Arch Iranian Med 2004; 7 (2): 128 – 129

Case Report

WOUND CAUSED BY SERICATA

Safar-Ali Talari PhD·, Fakhrodin Sadr MD, Abbas Doroodgar MSc, Mohammad-Reza Talari MSc, Ali-Shoja Gharabagh MSc

Lucilia sericata is one of the facultative parasites which causes myiasis in , and rarely in humans as an ectoparasite. Infestation in humans and domestic herbivorous animals occurs in wounds, mouth, eyes, and nose. It causes itching, pain, inflammation, secondary bacterial infections, eosinophilia, and erythema. We report on a 26-year-old man from Kashan, with a 12- year history of opium and a 3-year history of heroin injections was taken to Iran, following a heroine injection, and with signs of hypoxic encephalopathy, decreasing mental clearness, and coma. He was HBsAg and HIV negative, and HCV positive. From the wounds of his left hand, which were caused by repeated injections, 38 live larvae were removed. The larvae proved to be Lucilia sericata.

Archives of Iranian Medicine, Volume 7, Number 2, 2004: 128 – 129.

Keywords · Kashan · Lucilia sericata · myiasis

Introduction complete peritreme of posterior respiratory spiracles. After 4 – 8 days, larvae develop and drop ucilia sericata and Lucilia cuprina onto soil and after 6 to 14 days transform into adult belong to family which are . Lucilia larva very rarely invades living tissues L ectoparasites found in meat and corpse of and feeds. Larva has two posterior breathing animals, and cause myiasis in humans and spiracles can be seen. The third stage larva, after 1 – 3 leaving nutritious wounds continues to develop in domestic herbivorous animals. Lucilia species 6 are distributed in the world and are the most soil until becoming adult. known species in human infestation in America, Africa, and Asia.4 Case Report In humans, the myiasis due to Lucilia sericata was reported in 1826 by Magen who for the first The patient was a 26-year-old man, jobless time separated parasites from mouth, eyes, and living in Kashan, with a 12-year history of paranasal sinuses of a hospital patient.5 Adult addiction to opium and a 3-year history of Lucilia sericata has a metallic green or copper addiction to heroin. He, after injection of an green color with a diameter of 8 – 10 mm, and is unknown dose of heroin, was brought to Shaheed Beheshti Hospital of Kashan with signs of hypoxic seen around butcher shops and slaughter houses. encephalopathy and coma where he was With a hairy back and hairless squama wings it hospitalized. He was HIV and HBsAg negative but makes noise and bothers the residents. The female HCV positive. Thirty-eight larvae were separated lays eggs in meat, fish, corpse, infected 4, 5 from his wounds in the left hand caused by wounds of humans or animals, and excrement. repeated injections. The larvae were studied in the Service has reported that the developmental stage Laboratory of Kashan University of Medical 4 of Lucilia takes 10 – 23 days. Between 8 – 12 hr, Sciences. After complete larva stages, posterior the eggs transform into a conical larva, and spiracles and cephalopharyngial skeleton were fixed on slides by cytologic glue and studied by microscope. By the shape of posterior breathing Authors affiliation: Department of Parasitology, Kashan University of Medical Sciences, Kashan, Iran. spiracles and cephalopharyngial skeleton and ·Corresponding author and reprints: Safar-Ali Talari, PhD, hairless squama in adult wings, were diagnosed as Department of Parasitology, Kashan University of Medical Sciences, Lucilia (Figure 1). Kashan 87155, Iran. Fax: +98-361-458648.

128 Archives of Iranian Medicine, Volume 7, Number 2, April 2004 S.A. Talari, F. Sadr, A. Doroudgar, et al

sheep, according to the study by Smith et al,10 fipronil with a concentration of 0.5 ppm can kill 100% of larvae. We suggest more studies to be undertaken in humans and domestic animals in Kashan area.

Acknowledgment

The authors are thankful to Mr. Akramii, the Laboratory Technician, at Shaheed Beheshti Hospital of Kashan for his support.

References

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