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Myiasis is an infestation of living tissue with larvae of dipteran flies that commonly inhabit tropical and subtropical regions. The infection principally affects animals but human cases have been also reported. The larvae commonly invade the contaminated cutaneous structures such as wounds or furuncles, but sometimes can invade inner deeper structures. Many cases of myiasis affecting the newborn infants are globally reported with the highest incidence in rural communities with poor hygienic conditions. In this piece of research, we report a case of umbilical myiasis of an 11-day-old infant from Al-Mikhwah city, South Western Saudi Arabia. Parasitologic examination identified the infestation with tumbu fly (Cordylobia anthropophaga) larvae. The clinical presentation and epidemiology were discussed.

Myiasis is a skin infection caused by developing larvae (maggots) of various Diptera fly species. The two most frequent flies that cause human infestations around the world are Dermatobia hominis (human botfly) and Cordylobia anthropophaga (tumbu fly). Maggots have been found to infest the nose, ear, orbit, tracheostomy wound, face, gums, and serous cavities, among other places. Maggots at the colostomy site are an uncommon occurrence. We report a case of maggots infestation surrounding the colostomy site. We came across a rather rare finding in a patient with advanced inoperable rectum cancer who initially complained of persistent nonspecific pain, discomfort, and foul-smelling discharge from the colostomy site. The issue at hand was identified to be maggots, and their removal alleviated the patient's symptoms. We underline the importance of regularly monitoring stoma sites to avoid maggot infestation, especially in tropical regions.

The article reviews literature on myiasis in Africa and cases that originated in Africa over the last two decades (1998-2018). The relevant literature was obtained by using several databases (Science-Direct, JSTOR, Google Scholar, Ebscohost and PubMed). We searched for the following words or their combination myiasis, maggots, fly species responsible for myiasis found in Africa, and the different types of myiasis. References in several articles provided links to other relevant works. Only papers written in English were reviewed. In total, we reviewed 51 articles which covered a total of 849 myiasis cases. The review encompasses geographical distribution of the disease, dipteran species responsible, predisposing factors, sex of the patient, type of myiasis and treatment. Myiasis is found in most parts of the African continent, however only 18 articles reported myiasis cases in Africa during the period under review. The rest of the articles report cases from the rest of the world but acquired by travellers when visiting Africa. Cordylobia anthropophaga (Blanchard) was responsible for 93.28% of all the reported cases in this review. The low number of articles on human myiasis reported in Africa may be due to underreporting by physicians or most cases are not diagnosed. Therefore, the actual prevalence of myiasis in Africa is currently unknown.

The cutaneous myiasis has been rarely reported in the Republic of Korea. We intended to describe here a case of furuncular cutaneous myiasis caused by Cordylobia anthropophaga larvae in a Korean traveler returned from Central Africa. A patient, 55-year-old man, had traveled to Equatorial Guinea, in Central Africa for a month and just returned to Korea. Physical examinations showed 2 tender erythematous nodules with small central ulceration on the left buttock and thigh. During skin biopsy, 2 larvae came out from the lesion. C. anthropophaga was identified by paired mouth hooks (toothed, spade-like, oral hooklets) and 2 posterior spiracles, which lack a distinct chitinous rim. Although rarely described in Korea until now, cutaneous myiasis may be encountered more frequently with increasing international travel and exchange workers to tropical areas.

A fly larva was recovered from a boil-like lesion on the left leg of a 33-year-old male on 21 November 2016. He has worked in an endemic area of myiasis, Uganda, for 8 months and returned to Korea on 11 November 2016. The larva was identified as Cordylobia anthropophaga by morphological features, including the body shape, size, anterior end, posterior spiracles, and pattern of spines on the body. Subsequent 28S rRNA gene sequencing showed 99.9% similarity (916/917 bp) with the partial 28S rRNA gene of C. anthropophaga. This is the first imported case of furuncular myiasis caused by C. anthropophaga in a Korean overseas traveler.

The leading causes of cutaneous disease in returned travelers are skin and soft tissue infections (SSTI), insect bites, and tropical skin diseases. The clinical spectrum of SSTI is broad, but most cases are due to Streptococcus pyogenes or Staphylococcus aureus. Tropical skin infections account for about 20% of travel-related dermatoses. Hookworm-related cutaneous larva migrans (HrCLM) causes 95% of cases of creeping dermatitis; gnathostomiasis, larva currens, loiasis, and other parasites account for the remaining cases. Other less common parasitic skin infections are tungiasis, furuncular myiasis (Dermatobia hominis, Cordylobia anthropophaga, C. rodhaini), and localized leishmaniasis (Old World and New World). The tropical environment accounts for skin diseases such as sunburn, arthropod exposure, animal bites, insect stings, and to a lesser extent, marine envenomation.

