RESUMEN

Myiasis is a condition characterized by fly larvae infestation, most common in tropical regions, but with a risk of occurring anywhere in the world. Here, we report a case of nasal myiasis caused by a sarcophagid fly in a critically ill COVID-19 patient hospitalized in a reallocated ICU department in Serbia and discuss procedures that could prevent the occurrence of similar incidents in reallocated ICU departments worldwide.

RESUMEN

Introduction: Myiasis is the infestation of living bodies of animals and humans with fly larvae or maggots. These accidental or obligatory parasites grow in three stages in the host while feeding on his tissues. Myiasis in a hospital area is a rare situation when flies accidentally lay their eggs on patients, mostly in open wounds or cavities. Case presentation. We report a case of a 72-year-old patient admitted to a general surgery department for peritonitis, then to an intensive care unit (ICU) for septic shock where he was intubated. Some maggots were seen moving in his nasal cavity a few days after his admission and were sent to our laboratory for examination. The larvae were identified as the third larval stage of Lucilia sp. They were removed entirely after intense nasal washing. A checking examination of his nasal cavities revealed no evidence of further infestation. After nasal washing, no other larvae were seen but unfortunately, the patient died of septic shock a few days later. Discussion: Few cases of nasal myiasis in hospitalized patients were reported. ICU myiasis, extremely rare, is caused by the patient's inability to fend off the flies because of their conscious state, presence of blood or odors caused by infections, and the warm humid environment. Conclusion: Myiasis in intensive care unit is a delicate situation that might be underreported. Preventing this infection is directly related to the control of the flies.

Asunto(s)

RESUMEN

This is a video showing a case of nasal myiasis under direct visualization with flexible bronchoscopy in a patient admitted with septic shock and metastatic prostate cancer. Microbiology revealed Lucilia sericata larvae.

RESUMEN

Background and Aim: Nasal myiasis is a serious parasitic disease among camels caused by Cephalopina titillator larvae that negatively affect animal health and production globally. The diagnosis of the infestation relies on postmortem examination of the head region, which considers a cause impeding treatment of live animals and may be misdiagnosed as central nervous system disorders. This study aimed to identify the most diagnostic larval antigen with the capacity for monitoring C. titillator infestation, and to estimate the seroprevalence of nasal myiasis in camels in Egypt, using indirect enzyme-linked immunosorbent assay (ELISA). Materials and Methods: Three hundred and six male camels of Egyptian and Sudanese breeds, aged 2-5 years, were clinically evaluated for respiratory and/or nervous disorders in Cairo Governorate, Egypt. At the time of slaughter, blood samples were collected from all examined animals. The postmortem examination of 38 animals was conducted. Salivary glands, hemolymph, and somatic antigens were extracted from the second and third larval instars. Results: The results revealed that the salivary gland antigen was the most potent antigen in detecting C. titillator specific total IgG antibodies compared to haemolymph and crude somatic antigens. Using receiver-operating characteristic curves and area under the curve, the salivary gland antigen had a sensitivity of 91.67% and a specificity of 92.31%, respectively. It has the highest positive predictive value, 95.7%, and negative predictive value, 85.7%. However, using somatic and hemolymph antigens revealed a sensitivity of 79.17% and 70.83% and a specificity of 76.9% and 84.6%, respectively. There was complete concordance between ELISA results and autopsy findings (true positive). One hundred and forty out of 306 (45.8%) camel serum samples were found to contain C. titillator. Conclusion: This study demonstrated that salivary gland antigen is more effective than somatic and hemolymph antigens in accurately detecting nasal myiasis in camels. In addition, determining the seroprevalence of nasal myiasis with the salivary gland antigen through indirect ELISA revealed that it is a prevalent disease among camels in Egypt. Periodic surveillance of the C. titillator prevalence is necessary for effective management and control measures.

