Myiasis: Difference between revisions
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==Background== | ==Background== | ||
*Caused by ''Dermatobia hominis'' | *Caused by ''Diptera'' species. ''Dermatobia hominis'' (botfly) is most common cause in North America | ||
*Cutaneous (includes follicular, wound, and migratory) type is most common | |||
**Can also occur in mouth, urogenital, ophthalmic, nasopharyngeal location | |||
*Typically occurs in tropical and subtropical areas. US cases typically due to travel to endemic region<ref name="CDC"> | |||
*Bacterial superinfection is rare<ref name="McGraw" />https://www.cdc.gov/parasites/myiasis/faqs.html Accessed 02/06/17</ref> | |||
==Clinical Features== | ==Clinical Features== | ||
*Erythematous papule with central pore (allows for larval respiration)<ref name="McGraw">McGraw TA. Turiansky GW. Cutaneous myiasis. Journal of the American Academy of Dermatology. 58(6):907-26; quiz 927-9, 2008 Jun.</ref> | |||
*Sensation of movement within lesion | |||
*Serous drainage | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
[[File:Miasis human.jpg|thumb|Myiasis in patient neck]] | |||
*Clinical diagnosis | |||
==Management== | ==Management<ref name="McGraw" />== | ||
* | ''If entire larvae is not removed, severe inflammatory response occurs'' | ||
*Occlusion of central pore with petroleum jelly or mineral oil interrupts oxygen supply and causes larvae to migrate to surface where it can be grasped with forceps and removed | |||
**Can take up to 24 hours | |||
*Manual removal by squeezing out larvae | |||
*Surgical removal by making incision over larvae and removing with forceps | |||
*Ivermectin - single PO dose or topical application | |||
*Wound myiasis requires surgical debridement | |||
*Ocular, nasopharyngeal, urogenital myiasis should prompt appropriate specialist consultation for management | |||
==Disposition== | ==Disposition== | ||
*Cutaneous myiasis generally may be discharged after removal | |||
*Disposition of other forms based on discussion with specialist | |||
==See Also== | ==See Also== | ||
Revision as of 03:49, 7 February 2017
Background
- Caused by Diptera species. Dermatobia hominis (botfly) is most common cause in North America
- Cutaneous (includes follicular, wound, and migratory) type is most common
- Can also occur in mouth, urogenital, ophthalmic, nasopharyngeal location
- Typically occurs in tropical and subtropical areas. US cases typically due to travel to endemic regionCite error: Closing
</ref>missing for<ref>tag
Clinical Features
- Erythematous papule with central pore (allows for larval respiration)[1]
- Sensation of movement within lesion
- Serous drainage
Differential Diagnosis
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Domestic U.S. Ectoparasites
See also travel-related skin conditions
Evaluation
- Clinical diagnosis
Management[1]
If entire larvae is not removed, severe inflammatory response occurs
- Occlusion of central pore with petroleum jelly or mineral oil interrupts oxygen supply and causes larvae to migrate to surface where it can be grasped with forceps and removed
- Can take up to 24 hours
- Manual removal by squeezing out larvae
- Surgical removal by making incision over larvae and removing with forceps
- Ivermectin - single PO dose or topical application
- Wound myiasis requires surgical debridement
- Ocular, nasopharyngeal, urogenital myiasis should prompt appropriate specialist consultation for management
Disposition
- Cutaneous myiasis generally may be discharged after removal
- Disposition of other forms based on discussion with specialist