Myiasis has been defined as the infestation of organs and/or tissues with dipterous larvae. They are especially widespread in tropical and subtropical areas. Cutaneous myiasis is its most frequent clinical presentation. This report presents a case of furuncular myiasis caused by the larva of Cordylobia anthropophaga in a 22-year-old girl living in Bergamo, Northern Italy, who returned from Kenya (Watamu) with a big, painful furuncle in her right gluteus. The patient accidentally removed the larva from a large pimple and took it to the infectious disease ambulatory clinic at the ASST “Papa Giovanni XXIII” Hospital, Bergamo. In the Microbiology and Virology Department of the same hospital, a larva of C. anthropophaga was identified and the diagnosis of myiasis was confirmed.

Furuncular myiasis results when the larva penetrates healthy skin to cause a furuncle like nodule which may mimic common dermatoses like insect bites and pyoderma leading to misdiagnoses. Tumbu fly (Cordylobia anthropophaga) is the most common cause in Africa and is endemic in Malawi. We describe a case of C. anthropophaga furuncular myiasis from a 6-month-old baby who presented with an acute history of a rash and was initially misdiagnosed on two occasions. Treatment consisted of manual removal of the larva and subsequent local wound care with a good outcome. We believe that much as Malawi is in the endemic region of the Tumbu fly, the disease’s clinical mimicking of common dermatoses and the patients’ preference to treat themselves at home may result in clinicians gaining less experience in managing furuncular myiasis cases in their daily practice leading to misdiagnoses. This report therefore demonstrates the practical challenges which unwary clinicians and patients in Malawi might encounter when faced with this otherwise common condition. It further highlights the importance of dermatologists and other non-dermatologist clinicians to consider furuncular myiasis among differential diagnoses in like lesions which in turn will reduce the unnecessary use of antibiotics and delay correct patient treatment.

Myiasis is a temporary infection of the skin or other organs with fly larvae.1 The larvae develop into boil-like lesions. Creeping sensations and pain are usually described by patients. Following the maturation of the larvae, spontaneous exiting and healing is experienced. Herein we present a case of a traveler returning from Central African Republic. She does not recall insect bites. She never took off her clothing for recreational bathing, nor did she visit any rural areas. The lesions appeared on unexposed skin. The specific diagnosis was performed by morphologic characterization of the larvae, resulting in Cordylobia anthropophaga, the dominant form of myiasis in Africa. To our knowledge, this is the first reported case of C. anthropophaga in Latin America. Keywords: Cordylobia anthropophaga, Furuncular myiasis, Tumbu-fly

BACKGROUND Furuncular myiasis is likely to be seen by Western dermatologists because of the increasing number of international travelers but remains unfamiliar to most of them, who tend to refer these patients to hospitals. Different treatments have been proposed, but many of them are not achievable in outpatient consultation. METHODS We reported three typical cases of furuncular myiasis, according to each species involved, and proposed diagnostic and therapeutic guidelines for dermatologists in outpatient consultation. RESULTS One patient, complaining of an inflammatory nodule of the leg with a central punctum, was diagnosed with Dermatobia hominis infection, after a forest walk in French Guiana. One woman returned from Senegal with a nodule of the left buttock. She had been infected by a Cordylobia anthropophaga larva after drying her underwear under a mango tree. One woman living in Cameroon presented with scalp nodules, pain, fatigue, and facial edema. She had been infected by more than 40 larvae of Cordylobia rodhaini after drying her sheets under a mango tree. Manual extraction ensured complete healing in the three patients. We used neither doppler ultrasound nor occlusive dressing. Diagnosis was immediately made thanks to the typical clinical stories. CONCLUSIONS The diagnosis of furuncular myiasis requires only clinical skills and basic knowledge of life cycles. The treatment varies slightly depending on the species involved but is achievable in outpatient consultation and does not require occlusive dressing.

A fly larva was recovered from a boil-like lesion on the left leg of a 33-year-old male on 21 November 2016. He has worked in an endemic area of myiasis, Uganda, for 8 months and returned to Korea on 11 November 2016. The larva was identified as Cordylobia anthropophaga by morphological features, including the body shape, size, anterior end, posterior spiracles, and pattern of spines on the body. Subsequent 28S rRNA gene sequencing showed 99.9% similarity (916/917 bp) with the partial 28S rRNA gene of C. anthropophaga. This is the first imported case of furuncular myiasis caused by C. anthropophaga in a Korean overseas traveler.

