Urogenital myiasis due to Chrysomyia bezziana

Postpartum genital myiasis - Dermatobia hominis infestation with giant uterine fibroid: A rare case with review of literature

A 32-year-old multiparous rural woman having 26 weeks of pregnancy with giant uterine fibroid extending up to the cervix had stillbirth 2 weeks back and left hospital against medical advice. She was readmitted in emergency with necrotic prolapsed uterine fibroid with offensive vaginal bleeding. On examination, the patient had necrotic prolapsed fibroid with very offensive bloody discharge and a large number of larvae of Dermatobia hominis (human botfly) were crawling in necrotic tissue. The location of this infestation at genital region is an extremely rare occurrence in postdelivery patients.

Human Chrysomya bezziana myiasis: A systematic review

Background

Myiasis due to Old World screw-worm fly, Chrysomya bezziana, is an important obligate zoonotic disease in the OIE-list of diseases and is found throughout much of Africa, the Indian subcontinent, southeast and east Asia. C. bezziana myiasis causes not only morbidity and death to animals and humans, but also economic losses in the livestock industries. Because of the aggressive and destructive nature of this disease in hosts, we initiated this study to provide a comprehensive understanding of human myiasis caused by C. bezziana.

Methods

We searched the databases in English (PubMed, Embase and African Index Medicus) and Chinese (CNKI, Wanfang, and Duxiu), and international government online reports to 6^th February, 2019, to identify studies concerning C. bezziana. Another ten human cases in China and Papua New Guinea that our team had recorded were also included.

Results

We retrieved 1,048 reports from which 202 studies were ultimately eligible for inclusion in the present descriptive analyses. Since the first human case due to C. bezziana was reported in 1909, we have summarized 291 cases and found that these cases often occurred in patients with poor hygiene, low socio-economic conditions, old age, and underlying diseases including infections, age-related diseases, and noninfectious chronic diseases. But C. bezziana myiasis appears largely neglected as a serious medical or veterinary condition, with human and animal cases only reported in 16 and 24 countries respectively, despite this fly species being recorded in 44 countries worldwide.

Conclusion

Our findings indicate that cryptic myiasis cases due to the obligate parasite, C. bezziana, are under-recognized. Through this study on C. bezziana etiology, clinical features, diagnosis, treatment, epidemiology, prevention and control, we call for more vigilance and awareness of the disease from governments, health authorities, clinicians, veterinary workers, nursing homes, and also the general public.

Chrysomya bezziana larvae are characterized by feeding aggressively on the living tissues and body fluids of the host. The dreadful feelings of patients suffering from myiases with severe tissue and bone destruction, even death, and the enormous economic losses in the livestock industries have been described previously. But our findings indicate that C. bezziana myiases still appear to be under-recognized as a serious medical or veterinary condition throughout the world. Both in China and the world at large, it is probable that C. bezziana distribution could well be greater than currently reported. Our study provides an opportunity for clinicians and health authorities to gain a comprehensive understanding of this disease from its etiology, clinical features, diagnosis, treatment, epidemiology, prevention and control. In addition, our findings will engage governments, health staff, veterinary workers, aged-care facilities, and also the general public, in efforts to recognize, prevent, and control such infestations.

Effect of Temperature and Tissue Type on the Development of Myiasis Causing Fly; Chrysomya bezziana (Diptera: Calliphoridae)

Chrysomya bezziana Villeneuve is the major human myiasis producer in tropical countries, including Sri Lanka. Although of great medical and veterinary importance, only a single study has been published on the development of C. bezziana. This limitation is due in part to the difficulty of maintaining this species in a colony outside of using a living host. In this study, a novel technique that overcomes this limitation is presented along with development data for C. bezziana fed on three different meat types: swine muscle, swine liver, and bovine muscle at two temperature regimes: 35 and 37°C. The optimum development of C. bezziana was recorded at 35°C in bovine muscle (262.20 h) followed by swine muscle (286.00 h) and swine liver (307.00 h). Data from the current study indicate tissue type significantly impacts change in length and width of larvae over time, whereas the two temperatures examined had no significant effect.

Occurrence of human urogenital myiasis due to neglected personal hygiene: a review

Myiasis, the infestation of tissues or organs of vertebrate animals with dipteran larvae, is a common parasitic problem among domestic and wild mammals. The condition, which is also witnessed in humans, is relatively frequent in rural areas where people are in close contact with domestic animals. It is a subject of medical and veterinary importance, particularly in tropical and subtropical regions of the world. Human myiasis is generally encountered in open neglected wounds but can also affect body orifices with foetid discharge, such as the oral cavity, eyes, ears, anus and urogenital tract. Urogenital myiasis involves infestation of the urinary tract, as well as genital organs such as vaginal or penile orifices, with fly larvae. The condition is a rare among humans inhabiting developed countries but relatively more common in patients of low socio-economic status with poor hygienic conditions in developing countries. Damage varies from superficial to massive infestation, which may result in severe problems or even death of the individual. In the present study, the authors reviewed the past literature describing the cases of human urogenital myiasis, causative fly species and risk factors. The aim of the present article is to document the predisposing risk factors and provide guidelines for prevention and control of urogenital myiasis among humans. Besides poor genital hygienic conditions, other factors leading to urogenital myiasis include psychiatric disorders, the use of urinary catheters and uterine prolapse. Prevention of the condition is of utmost importance and involves the dressing and covering of open wounds, maintaining proper personal hygiene and control of fly populations.

