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Wound Myiasis Caused by Lucilia Sericata

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Wound Myiasis Caused by Lucilia Sericata Arch Iranian Med 2004; 7 (2): 128 – 129 Case Report WOUND MYIASIS CAUSED BY LUCILIA 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 animals, 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 flies onto soil and after 6 to 14 days transform into adult belong to Calliphoridae family which are fly. 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, animal 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 1 Mateos M, Leon A, Gonzalez-Herranz P, Burgos J, Lopez-Mondejar JA, Baquero F. Lucilia sericata infestation of the skin openings for the bone traction device in lengthening of the tibia: apropos of a case [in Spanish]. Enferm Infecc Microbiol Clin. 1990; 8: Figure 1. Spiracle (stigmal plates) of the Lucilia sericata 365 – 7. larvae. 2 Morsy TA, Fayad ME, Salama MM, Sabry AH, el- Serougi AO, Abdallah KF. Some myiasis producers in Discussion Cairo and Giza abattoris. J Egypt Soc Parasitol. 1991; 21: 339 – 46. Lucilia sericata is found in wounds and natural 3 Granz W, Schneider D, Schumann H. Human myiasis in middle Europe [in Germany]. Z Gesamte Inn Med. 1975; orifices of human body or animals particularly the 30: 293 – 301. mouth, eyes, and sinuses. If causes itching, pain, 4 Service MW. Medical Entomology for Students. London; erythema, bleeding, eosinophilia, and sometimes New York: Chapman and Hall; 1996. secondary bacterial infections.5, 6 5 Daniel M, Sramova H, Zalabska E. Lucilia sericata Pays et al 7 in 1976 reported a case of myiasis (Diptera: Calliphoridae) causing hospital-acquired 8 myiasis of a traumatic wound. J Hosp Infect. 1994; 28: due to Lucilia sericata and Cho et al in 1999 149 – 52. reported the first myiasis in human wound in 6 Kaufman GL, Gandevia BH, Bellas TE, Tovey ER, Korea. Daniel et al5 had reported a case of Baldo BA. Occupational allergy in an entomological traumatic myiasis of wound of nose in 1826 and research center. I. Clinical aspects of reactions to the sheep blowfly Lucilia cuprina. Br J Med. 1989; 46: separated 50 larvae from nose, paranasal sinuses 473 – 8. 5 and mouth of the patient. 7 Pays JF, Haas C. Wound myiasis caused by Lucilia In 1999, Bourel et al9 from France reported that sericata [in French]. Bull Soc Pathol Exot Filiales. 1976; there might a relationship between the effect of 69: 181 – 6. 8 Cho JH, Kim HB, Cho CS, Huh S, Ree HI. An aural morphine and development of larvae of Lucilia myiasis case in a 54-year-old male farmer in Korea. sericata. The addict who was reported in this study Korean J Parasitol. 1999; 37: 51 – 3. showed a fast development of Lucilia sericata 9 Bourel B, Hedouin V, Martin-Bouyer L, Becart A, larvae which could be due to repeated injections of Tournel G, Deveaux M, et al. Effects of morphine in heroine. decomposing bodies on the development of Lucilia sericata. J Forensic Sci. 1999; 44: 354 – 8. In current study, larvae were separated from 10 Smith KE, Wall R, Howard JJ, Strong L, Marchiondo wounds and by microscopic study they were AA, Jeannin P. In vitro insecticidal effects of fipronil and identified as Lucilia sericata larvae. The treatment beta-cyfluthin on larvae of the blowfly Lucilia sericata. in human beings has not been established but in Vet Parasitol. 2000; 88: 261 – 8. Archives of Iranian Medicine, Vol 7, No 2, April 2004 129 .
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