More affordable international travel, global trade and commerce, and the exporting of labor have all contributed to international population mobility. Furthermore, population migration leads to the incidence or recurrence of once-controlled diseases. Evidence shows that the popularity of travel can impact health through imported infections and illness. Imported cutaneous myiasis, a type of skin lesion, has attracted the attention of the current authors. This condition often occurs among travelers and it has been reported in several non-endemic countries. However, diagnosis of myiasis and identification of the larvae are difficult. Advances in molecular detection techniques could provide a new way to identify larvae. This study used sequencing of the 28S rRNA gene and morphology to identify the larva infesting the upper arm of a Chinese woman returning from Uganda. The larva was identified as Cordylobia anthropophaga (C. anthropophaga) and the sequences were submitted to GenBank (accession number: KM506761). As foreign interaction increases, imported health problems may become more common in China. Knowledge about various pathogens needs to be increased and molecular methods need to be used to accurately identify those pathogens.

Myiasis is defined as the infestation of live vertebrates, either humans or animals, with dipterous larvae. Many organs can be infested by these larvae with cutaneous myiasis being the most common form. Cutaneous myiasis can be divided into three categories: localized furuncular myiasis, migratory myiaisis and wound myiasis, which occurs when fly larvae infest the open wounds of the host. Human myiasis has worldwide distribution, with more species and a heavier burden in tropical and subtropical countries. In recent years with increased travel to the tropics, myiasis has become common in returning travelers from these regions, Furuncular myiasis, mainly Dermatobia homonis becomes the most common form seen among them. Treatment is based on full extraction of the larva and no antibiotic treatment is needed. Understanding the mode of transmission of each type of myiasis may help to prevent the infestation.

BACKGROUND: Cutaneous myiasis is the infestation of the skin by larvae (maggots) of the order Diptera (two winged). Being an imported and sporadic illness, furuncular myiasis often poses a diagnostic challenge to the treating physician. This traditionally endemic entity is being more frequently reported worldwide as ‘vacation’ disease in travellers returning from these regions. However, there is a paucity of large scale study, especially on individuals occupationally stationed for longer periods of time in these endemic geographic locations. METHODS: Sixteen Indian male patients with cutaneous furuncular myiasis presenting to dermatology outpatient department at a tertiary care field hospital deployed in a United Nations peacekeeping mission in Central Africa were studied for clinical presentation, sites involved, larvae/maggot extracted, period of resolution and complications if any. RESULTS: Average age of patients was 29 years. The average duration of infestation was 4 days. All lesions were found to be confined to sites over body normally covered with clothing, commonest being anterior abdomen in 9 (56.25%) patients followed by chest in 6 (37.5%) patients. The lesion count was also highest on anterior abdomen with 39 lesions. The average time to resolution following extraction of larvae (Cordylobia anthropophaga) was 6 days. CONCLUSION: The purpose of this study was to familiarize oneself with an endemic infestation which often masquerades itself as pyoderma to the naïve physician, more so in an imported case or more importantly, an ‘exported’ health care professional.

Myiasis is derived from the Greek word, myia, meaning fly. The term was first introduced by Hope in 1840 and refers to the infestation of live human and vertebrate animals with dipterous (two-winged) larvae (maggots) which, at least for a certain period, feed on the host's dead or living tissue, liquid body-substance, or ingested food. Myiasis is the fourth most common travel-associated skin disease and cutaneous myiasis is the most frequently encountered clinical form. Cutaneous myiasis can be divided into three main clinical manifestations: furuncular, creeping (migratory), and wound (traumatic) myiasis. The flies that produce a furuncular myiasis include Dermatobia hominis, Cordylobia anthropophaga, Wohlfahrtia vigil, and the Cuterebra species. Gasterophilus and Hypoderma are two flies that produce a creeping myiasis. Flies that cause wound myiasis include screwworm flies such as Cochliomyia hominivorax and Chrysomya bezziana, and Wohlfahrtia magnifica. This article reviews current literature, provides general descriptions, and discusses life cycles of each species. It also gives treatment techniques and descriptions of each type of illness that results from interaction/infestation.

Cordylobia anthropophaga (Blanchard) Dhee Ain (Al-Mekhwa) 19.55459° N, 41.26302° E: May 2012., Published as part of El-Hawagry, Magdi S., Sharaf, Mostafa R., Al Dhafer, Hathal M., Fadl, Hassan H. & Aldawood, Abdulrahman S., 2015, Addenda to the insect fauna of Al-Baha Province, Kingdom of Saudi Arabia with zoogeographical notes, pp. 1209-1236 in Journal of Natural History 50 on page 1227, DOI: 10.1080/00222933.2015.1103913, http://zenodo.org/record/3990247