RESUMEN

BACKGROUND: Nasal myiasis is a nasal infestation caused by house fly larvae (maggot). It's a rare condition with only a few reported cases and no treatment consensus. CASE PRESENTATION: A 54-year-old woman was admitted to the emergency unit with a complaint of larvae found in the left nasal cavity and bloody nasal discharge for 2 days. Anterior rhinoscopy found some living larvae in a narrowed left nasal cavity. Patient's management included larvae removal manually with forceps, nasal saline irrigation, a systemic broad-spectrum antibiotic, and insulin to controlled blood sugar. DISCUSSION: Removal of larvae in the nasal cavity using irrigation saline and systemic broad-spectrum antibiotics is effective in the absence of bone destruction. CONCLUSION: manual extraction combined with nasal saline irrigation and systemic broad-spectrum antibiotic was effective to manage nasal myiasis.

RESUMEN

Nasal myiasis is a rare parasitic disease. The growth of myiasis in the nasal cavity causes damage to the nasal cavity and paranasal sinuses. Once the dipeterous larvae are migrated, it causes damage to the surrounding structures such as eyes and skull cavity. Proper treatment and active prevention and control can reduce and avoid the occurrence of serious complications. On May 14, 2020, a patient with cerebral infarction and coma was admitted to Xiangya Hospital of Central South University and developed nasal myiasis. During the treatment of the primary disease, the patient was found to be infected with rhinomyiasis. The patient was treated with dehydration, cranial pressure reduction, brain protection, blood glucose control, blood pressure control, and anti-infection. Nasal endoscopy and nasal irrigation were carried out to treat nasal myiasis. The patient was properly placed and isolated for prevention and control so as to prevent the spread of myiasis in the ward. After 16 days, the patient regained consciousness, no worm was found in the nasal cavity, and was discharged from the hospital. The patient was followed-up for 6 months, no maggots were found in the nasal cavity of the patients, no complaints of nasal discomfort was occurred, and no other patients and medical staff were infected with myiasis. The prevention of myiasis is very important, and proper measures should be taken to reduce the risk of community and hospital infection.

Asunto(s)

RESUMEN

We are reporting a unique case of drosophila larva nasal myiasis (NM) in a 72-year-old male patient admitted to the ICU with diffuse muscle weakness and respiratory failure due to myasthenia gravis crisis and septic shock due to pseudomonas pneumonia. The myiasis was noticed on the third day of admission two days following traumatic insertion of a nasogastric tube. The patient underwent nasal endoscopic mechanical extraction and lidocaine nasal spray with saline nasal flushes. To our knowledge, this is the first case report of NM in a myasthenia gravis (MG) patient. Chronic muscle weakness in MG patients might play a role in having NM as these patients are less likely to be able to protect themselves from flies. Managing NM in our patient was challenging due to the potential neurologic side effects of most of treatment options mentioned in the literature.

RESUMEN

To evaluate the efficacy of oral Ivermectin, in patients suffering from nasal and nasopharyngeal myiasis. This was a prospective study, comprising 80 patients of nasal and nasopharyngeal myiasis. Patients underwent clinical examination and nasal endoscopy at the time of presentation and findings were recorded. The patients were randomly divided in two groups. In group-I the patients underwent manual extraction of the maggots after instillation of chloroform and turpentine oil mixture, whereas the group-II patients underwent manual extraction with administration of two doses (24 h apart) of oral Ivermectin (6 mg each). The patients were instructed to record the time when they noticed shedding of maggots, and evaluated for the clearance of maggots by endoscopy after 24, 48 h and 7 days after the initial examination. The mean maggot shedding time (by t test) in Group-I was 41.23 ± 4.23 h and in Group-II was 24.60 ± 3.15 h. The difference being highly significant statistically, (p = 0.0001). The endoscopic clearance of maggots (by Chi square test) between the two group of patients was also statistically significant at 24 and 48 h with p value of (p = 0.002) and (p = 0.006) respectively. Oral Ivermectin was effective in treating nasal and nasopharyngeal myiasis, in terms of early clearance, decreased morbidity and less hospital stay. We conclude that oral Ivermectin can be used as a safe and effective method for the treatment of nasal & nasopharyngeal myiasis.

