Myiasis: Difference between revisions

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==Background==
==Background==
Dermatobia hominis
[[File:Miasis human.jpg|thumb|Myiasis in patient neck]]


Odd question of Collembola (Springtail) implicated in one case series (J NY Entomol Soc, 2004)
*Caused by ''Diptera'' species. ''Dermatobia hominis'' (botfly) is most common cause in North America
==Treatment==
*Cutaneous (includes follicular, wound, and migratory) type is most common
-Pimozide (diphenylbutylpiperidine class antipsychotic) at 1–12 mg daily
**Can also occur in mouth, urogenital, ophthalmic, nasopharyngeal location
*Typically occurs in tropical and subtropical areas. US cases typically due to travel to endemic region<ref name="CDC">https://www.cdc.gov/parasites/myiasis/faqs.html Accessed 02/06/17</ref>
*Bacterial superinfection is rare<ref name="McGraw" />
 
==Clinical Features==
*Erythematous papule with central pore (allows for larval respiration)<ref name="McGraw">McGraw TA. Turiansky GW. Cutaneous myiasis. Journal of the American Academy of Dermatology. 58(6):907-26; quiz 927-9, 2008 Jun.</ref>
*Sensation of movement within lesion
*Serous drainage
 
==Differential Diagnosis==
{{Travel Skin Conditions DDX}}
{{Ectoparasite DDX}}
 
==Evaluation==
*Clinical diagnosis
 
==Management<ref name="McGraw" />==
''If entire larvae is not removed, severe inflammatory response occurs''
*Occlusion of central pore with petroleum jelly or mineral oil interrupts oxygen supply and causes larvae to migrate to surface where it can be grasped with forceps and removed
**Can take up to 24 hours
*Manual removal by squeezing out larvae
*Surgical removal by making incision over larvae and removing with forceps
*Ivermectin - single PO dose or topical application
*Wound myiasis requires surgical debridement
*Ocular, nasopharyngeal, urogenital myiasis should prompt appropriate specialist consultation for management
 
==Disposition==
*Cutaneous myiasis generally may be discharged after removal
*Disposition of other forms based on discussion with specialist


==See Also==
==See Also==
*[[Parasitic Diseases]]
*[[Parasitic Diseases]]
*[[Travel Medicine]]
*[[Travel Medicine]]
==External Links==
==References==
<references/>


[[Category:ID]]
[[Category:ID]]
[[Category:TropMed]]
[[Category:Tropical Medicine]]

Revision as of 03:52, 7 February 2017

Background

Myiasis in patient neck
  • Caused by Diptera species. Dermatobia hominis (botfly) is most common cause in North America
  • Cutaneous (includes follicular, wound, and migratory) type is most common
    • Can also occur in mouth, urogenital, ophthalmic, nasopharyngeal location
  • Typically occurs in tropical and subtropical areas. US cases typically due to travel to endemic region[1]
  • Bacterial superinfection is rare[2]

Clinical Features

  • Erythematous papule with central pore (allows for larval respiration)[2]
  • Sensation of movement within lesion
  • Serous drainage

Differential Diagnosis

Travel-related skin conditions

See also domestic U.S. ectoparasites

Domestic U.S. Ectoparasites

See also travel-related skin conditions

Evaluation

  • Clinical diagnosis

Management[2]

If entire larvae is not removed, severe inflammatory response occurs

  • Occlusion of central pore with petroleum jelly or mineral oil interrupts oxygen supply and causes larvae to migrate to surface where it can be grasped with forceps and removed
    • Can take up to 24 hours
  • Manual removal by squeezing out larvae
  • Surgical removal by making incision over larvae and removing with forceps
  • Ivermectin - single PO dose or topical application
  • Wound myiasis requires surgical debridement
  • Ocular, nasopharyngeal, urogenital myiasis should prompt appropriate specialist consultation for management

Disposition

  • Cutaneous myiasis generally may be discharged after removal
  • Disposition of other forms based on discussion with specialist

See Also

External Links

References

  1. https://www.cdc.gov/parasites/myiasis/faqs.html Accessed 02/06/17
  2. 2.0 2.1 2.2 McGraw TA. Turiansky GW. Cutaneous myiasis. Journal of the American Academy of Dermatology. 58(6):907-26; quiz 927-9, 2008 Jun.