Video:Myiasis
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Description
Myiasis, also known as fly strike, is a parasitic infestation by fly larvae (maggots).[1] While there are a number of forms, most commonly the skin or a wound is involved.[1] Symptoms may include pain, itchiness, and the feeling of movement.[1] Complications may include a bacterial infection or scarring.[1] Treatment can be done via surgical removal.[2]
Presentation
How myiasis affects the human body depends on where the larvae are located. Larvae may infect dead, necrotic (prematurely dying) or living tissue in various sites: the skin, eyes, ears, stomach and intestinal tract, or in genitourinary sites.[3] They may invade open wounds and lesions or unbroken skin. Some enter the body through the nose or ears. Larvae or eggs can reach the stomach or intestines if they are swallowed with food and cause gastric or intestinal myiasis.[4][5]
Vectors
There are three main fly families causing economically important myiasis in livestock and also in humans: calliphoridae (blowflies), oestridae (botflies) and sarcophagidae (fleshflies).[6]
Mechanism
In terms of the life cycle we find that female insects lay their eggs in or near wounds, or on the skin. Some species, such as the human botfly , utilize vectors like mosquitoes to transfer their eggs. The eggs hatch into larvae , which penetrate the skin or enter through openings, such as the nose or mouth. These larvae feed on host's tissue. Following the feeding period, which lasts for several weeks, the larvae drop to the ground and pupate in environment. This stage lasts approximately a month. Adult flies emerge from the pupae, mate, and the cycle begins anew.[7]
Diagnosis
Myiasis is often misdiagnosed in the United States because it is rare and its symptoms are not specific. Intestinal myiasis and urinary myiasis are especially difficult to diagnose.[4]Clues that myiasis may be present include recent travel to an endemic area, one or more non-healing lesions on the skin, itchiness, movement under the skin or pain, discharge from a central punctum (tiny hole), or a small, white structure protruding from the lesion.[8] Serologic testing has also been used to diagnose the presence of botfly larvae in human ophthalmomyiasis.[9]
Classification 1
In terms of the classification we find that the classical description of myiasis is according to the part of the host that is infected. This is the classification used by ICD-10. For example:dermal, sub-dermal and cutaneous.[10]
Classification 2
Another aspect is the relationship between the host and the parasite and provides insight into the biology of the fly species causing the myiasis and its likely effect. Thus the myiasis is described as either: obligatory, where the parasite cannot complete its life cycle without its parasitic phase, which may be specific, semispecific, or opportunistic.And the other is facultative, incidental, or accidental, where it is not essential to the life cycle of the parasite.[10][4]
Prevention
To prevent myiasis in humans, there is a need for general improvement of sanitation, personal hygiene, and extermination of the flies by insecticides. Clothes should be washed thoroughly, preferably in hot water, dried away from flies, and ironed thoroughly. The heat of the iron kills the eggs of myiasis-causing flies.[8]
Treatment
In a clinical setting the treatment could be with or without an incision. First the larva must be eliminated through pressure around the lesion and the use of forceps. Secondly the wound must be cleaned and disinfected.[11][1]
Epidemiology
Myiasis is usually among the five most common dermatologic conditions, representing 7 (point) 3 percent to 11 percent of cases. Myiasis typically occurs in tropical and subtropical areas, and people with untreated or open wounds have a higher risk of getting it.[1][2]
History
Frederick William Hope coined the term myiasis in 1840 to refer to diseases resulting from dipterous larvae as opposed to those caused by other insect larvae (the term for this was scholechiasis). Hope described several cases of myiasis from Jamaica caused by unknown larvae, one of which resulted in death.[12]
Maggot therapy 1
Maggot therapy also known as maggot debridement therapy (MDT), larval therapy, larva therapy, or larvae therapy – is the intentional introduction by a health care practitioner of live, disinfected green bottle fly maggots into the non-healing skin and soft tissue wounds of a human or other animal for the purpose of selectively cleaning out only the necrotic tissue within a wound in order to promote healing.[13]
Maggot therapy 2
Although maggot therapy has been used in the US for the past 80 years, it was approved by the FDA as a medical device only in 2004 .[14] Maggots were the first live organism to be marketed in the US according to FDA regulations, and are approved for treating neuropathic (diabetic) foot ulcers, pressure ulcers, venous stasis ulcers, and traumatic and post-surgical wounds that are unresponsive to conventional therapies. In 1990, California internist Ronald Sherman began treating patients with maggots produced at his lab at the UC Irvine School of Medicine. Sherman went on to co-found Monarch Labs in 2005, which UC Irvine contracted to produce maggots for Sherman's own continuing clinical research on myiasis at the university. [15][14]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Francesconi, F; Lupi, O (January 2012). "Myiasis". Clinical Microbiology Reviews. 25 (1): 79–105. doi:10.1128/CMR.00010-11. PMC 3255963. PMID 22232372.