Background Domestic cavies (Cavia porcellus) are increasingly reared in rural areas of Cameroon for meat and income generation. Unfortunately, health constraints due to various pathogens including parasites stand as one of the major obstacles to the development of cavy industry in the country. The main objective of this study was to investigate the species of gastrointestinal parasites in cavy husbandry in the western highlands of Cameroon and to detect external parasites in those animals affected with dermatological disorders. Methods Pooled fecal samples were collected from 62 privately-own farms, as well as individual fecal samples from 21 animals at the Teaching and Research Farm of the University of Dschang, and examined for parasite eggs and oocysts/cysts. Ectoparasites were also collected from cavies and identified. Results The overall infection rate with both helminthes and arthropods was 40.3 %. Ectoparasites were found in 19 out of 62 farms (30.6 %) while 12.9 % of farms were infected with helminthes. Eggs of Graphidium strigosum (8.1 %), Trichostrongylus sp. (3.2 %) and Paraspidodera uncinata (3.2 %) were found at farm level. Oocysts of Eimeria caviae and eggs of Paraspidodera uncinata were found in 14.3 and 9.5 % of examined animals respectively. Concerning ectoparasites, Cordylobia anthropophaga and Pulex sp. were observed in 25.8 % and 6.6 % of farms respectively. Conclusion The parasites are apparently composed of host-specific species in the original habitat (South America) and species acquired later from other mammals. These parasites are either deleterious to cavy health or zoonotic. Preventive measures should be put in practice to avoid their presence on farms due to their harmful effect on cavy rearing.

Background Cordylobia anthropophaga is one of the most common agents of urogenital myiasis in African tropical regions. A case of vulvar myiasis due to the larvae of Cordylobia anthropophaga in a 16-year-old female is presented with a systematic review of the literature. Case A 16-year-old female with a history of recent journey to Senegal presented with a vulvar boil-like inflammatory lesion. A living insect larva was extracted from the lesion. It was identified as a Cordylobia anthropophaga larva. Summary and Conclusions Diagnosis of vulvar myiasis must be considered if vulvar boil-like inflammatory papules are found, essentially in travelers to and from endemic countries. The diagnosis is mainly clinical and its management consists of the extraction of the larva.

Furuncular myiasis is a parasitic infestation of human and other vertebrate tissues by fly larvae of primarily two species: Dermatobia hominis (human botfly, t6rsalo, or berne) in Mexico and South and Central America and Cordylobia anthropophaga (tumbu fly or mango fly) in Africa. Cuterebra species (rabbit and rodent botflies) are also rarely reported to cause furuncular myiasis only within the United States. Although these species inhabit different geographic regions and have different life cycles, their clinical presentations can be similar. We describe a case of "imported" human botfly (D. hominis) furuncular myiasis in a U.S. Army soldier stationed in Germany. We review the life cycles of human botflies and key aspects of their clinical presentation, differential diagnosis, and various therapeutic modalities. Most physicians may never encounter myiasis and attribute a patient's complaints to an insect bite or skin infection that will heal without treatment. However, the diagnosis of furuncular myiasis should be considered by remembering the basic elements of this condition: recent travel history to the tropics and a sterile, persistent furuncle with sensations of movement and pain.

Résumé Nous rapportons un cas de myiase préputiale chez un enfant qui a consulté pour une tuméfaction pénienne douloureuse faisant croire à une balanoposthite. Le traitement a consisté à une extraction manuelle du ver suivie d’une circoncision. L’examen parasitologique du ver a permis d’identifier une larve de Cordylobia anthropophaga de stade 3. À travers cette observation et une revue de la littérature, nous allons discuter des particularités épidémiologiques, diagnostiques et thérapeutiques des myiases humaines.

Background Cutaneous myiasis is a well-established diagnosis in returning travelers from tropical countries. The most common form of myiasis seen in this population is localized furuncular myiasis caused by Dermatobia hominis and Cordylobia anthropophaga . There are limited data on the disease course and outcome in travelers to tropical countries. Methods A retrospective observational study of patients who presented with myiasis was conducted between 1999 and July 2014 in the post-travel clinics in Israel. Data regarding exposure history, travel duration, clinical presentation, treatment, and parasitological identification were collected and analyzed. Results Among 6,867 ill returning Israeli travelers, 1,419 (21%) had a dermatologic complaint, 90 (6.3%) of them were diagnosed with myiasis. Myiasis was acquired in Latin America by 72 (80%) patients, mainly (54%) in the Madidi National Park, Amazonas Basin, Bolivia; 18 cases (20%) were acquired in Africa. In 76% of cases, manual extraction was sufficient to remove the larva; 24% required surgical intervention. Despite the fact that most patients did not receive antibiotic treatment, only one developed secondary infection, upon partial removal of the larva. Conclusions This is the largest myiasis case series in ill returning travelers. Myiasis is not a rare dermatologic complaint with most Israeli cases imported from Latin America and specifically the Madidi National Park in Bolivia. Treatment is based on full extraction of the larva after which no antibiotic treatment is needed. Myiasis is a preventable disease and travelers should be informed of the different preventive measures according to their travel destination.

