Accidental myiasis, defined as the infestation of living or necrotic tissue by Diptera larvae, represents a neglected but profoundly distressing complication in patients afflicted with advanced malignancies, particularly head and neck cancers (HNC). HNC constitutes a major global health burden, with an exceptionally high incidence in low- and middle-income countries (LMICs), such as India, where delayed presentation often culminates in large, ulcerative malignant fungating wounds (MFWs). These MFWs, coupled with environmental factors, socioeconomic disadvantage, poor hygiene, and patient debility, create a fertile environment for obligatory parasitic fly species, notably Chrysomyia bezziana and Cochliomyia hominivorax, whose larvae aggressively destroy host tissues. The resulting infestation leads to severe pain, relentless odor, rapid tissue erosion, and profound psychological distress, demanding urgent and definitive intervention. Given the paucity of standardized protocols, this review synthesizes the current global and Indian evidence (2000-2025) on the pathophysiology, clinical burden, and management of malignant wound myiasis. The evidence strongly supports an integrated approach centered on systemic antiparasitic administration. Specifically, the "Triple Therapy" regimen-Oral ivermectin, albendazole, and clindamycin-is highlighted for its promising efficacy reported in a single-center prospective cohort in achieving rapid clearance (> 90% reduction in larval burden by Day 3) and significantly improving associated palliative metrics, including pain and odor control. Practical guidelines emphasizing patient safety, ethical use of topical agents, and the essential role of comprehensive psychosocial and caregiver support are provided to establish a high-value, patient-centered standard of care.

ABSTRACTWound myiasis commonly occurs in tropical regions and is caused by flies laying eggs on open wounds. It is essential to raise awareness about preventive measures and treatment methods for this disease, especially because many people now visit endemic areas from non‐endemic regions. This report presents a wound myiasis case caused by Chrysomya bezziana, resulting from a small wound sustained by a spectator of “Tip‐Cat‐sport.” A 64‐year‐old woman was admitted to a hospital in Bangladesh with a severe facial wound infection and symptoms of fever, pain, and swelling. She sustained an injury from the tip‐cat tool while watching the sport, and the wound remained untreated. Magnetic resonance imaging was used to diagnose the infection as wound myiasis caused by Chrysomya bezziana. Turpentine oil was applied to the open wound to create an oxygen‐deficient environment that forces maggots (larval stage of the fly) on its surface to be removed. After removal, wound debridement was performed, followed by surgical excision of the affected tissue and skin grafting. After 2 months, the wound completely healed. We hope this case report will enhance the knowledge about wound myiasis, including preventive measures and treatment options, among those with limited awareness of this condition.

Old World screwworm myiasis: first report of Chrysomya bezziana in Chinese Milu (Elaphurus davidianus).

A novel real-time PCR for New World screwworm fly (Cochliomyia hominivorax) and its application in a non-destructive multiplex for efficient detection of screwworm flies.

“The Crawling Curse: Ophthalmomyiasis Exposed” Ocular Myiasis Caused by Chrysomya Bezziana in a Known Case of Oral Cavity Cancer. A Case Report

Background. Myiasis, derived from the Greek “myia” (fly) and “iasis” (disease), refers to infestation by dipterous larvae. First coined by Hope in 1840 and later defined by Zumpt, myiasis involves larvae feeding on live or necrotic tissues. Oral myiasis, a rare condition first described by Laurence in 1909, typically affects individuals with compromised oral hygiene, necrotic lesions, or systemic debilitation.Case presentation. We report a case of oral myiasis in a 73-year-old non-ambulatory female with multiple comorbidities. The patient presented with pain and swelling in the maxillary anterior region, accompanied by severe halitosis, poor oral hygiene, and live larvae emerging from necrotic oral tissues. Clinical and entomological examination identified the larvae as Chrysomya bezziana. Necrotic tissue was surgically debrided, mobile teeth extracted, and the patient was followed up after anti helminthic medications. Post-operative care included oral hygiene instruction and follow-up. The patient responded well to the treatment. Conclusions. Oral myiasis is an uncommon yet serious condition, predominantly affecting debilitated or geriatric patients with poor oral hygiene. Awareness and early intervention are crucial for effective management. Preventive strategies such as routine oral care and regular follow-up are essential, especially in vulnerable populations.

Chrysomya bezziana, the Old-World Screwworm, is a parasitic blowfly that causes myiasis, an infestation where larvae feed on live tissues of vertebrate hosts. Myiasis caused by C. bezziana poses a threat for public health and livestock economy in Asia with a potential risk of global spread by human travelers and animals. Genome resources for this parasite are urgently needed as these can facilitate the development of novel control methods to mitigate the impact of C. bezziana on public health and livestock industries. Here, we present the first genome assembly and annotation for C. bezziana. The genome exhibits high-quality with a size of 472 Mb and an N50 of 1.8 Mb and 98.4% of BUSCO single and 0.5% of duplicated genes, showing high completeness and haploid resolution. This initiative, when combined with other blowfly genomes available, will contribute to the ongoing effort to understand the evolutionary origin and molecular underpinnings of parasitic behavior in blowflies. Furthermore, it will also contribute to the development of pest management strategies to control the spread and the impact of this harmful parasite.

