.

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.

Oftalmomiíase externa / External ophthalmomyiasis

RESUMO O objetivo deste resumo é relatar um caso de portador de oftalmomiíase externa, discorrendo sobre o quadro clínico, os diagnósticos diferenciais e as opções de tratamento. As informações foram obtidas por meio de revisão do prontuário, entrevista com o paciente e registro fotográfico dos métodos diagnósticos e terapêuticos aos quais o paciente foi submetido. Dados foram analisados junto a uma extensa revisão da literatura. O nosso artigo relata um caso de um paciente que foi inicialmente diagnosticado e tratado como celulite pré -septal e após avaliação de especialista em oculoplástica foi realizado o diagnóstico e tratamento adequado para oftalmomiíase. Também revela a importância deste diagnóstico, infrequente nos grandes centros urbanos, seu tratamento e evolução.

ABSTRACT The purpose of this report is to describe a case of external ophthalmomyiasis, discussing the clinical picture, differential diagnoses and treatment options. The information was obtained by means of a review of the medical record, an interview with the patient and a photographic record of the diagnostic and therapeutic methods to which the patient was submitted. Data were analyzed together with an extensive review of the literature. Our article reports a case of a patient who was initially diagnosed and treated for pre-septal cellulitis and after evaluation by a specialist in oculoplastics, the diagnosis and appropriate treatment for ophthalmomyiasis was performed. It also reveals the importance of this diagnosis, infrequent in large urban centers, its treatment and evolution.

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.

Myiasis associated with an invasive ductal carcinoma of the left breast: case study.

Most breast cancers originate in the ductal epithelium and are referred to as invasive ductal carcinoma. In this study we report on the clinical procedures adopted to diagnose myiasis in association with infiltrating metastatic breast carcinoma in a female patient. A 41 years old woman came to the Federal Hospital of Andaraí complaining of intense itching, warmth, redness and hardening of the breast, which had acquired the aspect of an orange peel. A lesion in the left breast was cavitated, dimpled, had fetid odor, and had fibrotic and infected air nodules filled with exudate and Dipteran larvae. The tissue was cleaned and 33 larvae were extracted. The patient was hospitalized and received Ivermectin. Eighteen of the larvae extracted from the patient were placed in 70% alcohol, and twelve were placed in a container with sterile wood shavings under controlled conditions until they metamorphosed into adults. The taxonomic identification of the flies revealed that the culprit was Cochliomyia hominivorax. A histopathological exam conducted three months earlier had revealed infiltrating ductal carcinoma. Two months after the myiasis treatment, the breast tissue had healed. The patient had waited ten days from the onset of the myiasis to seek treatment, and that delay interfered negatively in the prognosis of both the neoplasm and the myiasis. This study is relevant to public health in view of the strong social impact of myiasis.

[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.

Serie parasitosis en dermatología. Miasis: diferentes formas de presentación clínica / Parasitic series in dermatology. Myiasis: different forms of clinical presentation

La miasis es una infestación por larvas en desarrollo de una gran variedad de moscas del orden Díptera. Según el sitio de invasión, se clasifica en miasis cavitarias, que pueden deberse a invasión de cavidades naturales o de heridas, y miasis forunculoide, cuando atraviesa piel indemne. Esta infestación presenta una distribución mundial, con variaciones estacionales en relación con la latitud geográfica y el ciclo de vida de distintas especies de moscas. Presentamos una serie de tres casos de pacientes con distintas formas clínicas de manifestación de miasis. (AU)

Myiasis is the tissue infestation by a variety of Diptera order larvae flies. According to the invasion site, they are classified in myiasis of cavities, which can be because of an invasion of natural cavities or wounds, and furuncular myiasis, when they invade through intact skin. This infestation has a worldwide distribution, with seasonal variations in relation to the geographic latitude and the life cycle of different species of flies. We present three cases of patients with different clinical forms of presentation of myiasis. (AU)

Miasis cutánea por Cochliomyia hominivorax asociada a dermatitis seborreica: case report / Cutaneous myiasis due to Cochliomyia hominivorax associated with seborrheic dermatitis

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.