Myiasis in Kuwait: Nosocomial Infections Caused by Lucilia Sericata and Megaselia Scalaris

Abstract

Myiasis, the invasion of live human tissue by larvae of Diptera, is reported in the nasopharynx and a leg wound in two patients who were hospitalized for more than 72 hours in Mubarak Al-Kabeer Teaching Hospital in Kuwait City, Kuwait. On the fourth and fifth days after a 10-year-old Kuwaiti boy was admitted to the hospital intensive care unit in a bloodied and comatose state following a traffic accident, 'worms' that came out of his nostrils were fixed, cleared, and identified as second and third instar of Lucilia sericata (Diptera: Calliphoridae). After 14 days, 'worms' were seen in the original dressing of a 35-year-old Iranian man admitted to the Orthopedic Unit of the hospital with multiple lacerations and fractures. The larvae, in various stages of development, were identified as those of Megaselia scalaris (Diptera: Phoridae). Since the presence of larvae in both patients was recorded after a stay of at least 3-4 days in the hospital, by definition, these infestations are considered nosocomial.

Myiasis

“…Comatose and handicapped patients are particularly prone to myiasis, with reported cases of wound myiasis (169), nasal and nasopharyngeal myiases (98,139,157,175,184,215,281,318), orotracheal myiasis (68), myiasis of trachea (139), ocular myiasis (66), pin-site myiasis (157), urogenital myiasis (146), myiasis of nasogastric tube (67), and intestinal myiasis (320).…”

“…The following species have been recognized as causative agents of nosocomial myiasis: L. sericata (35,76,139,157,169,215), Megaselia scalaris (157), Sarcophaga spp. (235), C. hominivorax (82,98,281), Cochliomyia macellaria (66,175,318), and M. domestica (146).…”

Human external ophthalmomyiasis caused by Lucilia sericata Meigen (Diptera: Calliphoridae) – a green bottle fly

“…The first was the condition of the patient -she had long-term mental and physical dependency and disturbed consciousness, which prevented her sensation of fly contact. A computerized tomography scan showed massive damage of brain tissue by infarction of the brain, causing tissue reduction incompatible with mental recovery [13].…”

A Laboratory-Based Study for First Documented Case of Urinary Myiasis Caused by Larvae of Megaselia scalaris (Diptera: Phoridae) in Saudi Arabia

“…Several workers reported cases of intestinal myiasis due to M. scalaris [7][8][9]. Hira et al [10] described in 2004 a case of nosocomial myiasis in Kuwait caused by M. scalaris. The first report of human urogenital myiasis due to a species of Megaselia was represented in 1978 by Disney and Kurahashi [11], and then more cases were reported [12][13][14].…”