RESUMEN

In the Mediterranean basin, one of the most important agents of myiasis is Oestrus ovis Linnaeus 1758 (Diptera, Oestridae). Herein, we report a rare case of nasal myiasis with a secondary infection complication in a patient from northern Italy who had been visiting Corsica. A healthy, 39-year-old Italian woman spent 2 weeks of vacation in Corsica in June 2018. During her stay, she suddenly felt a foreign body inside her nose, followed by cough, pain, burning at the pharyngeal level, cephalalgia, and nasal congestion with secretions from the nostrils. The clinical examination showed a hyperemic and irritated mucosa and endoscopic examination of the patient's nose and right maxillary sinus revealed three tiny mobile larvae, morphologically and molecular identified as L1 instar larvae of Oestrus ovis. The patient's infestation was probably imported from Corsica, as Mediterranean islands are ideal geographical areas for the development of O. ovis, and the timing of infestation match with the period of O. ovis larviposition. Although rhinomyiasis is rare, it should be considered in people returning from abroad presenting with an acute-onset and foreign body sensation in the nose.

RESUMEN

BACKGROUND: Oestrosis, caused by the larvae of Oestrus ovis, commonly known as sheep nose bot, is an obligatory cavitary myiasis of sheep and goats. Oestrus ovis is a widespread parasite, but little is known about the prevalence of oestrosis at the global and broad geographical levels. The present study aimed to explore the epidemiology of oestrosis at the global and regional level to estimate prevalences and their associated factors using a systematic approach. This is, to the author's knowledge, the first meta-analysis of oestrosis in sheep and goats. METHODS: Published articles were obtained from nine electronic databases (PubMed, CAB Abstracts, Web of Science, Scopus, UCB library, Medline, Biosis Citation Index, Indian journals and Google Scholar) reporting the prevalence of O. ovis in sheep and goats from 1970 to 2018. Pooled prevalences were estimated using a random effect meta-analysis model. RESULTS: Sixty-six studies were eligible, and data from 40,870 sheep and 18,216 goats were used for quantitative analysis. The random effect estimated prevalence of oestrosis at the global level in sheep was 51.15% (95% CI: 42.80-59.51%) and in goats was 42.19% (95% CI: 33.43-50.95%). The pooled prevalence estimates for Africa, Asia, Europe and the Americas were 47.85% (95% CI: 36.04-59.66%), 44.48% (95% CI: 33.09-55.87%), 56.83% (95% CI: 48.92-64.74%) and 34.46% (95% CI: 19.90-49.01%), respectively. Heterogeneity (I2 > 80%) was detected in most pooled estimates. CONCLUSIONS: Oestrosis is highly prevalent in many geographical regions of the world, especially in Europe and Africa. Factors that contribute to the pooled prevalence estimate of oestrosis need to be emphasised in any survey to estimate the true prevalence of oestrosis. Furthermore, there is a need for immunisation or implementation of other preventive measures to reduce the burden of oestrosis in sheep and goats and to improve the health and welfare status.

Asunto(s)

RESUMEN

PURPOSE: Orbital myiasis is a rare condition. We report a case of massive orbital myiasis (ophthalmomyiasis profunda) arising from nasal myiasis and caused by Chrysomya bezziana in a patient with diabetes. OBSERVATIONS: A 55-year-old woman presented with massive orbital myiasis from larvae invading the entire orbit, with only a small part of sclera and bulbar conjunctiva left of the ocular structures left unaffected. The patient complained of breathing difficulty and drooping of the left eyelid with no other significant complaints. Computed tomography of paranasal sinuses was performed to determine the extent of intraocular invasion of larvae and the surrounding area that might be involved. The larvae filled the nasal and orbital cavity with bony destruction. The patient had a history of diabetes mellitus with uncontrolled blood sugar. CONCLUSIONS AND IMPORTANCE: Orbital myiasis is an infestation of any anatomical structure of the orbit with larvae from the order Diptera. To our knowledge, this is the first reported case of massive orbital myiasis arising from nasal myiasis caused by C. bezziana in a patient with diabetes. Eliminating the causative larvae and topical treatment with antibiotics eye ointment therapy improved the patient's symptoms. Epidemiological data are required to improve documentation of the incidence rate of myiasis.