A scanning electron microscopy study of the third larval instar of Cordylobia rodhaini Gedoelst (Diptera: Calliphoridae), causing obligatory furuncular myiasis, is presented here for the first time. The larvae were collected from a patient exposed to them in the tropical rainforest of Kibale National Park (Uganda). Distinctive features are described in sequence from the anterior region to the posterior region, highlighting the morphological features of antennae, maxillary palps, structures related to mouth opening, sensory structures, thoracic and abdominal spines, and anterior and posterior spiracles. The results are compared with those of other Calyptrata flies, mainly from the family Calliphoridae and, when possible, with Cordylobia anthropophaga Blanchard (Diptera: Calliphoridae), the only other species of genus Cordylobia investigated by scanning electron microscopy.

Resumen —Miasis es un termino que significa la infestacion de organos y tejidos de vertebrados por dipteros, habitualmente moscas. Presentamos dos casos de miasis forunculoide, poco frecuentes en nuestro pais, ya que las especies de moscas que producen este tipo de miasis no habitan en Espana. El primero se trataba de una miasis producida por Cordylobia anthropophaga o mosca tumbu que habita en Africa, en el sur del Sahara. El segundo de los casos estaba producido por Dermatobia hominis, conocida como torsalo, berne o moscardon de los humanos, comun en America Central y Sudamerica. Las lesiones consistian en nodulos cutaneos, con ulceracion superficial de la que emergian las larvas. Estas larvas fueron estudiadas histopatologicamente, prestando especial atencion a las caracteristicas que permiten diferenciar las dos especies.

Die kutane Myiasis ist eine temporare Infestation der Haut mit Fliegenlarven, die aufgrund des zunehmenden Fernreisetourismus in subtropische Gebiete auch vermehrt in Europa angetroffen wird. In Mittel- und Sudamerika wird die kutane Myiasis meistens durch die Larven der Bot- oder Dasselfliege (Dermatobia hominis) verursacht. Moskitos oder andere blutsaugende Insekten ubertragen die Larven der Dasselfliege durch Phoresis, einem einzigartigen Mechanismus der Eiablage. Im afrikanischen Raum losen die Larven der Tumbufliege (Cordylobia anthropophaga) haufig die kutane Myiasis aus. In Kleidung oder Handtuchern abgelegte Eier der Tumbufliege fuhren dabei nach direktem Kontakt zur Infestation. Klinisch imponiert eine Furunkel-ahnliche Lasion, vereinzelt wird uber spurbare Bewegungen in der Haut berichtet. Nach dem „Schlupfen” der Larven erfolgt in der Regel eine spontane Heilung. Die Extraktion der Larven wird jedoch empfohlen, um starker entzundliche Reaktionen und Sekundarinfektionen zu verhindern.

A case of exotic myiasis caused by tumbu fly (Cordylobia anthropophaga) parasitism acquired while travelling in the Republic of Namibia is reported. This is the fifth case reported in Japan, and is very unusual in that the patient was infected with 19 larvae. This is also the first case diagnosed using molecular methods in Japan. We cultured the extracted larvae in vitro and successfully obtained pupae.

Myiasis bezeichnet den Befall von humanem oder tierischem Gewebe durch Fliegenlarven. Wir stellen eine kutane Myiasis (Tumbu-Fliege; Cordylobia anthropophaga) eines Touristen vor, der sich in Afrika aufgehalten hatte. Die Diagnose basiert auf der Reiseanamnese und typischen Merkmalen der furunkularen Hautlasionen. Die Larven werden entweder mit einer Pinzette extrahiert oder chirurgisch entfernt.

Myiasis-causing larvae were extracted from dogs attending veterinary clinics in Plateau State, Nigeria and subjected to molecular analysis involving polymerase chain reaction amplification of the 28S rRNA gene of blowflies, cloning and sequencing techniques. All larvae were confirmed as Cordylobia anthropophaga Blanchard (Diptera: Calliphoridae) after the initial morphological identification. This is the first molecular identification of any myiasis-causing fly species in Nigeria and may serve as a reliable alternative to morphological identification where samples are not well preserved or difficult to identify to species level.

