Myiasis

Myiasis is usually caused by flies of the Calliphoridae family is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucumán Province for a consultation concerning an ulcer in his right foot. The identification of the immature larvae was based on their morpho logical characters, such as the cylindrical, segmented and tracheas with strong pigmentation.

A Dutch survey showed myiasis occurring more frequently on farms with over 25 ewes compared to smaller farms. Occurrence was most frequently associated with hot and humid weather and was mainly observed in the area around the tail. Ewes and ewe lambs had significantly more myiasis than rams and ram lambs. There was no relationship with tail docking, breed time of shearing, soil type, the environment (bush, trees, water, etc.), type of treatment, the insecticides used, the number of preventive treatments, the time of treatment or the number of flock observations.

This applies once an infestation is established. In many circles the first response to cutaneous myiasis once the breathing hole has formed, is to cover the air hole thickly with petroleum jelly. Lack of oxygen then forces the larva to the surface, where it can more easily be dealt with. In a clinical or veterinary setting there may not be time for such tentative approaches, and the treatment of choice might be more direct, with or without an incision. First the larva must be eliminated through pressure around the lesion.

In the US, demand for these fly larvae doubled after the FDA ruling. Maggot therapy is now used in more than 300 sites across the country.The American Medical Association and Centers for Medicare and Medicaid Services recently clarified the reimbursement guidelines to the wound care community for medicinal maggots, and this therapy may soon be covered by insurance.The larvae of the green bottle fly are now used exclusively for this purpose, since they preferentially devour only necrotic tissue.