RESUMEN

Myiasis is caused by invasion of larvae stage of dipterans fly in living tissue of vertebrate host including human and animals. The most important family is Calliphoridae and included Calliphora, Lucilia, Chrysomyia and Cochliomyia genus. A 35-yr-old man with gastric cancer history referred to Golestan Hospital in Ahvaz Southwest of Iran in 2015. He was infected by nasal myiasis from Lucilia spp. in ICU. The genus of third larvae stage was identified by microscopic examination and culture of pupa. The population of flies inducing myiasis should be controlled in hospitals.

RESUMEN

A 74 yr old woman from Gonabad, southern part of Khorasan Razavi Province of Iran was admitted to a Hospital of Gonabad, because of respiratory distress, exertional dyspnea and fever. Close contact with domestic animals, history of chronic obstructive pulmonary disease (COPD), and completely resolved pulmonary tuberculosis (TB) in remote past, were notable parts of her past medical history. Due to clinical, paraclinical and radiographic findings and because of recent hospitalization, she was admitted to internal medicine ward with the diagnosis of health care associated pneumonia (HCAP). Despite the application of broad-spectrum antibiotics and appropriate supportive care, she had a poor response to the treatment. During the daily visit in Intensive Care Unit (ICU), numerous white larvae were detected in both nostrils. Further investigation of oropharynx and tracheal tube aspiration, showed no more larvae in mentioned parts. An hour later, nasal spontaneous bleeding occurred. Otorhinolaryngology consultation was performed and led to surgical procedure. In ENT examination, there were numerous larvae and massive clot formation in both inferior meatuses and distal nasal septum perforation. Thirty-seven extracted larvae were transferred to Medical Entomology lab by vial 70% ethanol and 5 live larvae for rearing. After precise investigation by aid of light microscopy, the larvae were identified as Chrysomya bezziana. Due to discovered 2nd larvae stage and duration of hospitalization, this infestation was identified as nasal myiasis.

RESUMEN

We report a case of human nasal myiasis caused by flower fly larva in a 14-year-old rural girl in Central Province of Iran. Entomological studies on larva showed the larva as Eristalis tenax which is a rarely cause of nasal myiasis. This is the first reported case of E. tenax larva causing human nasal myiasis in Iran.

RESUMEN

BACKGROUND: Nasal myiasis is very distressing condition of the nose that occurs among patients with atrophic rhinitis. This condition is frequently found among those belonging to the lower socioeconomic status suffering from bad nasal hygienic conditions. A retrospective study was done of 58 cases of patients admitted for nasal myiasis. All the patients belonged to the lower socio- economic class and suffered from poor hygienic condition. The majority of the patients were over the age of 60 years and male female ratio was 1 : 1.5 .The primary complaints of this condition were epistaxis, foul smelling nasal discharge, passage of worms from the nose and pain. The majority of the patients were suffering from primary atrophic rhinitis and a few from the secondary atrophic rhinitis due to syphilis and leprosy. TREATMENT: As a first step of treatment, the maggots were removed manually and endoscopically. All the patients became maggot free in 2-3 days time. Alkaline nasal douching was then started along with 25% glucose in glycerine nasal drop. Complications such as septal perforation, saddling nose, palatal perforation were observed in a few cases. The incomplete closure of nose (modified Young's operation) was performed in a few cases. CONCLUSION: Manual and endoscopic removal should be done repeatedly. Antimeningitis prophylaxis should be started at once. And, to prevent recurrence, mosquito net should be used while sleeping, and incomplete closure of both the nasal cavity (modified Young's operation) should be carried out.

Asunto(s)