We report a case of furuncular myiasis complicated by Staphylococcus aureus infection and beta-hemolytic streptococcal cellulitis. The Dermatobia hominis larva that caused this lesion could not be extracted using standard methods, including suffocation and application of lateral pressure, and surgery was contraindicated because of cellulitis. The botfly maggot was completely and rapidly extracted with an inexpensive, disposable, commercial venom extractor.

A study was carried out to establish the emergence of cutanous myiasis with its zoonotic implication in Vom and Bukuru metropolis of Jos South Local Government Area of Plateau State. 6 individuals (3 males and 3 females) who were suspected to have boils on their skin were diagnosed to be 100% infested with the larvae of Cordylobia anthropophaga. Similarly, in an investigation of dogs, out of 510 dogs examined in Evangelical Church of West Africa and NVRI Veterinary clinics, 47(9.2%) dogs had larvae in their cutanous tissues. Of 300 dogs from ECWA vet clinic 31 (10.3%) were positive, while 16 (7.6%) were positive from 210 dogs screened in NVRI vet clinic. All results were statistically significant at P< 0.05. In comparism, the larvae extracted from human and dogs were all identified to be of Cordylobia anthropophaga. Of 184 Alsatian 13(7.1%) were positive, of 258 Mongrel 27(10.5%) were positive, 3(21.4%) among 14 Doberman were positive and of 54 Rottweiler 4(7.4%) were positive. Out of the 47 positive cases, 31(66.0%) were female while 16 (34%) were males. Among the female positive cases Mongrel showed a prevalence of 18(58.1%). Infestation in July showed a high occurrence of 22(46.8%). Secondary bacterial infection was encountered in two cases of human infestation.

SIX MONTHS to the day after US military forces landed in Somalia to "Restore Hope"—as the operation was called—the United Nations is beginning a $1-billion—plus, 6-month to 2-year attempt to keep peace and start to rebuild that country's entire infrastructure, including health services. Health services are particularly important. The numerous diseases endemic to the region have gained an even greater foothold in the chaos since the government of this civil-war-ravaged northeast African coast nation collapsed, and US military medicine participated in rescuing American and other diplomatic personnel (JAMA. 1991;265:1791-1793, 1797; and 266:619-620). A few of the more immediately threatening endemic disorders include acute diarrheal diseases (species ofShigella, Salmonella, andCampylobacter, andEscherichia coli), Congo-Crimean hemorrhagic fever, dengue, louse- or tick-borne typhus, meningococcal meningitis, myiasis (Cordylobia anthropophaga[tumbu fly] larvae infestation), parenterally transmitted acute viral hepatitis (B, C, and D), hepatitis A and E, plague,Plasmodium falciparum(which accounts for

We describe a case of cutaneous myiasis caused by Cordylobia anthropophaga acquired in the UK from contact with another person's clothes. We propose that this diagnosis should be considered in both returning travellers and also their household contacts.

Cutaneous myiasis is a temporary parasitic infestation of the skin of domestic and wild animals and occasionally of humans by the larvae of flies. Larvae of many flies from various geographic areas can cause myiasis: in Central and South America, human cutaneous myiasis is mainly caused by the larvae of Dermatobia hominis; in Africa, by the larvae of Cordylobia anthropophaga; in the northern hemisphere (North America, Europe, Africa and Asia), by the larvae of Hypoderma spp. A case of cutaneous myiasis in a 47-year-old woman, co-author of the present report, is described. She returned to Slovenia from a three-week trip to Ladakh in Northern India. The parasite, nested in tumor-like swelling about 1-2 cm in diameter and 0.5 cm high in her neck, was removed. The parasite was identified by its morphological characteristics as the larva of Hypoderma lineatum. After the removal of the larva, which was yellowish-white, oval-shaped and about 6 mm long and 1.5 mm wide, the lesion healed in two weeks without further treatment. Clinical and laboratory staff will need to be alert in the future, not only to myiasis caused by Dermatobia and Cordylobia larvae from tropical and subtropical areas but also to Hypoderma larvae from the Himalayan area from where the patient returned to Slovenia.

Studies on clinical and epidemiological aspects of human ectoparasites among some rural dwellers in Edo State Nigeria were carried out between September 2002 and August 2003. A total of 910 subjects who had complained of having been infested by arthropod parasites were enrolled for this study. The study participants were clinically examined for arthropod infestations. All ectoparasites recovered from the subjects were microscopically identified. The result of this investigation reveals an overall prevalence rate of 412 (45.3%), with percentage prevalence of six arthropod parasite species encountered as follows: Sarcoptes scabiei 225 (24.7%), Pediculus capitis 116 (12.7%) Tunga penetrans 53 (5.8%), Cordylobia anthropophaga 10 (1.1%) Ixodid spp 4 (0.4%) and Pthirus pubis 4 (0.4%). The difference in age specific prevalence rates was not significant x = 3.139 (P > 0.05). Males were more significantly infested than females x = 6.44, (P < 0.05). Associated morbidities and predisposing factors for ectoparasitic infestations in these rural communities are presented and discussed. Keywords: Ectoparasitoses, Rural dwellers, Nigeria, Arthropods. Annals of Biomedical Science Vol. 3 (1&2) 2004: pp. 45-53

