Two Cases of Myiasis Associated with Malignancies in Patients Living in the Continental United States

Abstract

Myiasis is the infestation of humans with dipterous larvae. Traditionally, myiasis was thought to affect individuals living in tropical regions, however, several cases in temperate zones have been reported. We encountered two patients with histories of malignancies that presented with complaints of myiasis, in Chicago, in the spring and summer of 2016. The first patient, a 54-year-old female with a history of breast cancer, presented with complaints of maggots infesting her postsurgical chest wounds. She was diagnosed with sepsis, cellulitis, and wound myiasis. The second patient, a 63-year-old female with a history of recurrent ovarian cancer, presented with complaints of passing maggots vaginally and seeing worms mixed with her stools. She was diagnosed with internal urogenital myiasis. The first lesson that we learned from these cases is that myiasis can occur in individuals living in any part of the world. Second of all, for patients with accidental myiasis, a sample of the larvae should be sent for analysis to help guide the treatment. Third of all, myiasis has been associated with new or recurrent malignancies, and therefore a biopsy of the affected tissue should be sent for analysis. Finally, we learned that myiasis can serve as a form of tissue debridement; this coinciding benefit should not prevent the treatment of accidental myiasis.

Myiasis-induced sepsis: a rare case report of Wohlfahrtiimonas chitiniclastica and Ignatzschineria indica bacteremia in the continental United States

“…[2] While there are clinical applications to the use of controlled myiasis for debridement of necrotic tissue, there are also cases where accidental myiasis occurs. [1,3] Typically, people of low economic means and those who have poor hygiene have increased susceptibility—these populations include, but are not limited to, homeless, alcoholics, low-income farmers, and those who lack needed assisted care (i.e., elderly, paraplegics, etc.). [1,3–8] Due to higher likelihood of parasitic flies in their area of residence, those who live in close proximity to livestock are at increased risk of myiasis as well.…”

“…[1,3] Typically, people of low economic means and those who have poor hygiene have increased susceptibility—these populations include, but are not limited to, homeless, alcoholics, low-income farmers, and those who lack needed assisted care (i.e., elderly, paraplegics, etc.). [1,3–8] Due to higher likelihood of parasitic flies in their area of residence, those who live in close proximity to livestock are at increased risk of myiasis as well. [8] In the past, myiasis was thought to be almost exclusively associated with tropical and subtropical regions, but in recent years, more literature has begun to surface about cases in temperate climates.…”

“…[8] In the past, myiasis was thought to be almost exclusively associated with tropical and subtropical regions, but in recent years, more literature has begun to surface about cases in temperate climates. [1,3] As with any sort of infestation of parasites, myiasis causes concerns for the possibility of secondary bacterial infection, since certain species of fly and their larvae harbor associated bacteria. For this reason, myiasis should prompt healthcare providers to suspect possible bacterial infection, both of the tissue and the blood.…”

Breast myiasis: Are we prepared for the correct diagnosis?

“…Myiasis is a common dermatosis in Central and South America, caused by skin infestation by Dermatobia hominis (botfly) larvae 1,2 . The high demand for tropical tourist areas demonstrates the importance of knowing the clinical and imaging features of this condition 3 .…”

Molecular detection of methicillin resistant staphylococcus aureus (MRSA) from a clinical case of myiasis wound: a case report

“…Myiasis is a well-known condition to veterinarians from underdeveloped regions and causes severe economic losses globally [4]. The prevalence of myiasis are reported both in human and animals mostly in rural, tropical and subtropical regions but now commonly seen in temperate zone also [5,6].…”