Case Report of Children Cutaneous Myiasis and Review of the Literatures

Abstract

Objective Cutaneous myiasis is skin infestation by the larvae (maggots) of certain fly species.The aim of this study is to acquire more knowledge about cutaneous myiasis. Methods One case of children cutaneous myiasis in this hospital was reported. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of West China Second University Hospital, Sichuan University. Informed consent was obtained from the parents of this child. 98 cases of cutaneous myiasis reported by other domestic hospitals from January 1999 to August 2013 were reviewed. The epidemiology, clinical manifestation, diagnostic methods and treatment of cutaneous myiasis were analyzed and summarized. Results A six-year-old boy presented with fever, myalgia, multiple painful subcutaneous node, skin lesions, microscopic hematuria, eosinophilia and left pleural effusion. Maggot lured by honey was identified as Hypoderma bovis. And this boy was orally treated with mebendazole tablet for three days and fully recovered two weeks later. The domestic document showed that cutaneous myiasis was second only to ocular myiasis and most of the infected were children. Main pathogens of cutaneous myiasis were Hypoderma bovis and Hypoderma lineatum. Cutaneous myiasis mainly distributed at pastoral areas, especially in the northwest of Sichuan province, next in Qinghai province. Typical clinical manifestation included fever, migratory painful hypodermic nodule, eosinophilia and skin lesions. Cutaneous myiasis was complicated by visceral lesions.The organ involved included heart, lung, gut and brain. Atypical cutaneous myiasis was misdiagnosed as other diseases such as tuberculous pleurisy, erysipelas, rheumatoid arthritis, urticaria, and mumps. Diagnosis of cutaneous myiasis was made after finding maggot. Treatment was non-specific and consisted of extraction of larva and symptomatic treatment. Oral helminthicide such as albendazole tablet, chloroquine tablet, or metronidazole tablet was applied when visceral lesions occured. Conclusions Most of the cutaneous myiasis patients are children. Cutaneous myiasis should be considered in patients with fever of undetermined origin, migratory painful hypodermic nodule, eosinophilia or skin lesions drilled by maggot. Diagnosis of cutaneous myiasis is mainly based on finding maggot. Treatment of cutaneous myiasis is non-specific. Key words: larva; myiasis; child