Background: Subcutaneous myiasis, a maggot infiltration of human tissue, is common in tropical countries. However, physicians in the United States may be unlikely to consider this etiology of dermatologic abnormalities even when a travel history suggests the diagnosis should be included in the differential. Case Report: We report the case of a patient who returned from Sierra Leone with an infestation of a maggot of Cordylobia anthropophaga (tumbu fly) that was diagnosed and appropriately treated based on ultrasound findings. Conclusion: As international travel increases, clinicians should maintain a high level of suspicion for tumbu fly infestation in returned travelers from endemic areas. The increasing use of ultrasound in the Emergency Department for evaluation of skin and soft tissue infections may aid the physician in making the diagnosis of subcutaneous myiasis.

Sonographers increasingly face imported diseases such as subcutaneous myiasis. In myiasis, some fly species such as the American Dermatobia hominis and the African Cordylobia anthropophaga use humans as intermediate hosts for the maturation of their larvae. High-resolution gray-scale and color Doppler sonography enabled us to identify D hominis larvae in 2 travelers to Central America by visualizing their typical shape, segmentations, and the continuous fluid transport inside the larval body cavity and spiracles. The small C anthropophaga larva in an individual returning from Namibia was initially not detected. Only when using color Doppler sonography was the larva discerned by its intralarval fluid transport. Sonography enables clinicians to locate viable subcutaneous larvae in suspected cases of myiasis. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008

Myiasis is the infestation of living tissue by the larvae of flies in the order Diptera. Cutaneous involvement is the most common type of myiasis. Cutaneous myiasis can be subdivided into furuncular, migratory, and wound myiasis. Each subtype is reviewed with discussion of the larvae involved, presenting signs and symptoms, clinical differential diagnoses, and treatment. Preventive measures are also described.At the conclusion of this learning activity, participants should be familiar with the causal agents, clinical manifestations, and treatment of human cutaneous myiasis.

Myiasis, from the Greek myia for “fly,” has been defined as the infestation of live human or vertebrate animals with larvae of the insect order Diptera (flies), which feed on living or necrotic tissue. The majority of flies causing myiasis can be categorized into 1 of 2 groups, based on relationship with their hosts. Obligate parasites grow only on healthy tissue of live hosts whereas facultative parasites, associated usually with carrion, feces, or decaying plant material, can develop on necrotic tissue of living animals and tend not to invade healthy tissue. Accidental infestations represent a third category in which the eggs or larvae of saprophagous flies are inhaled or swallowed inadvertently with contaminated food (gastrointestinal myiasis). Myiasis can also be classified according to the site of infestation. Cutaneous myiasis involves the invasion of the skin, with the most common target being a wound, near which an obligatory or facultative parasitic fly will lay eggs. In “wound myiasis,” both healthy and necrotic tissues can be fed on by the larvae, depending on the conditions and species of fly involved. Other flies (eg, the human botfly Dermatobia hominis [L. Jr.] in tropical America, the “tumbu fly” Cordylobia anthropophaga [Blanchard and Berenger-Feraud] in tropical Africa, and Wohlfahrtia vigil [Walker] in North America) penetrate healthy skin and produce itchy sores that develop into painful boil-like lesions or furuncles, hence the term “furuncular myiasis.” Creeping myiasis is a type of cutaneous myiasis involving the migration of fly larvae underneath the skin. Apart from the skin, the eyes, ears, nose, and sinuses represent relatively common sites of attack whereas less common sites are the mouth, throat, urogenital, and gastrointestinal tracts. The invasion of body orifices is sometimes considered accidental myiasis, especially when the larvae cannot complete their development. The most severe cases of myiasis involve obligate parasites, typically those invading wounds or mucous membranes associated with body orifices (screwworm flies) in tropical America (Cochliomyia hominivorax Coquerel) or in the Old World (Chrysomya bezziana Villeneuve, Wohlfahrtia magnifica Schiner), although some facultative myiasis can be dangerous if left untreated. Myiasis occurs mainly in tropical and subtropical latitudes and often originates in these areas even when reported in temperate climates. The main contributing factors are probably the higher levels of exposure to myiasis-causing flies due to poorer clothing and hygiene conditions, combined with the increased aggressiveness of myiasis-causing flies in the tropics. Nevertheless, many cases acquired in temperate parts of Eurasia and North America, including Canada, have been described in the literature. Despite these records, human myiasis remains an unfamiliar illness for most physicians in North America; misdiagnosis and inappropriate treatment are common. Awareness of myiasis by health professionals *Doctoral Student, Laboratoire d’Organogenese Experimentale