Parasitic Infections of the Skin and Subcutaneous Tissues

A variety of arthropods, protozoa, and helminths infect the skin and subcutaneous tissues and may be identified by anatomic pathologists in standard cytology and histology preparations. The specific organisms seen vary greatly with the patient's exposure history, including travel to or residence in endemic countries. Arthropods are the most commonly encountered parasites in the skin and subcutaneous tissues and include Sarcoptes scabei, Demodex species, Tunga penetrans, and myiasis-causing fly larvae. Protozoal parasites such as Leishmania may also be common in some settings. Helminths are less often seen, and include round worms (eg, Dirofilaria spp.), tapeworms (eg, Taenia solium, Spirometra spp.), and flukes (eg, Schistosoma spp.). This review covers the epidemiologic and histopathologic features of common parasitic infections of the skin and subcutaneous tissues.

Urogenital myiasis caused by Psychoda albipennis

Myiasis is a parasitic infestation of vertebrate animals caused by the eggs and larvae of flies within the Diptera species. Psychoda albipennis is a rare cause of urogenital myiasis in humans. We present the case of a 42-year-old male diagnosed with urogenital myiasis caused by Psychoda albipennis.

Incidence of myiasis among humans-a review

Myiasis, the infestation of tissues of live humans and other vertebrate animals with dipteran larvae (maggots), is a phenomenon of widespread occurrence throughout the tropical regions of the world. It is commonly seen in domestic and wild animals but occurs rarely in man also. The tissue invasion in man by maggots is generally a well-recognized complication of neglected wounds. The condition may be asymptomatic but occasionally results in more or less severe problems and even death when larvae invade body cavities or areas that forbid their direct visual examination. Many cases of myiasis, however, usually do not reach the attention of medical practitioners because of the tendency of the mature larvae to migrate out of the lesion for pupation. In the present study, the authors reviewed the past literature describing the cases of human myiasis, causative fly species and predisposing factors for the onset of the same. The aim of the present manuscript is to provide a database for the future reference of medical entomologists, medical practitioners and veterinarians. Review of literature revealed that 37 fly species belonging to ten families were responsible worldwide for the onset of human myiasis. The incidence of myiasis among humans can be correlated to increasing fly populations, poor hygienic conditions and presence of domestic animals in the close vicinity. Other factors responsible for myiasis include neglected open wounds and foul-smelling discharge from natural body openings. Moreover, ignorance plays a key role in its occurrence since people are generally unaware about the actual cause and often correlate the condition to their superstitious beliefs. It is emphasized that the patients should not neglect their wounds and should take proper medical care; otherwise, myiasis may supervene.

Vulval myiasis: An unusual presentation of a rare entity in an adolescent female

Human myiasis refers to parasitic infestation of body tissues by larvae of several fly species. The entity has a simple management. Human myiasis is well-documented in the literature however genital myiasis in females is scarcely reported in the literature. We hereby report this entity in an adolescent female who presented with urinary retention and concomitant urinary tract infection.

Laboratory identification of arthropod ectoparasites

The collection, handling, identification, and reporting of ectoparasitic arthropods in clinical and reference diagnostic laboratories are discussed in this review. Included are data on ticks, mites, lice, fleas, myiasis-causing flies, and bed bugs. The public health importance of these organisms is briefly discussed. The focus is on the morphological identification and proper handling and reporting of cases involving arthropod ectoparasites, particularly those encountered in the United States. Other arthropods and other organisms not of public health concern, but routinely submitted to laboratories for identification, are also briefly discussed.

Maggots in prolapsed uterus - Polluted progress of life style

Myiasis is infestation by dipterous larva that thrives on host's living or necrotic tissue and cause massive tissue infection. We present a case of Myiasis in uterine cavity of a prolapsed uterus of a 77-year-old multiparous lady of West Midnapore District, West Bengal, India. It is a very rare case as only a few reports have been previously published in literature. She had presented with genital pruritus and vague perennial discomfort for last 1 month along with bleeding and foul smelling discharge from vagina for last 2 days. Pelvic examination revealed 'Stage-IV' genitourinary prolapse according to POP-Q classification, with a big excavatory ulcer indwelled with maggots of Musca domestica. About 80 to 90 such maggots were subsequently manually removed with a forceps under anaesthesia. She was advised to undergo definitive surgical treatment for prolapsed uterus. Owing to very low socioeconomic condition or for the fear of the operation, the patient ultimately never turned up.

Myiasis

Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. In mammals (including humans), dipterous larvae can feed on the host's living or dead tissue, liquid body substance, or ingested food and cause a broad range of infestations depending on the body location and the relationship of the larvae with the host. In this review, we deeply discuss myiasis as a worldwide infestation with different agents and with its broad scenario of clinical manifestations as well as diagnosis techniques and treatment.

Myiasis arising in condylomata acuminata: an unusual presentation

Myiasis is infestation of skin, mucosa, orifices or natural cavities of humans or animals by larvae of flying dipterous insects that, at least for a certain period of their life cycle, feed from live or necrotic tissue of the host. The distribution is worldwide with more cases being reported from tropical, subtropical and warm temperate areas. This report describes a rare case of perianal condylomata acuminata complicated with myiasis due to Chrysomya bezziana, seen in the presence of poor hygiene in a tropical country with a high fly population.