- ↑ 2.0 2.1 "About Myiasis". Myiasis. 13 September 2024. Retrieved 17 February 2025.
- ↑ Ockenhouse, Christian F.; Samlaska, Curt P.; Benson, Paul M.; Roberts, Lyman W.; Eliasson, Arn; Malane, Susan; Menich, Mark D. (1990). "Cutaneous myiasis caused by the African tumbu fly (Cordylobia anthropophaga)". Archives of Dermatology. 126 (2): 199–202. doi:10.1001/archderm.1990.01670260069013. PMID 2301958.
- ↑ 4.0 4.1 4.2 John, David; Petri, William, eds. (2006). Markell and Voge's Medical Parasitology (9th ed.). Missouri: Saunders Elsevier. pp. 328–334. ISBN 978-0-7216-4793-7.
- ↑ Gupta, Sanjeev; Kataria, Usha; Siwach, Sunita (2013). "Myiasis in female external genitalia". Indian Journal of Sexually Transmitted Diseases and AIDS. 34 (2): 129–131. doi:10.4103/0253-7184.120555. ISSN 0253-7184. PMC 3841665. PMID 24339466. Archived from the original on 2023-05-19. Retrieved 2023-06-12.
- ↑ Nouri N, Vahedi; A, Salehi (2020). "Myiasis in humans and animals". Animal Husbandry, Dairy and Veterinary Science. 4 (2). doi:10.15761/AHDVS.1000178. Retrieved 21 January 2025.
- ↑ "CDC - DPDx - Myiasis". www.cdc.gov. 6 June 2024. Archived from the original on 7 February 2025. Retrieved 10 February 2025.
- ↑ 8.0 8.1 Adisa, Charles Adeyinka; Mbanaso, Augustus (2004). "Furuncular myiasis of the breast caused by the larvae of the Tumbu fly (Cordylobia anthropophaga)". BMC Surgery. 4: 5. doi:10.1186/1471-2482-4-5. PMC 394335. PMID 15113429.
- ↑ Lagacé-Wiens, Philippe R. S.; Dookeran, Ravi; Skinner, Stuart; Leicht, Richard; Colwell, Douglas D.; Galloway, Terry D. "Human Ophthalmomyiasis Interna Caused by Hypoderma tarandi, Northern Canada - Volume 14, Number 1—January 2008 - Emerging Infectious Diseases journal - CDC". Emerging infectious diseases. doi:10.3201/eid1401.070163.
- ↑ 10.0 10.1 Janovy, John; Schmidt, Gerald D.; Roberts, Larry S. (1996). Gerald D. Schmidt & Larry S. Roberts' Foundations of parasitology. Dubuque, Iowa: Wm. C. Brown. ISBN 0-697-26071-2.
- ↑ "Myiasis Treatment & Management: Emergency Department Care, Consultations, Complications". eMedicine. 13 June 2023. Retrieved 23 January 2025.
- ↑ "Introduction to myiasis | Natural History Museum". Nhm.ac.uk. Archived from the original on 2012-08-02. Retrieved 2013-11-05.
- ↑ Mohd Zubir, Mohd Zurairie; Holloway, Samantha; Mohd Noor, Norhayati (21 August 2020). "Maggot Therapy in Wound Healing: A Systematic Review". International Journal of Environmental Research and Public Health. 17 (17): 6103. doi:10.3390/ijerph17176103. Retrieved 19 February 2025.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ↑ 14.0 14.1 Rubin, Rita (2004-07-07). "Maggots and leeches: Good medicine". Usatoday.Com. Archived from the original on 2012-07-02. Retrieved 2013-11-05.
- ↑ Carlson, Bob (February 2006). "Crawling Through the Millennia: Maggots and Leeches Come Full Circle". Biotechnology Healthcare. 3 (1): 14–17. PMC 3571037. PMID 23424330.