Myiasis is the infection of tissue or organ of living humans or animals by the maggot or larval stages of flies. In Africa, the most common fly responsible for cutaneous myiasis is the tumbu fly, Cordylobia anthropophaga2. We present two cases of cutaneous myiasis seen on the upper abdominal wall and anterior chest wall. Both were initially diagnosed as furuncle (common boil), but from high index of suspicion of myiasis, followed by application of petroleum jelly and palm oil to occlude the spiracle and the expulsion of larva stage of Cordylobia anthropophaga the diagnoses in both cases were confirmed. Keywords: cordylobia anthropophaga, cutaneous myiasisRésuméLa myiase est une maladie parasitaire due à l'infestation par des larves d'insectes (diverse aspèces de mouches) infection du tissu ou organe du l'être humain ou bien un animal. En Afrique, la mouche la plus ordinaire responsable pour la myiase cutanée est la mouse tumbu cordylobie anthropophaga2. Nous présentons deux cas des myiases cutanées vues dans la paroi abdominale supérieure et la paroi de la potrine antérieure. D'abord, on avait diagnostiqué les deux comme le furoncle (furoncle ordinaire) mais à partir d'un index élevé du soupçon de la myiase, suivi par l'application d'une vaseline et l'huile de palme afin de boucher le stimale et l'expulsion d'état de la larve de cordylobie anthropophagie les diagnostics dans les deux cas ont été confirmés. West African Journal of Medicine Vol. 24(4) 2005: 346-347

Cutaneous myiasis is a temporary parasitic infestation of the skin of human and other vertebrates by fly larvae, primarily species of the flies Dermatobia and Cordylobia. In Central and South America cutaneous myiasis is mainly caused by the larvae of Dermatobia hominis; in Africa it is mostly due to the larvae of Cordylobia spp. We describe a case of cutaneous myiasis in a family who returned to Slovenia from a three-week trip to Ghana. The parasites, in tumor-like swellings about 1–2 cm in diameter and 0.5–1 cm high, were removed from the back of the 48-year-old man, the nose, shoulder and wrist of his 47-year-old wife, and the back of their 14-year-old daughter. The parasites were identified as larvae of the fly C. anthropophaga. After removal of the larvae, which were oval-shaped and about 8 mm long, the lesions healed in two weeks without further treatment. Human cases of cutaneous myiasis are most probably underreported because many remain undiagnosed or unpublished. Because of increasing travel to tropical and subtropical areas, clinical and laboratory staff will need to be more alert to the possibility of Cordylobia myiasis in patients with furuncle-like lesions, particularly in individuals who have recently returned from tropical Africa.

International travel to tropical countries accounts for an increasing incidence of imported diseases. An unusual case of furuncular myiasis due to Cordylobia anthropophaga (Blanchard) is reported in northern France in a 9-mo-old infant, after a 4-mo stay in Congo. A review has been made of the major cases of imported furuncular myiasis due to Cordylobia, as well as identification of second larval instars and management of the myiasis.

Background Cutaneous myiasis of the breast due to infestation by the larva of Cordylobia anthropophaga is rare. To the best of our knowledge, only one case has been reported in the English literature. This rarity calls for an awareness of its possibility as a cause of furuncular breast lesions, especially in areas where the C. anthropophaga (Tumbu fly) is endemic or in patients returning from such areas. As it can be easily confused with other furuncular breast lesions (like tuberculosis, mycosis, actinomycosis, furunculosis, chronic breast abscess and fungating malignancies), this awareness is important to avoid misdiagnosis or delay in diagnosis. We present a case of furuncular breast myiasis due to the larvae of C. anthropophaga earlier misdiagnosed as mastitis in a patient living in tropical Africa (Nigeria) where the Tumbu fly is endemic. Case presentation We report a 70 year old woman who presented with a week history of itchy multiple discharging sinuses of the right breast. The sinuses contained wriggling larvae of C. anthropophaga. Fourteen larvae were extracted from the breast and the sinuses healed quite well after the extraction. Conclusions Cutaneous myiasis of the breast is rare, hence, an awareness of its clinical features is necessary when a patient presents with furuncular skin lesions especially in endemic areas or people returning from such areas. Diagnosis is mainly clinical and lesions heal well after the extraction of the larvae. Preventive measures such as ironing after drying of dresses and a good personal hygiene are crucial in controlling C. anthropophaga infestation.