Abstract Background Chrysomya bezziana (Villeneuve, 1914), the screw-worm fly, is a significant parasitic blow fly species that causes obligatory myiasis in livestock and, in some cases, in humans. Its ability to infest wounds and cause extensive tissue damage makes it a significant concern in the veterinary and public health sectors. Accurate and timely identification of C. bezziana is critical for managing outbreaks and implementing control measures. This study confirms the occurrence of C. bezziana in Egypt through both morphological and molecular identification, as only a few studies have reported its presence in Egypt so far. Adult samples of C. bezziana were collected using meat-baited traps situated in the cemeteries of two localities in Egypt (Port Said and El-Sharkia Governorates). DNA was extracted from the specimens for molecular identification using the cytochrome oxidase I (cox1) gene. Results Morphologically, C. bezziana adult flies were identified by a row of hairs on the dorsal surface of the wing's stem vein, blackish anterior spiracles, and the most distinctive characteristic, a white calypter with a whitish-yellow distal end, which differentiates this species from the most closely related species, Chrysomya megacephala. Genetically, it was found that based on a 703 bp fragment of the cox1 gene, C. bezziana was accurately identified, and further phylogenetic analysis confirmed the DNA-based identification of adult specimens of C. bezziana examined. This finding confirms the presence of C. bezziana and expands our knowledge of its distribution in Egypt. Conclusion This study is the first to report the occurrence of C. bezziana in Egypt using an integration of molecular and morphological methods.

Oral myiasis, a rare condition characterised by infestation of dipterous larvae in the oral cavity, poses unique diagnostic and therapeutic challenges. Herein, we present a case study of a 35-yearold quadriplegic man presenting with oral myiasis localised to the palatal region, likely attributable to malnutrition and suboptimal oral hygiene. Manifestations comprised oral bleeding, fever, and necrotic palatal ulcers infested with maggots. Initial diagnostic considerations encompassed mucormycosis and neoplastic lesions; however, further scrutiny revealed primary palatal myiasis caused by Chrysomya bezziana species. Therapeutic interventions entailed bedside maggot removal and meticulous wound care, with topical hyaluronic acid application and oral hygiene guidance. This case underscores the significance of uncommon conditions such as palatal myiasis, especially among patients with intricate medical backgrounds. A comprehensive diagnostic approach and optimal treatment ensure favourable outcomes.

Background: Myiasis, the infestation of live human tissue by dipterous larvae, is a rare condition in modern clinical practice but can present with severe complications in vulnerable individuals. Chrysomya bezziana, the Old World screwworm fly, is an obligate parasite known to cause aggressive tissue destruction, particularly in tropical regions. Case Presentation: We present a rare and severe case of extensive palatal necrosis caused by Chrysomya bezziana in a 62-year-old immunocompromised patient from a rural area. The patient presented with facial swelling, halitosis, and a necrotic lesion in the palate, initially misdiagnosed as a fungal infection. Direct examination revealed numerous live larvae within the necrotic tissue. Imaging studies ruled out deeper craniofacial involvement. Management included mechanical debridement, systemic antibiotics, and antiparasitic therapy, followed by reconstructive surgery. Conclusion: This case highlights the importance of considering myiasis in differential diagnoses of orofacial necrosis, especially in endemic regions and among immunocompromised or neglected populations. Early recognition and appropriate intervention are crucial to prevent extensive tissue damage and systemic complications.

Myiasis is a universal term for extreme infection by the parasitic fly larvae that feed on their host living/dead tissue. Oral myiasis is a disease in humans associated with poor oral hygiene, suppurative oral lesions, alcoholism, and senility. It rarely occurs in young children with otherwise normal health. We are presenting a case of oral myiasis in the maxillary anterior region of a 10-year-old girl child.

Introduction: Myiasis is a condition characterized by the infestation of tissues and organs in humans and other vertebrates with the larvae of certain fly species. It poses a significant medical and public health concern for humans and is also an economic burden for a wide range of domestic and wild animals in tropical and subtropical regions. This systematic review aims to provide an overview of the epidemiology of myiasis in Iran.Methods: Following the PRISMA 2020 guidelines, a thorough search of international and local databases such as PubMed, Web of Science, Scopus, Google Scholar, ProQuest, SDI, Magiran, Barakat Knowledge Network System, and the Islamic World Science Citation Database (ISC) was conducted from the inception of the databases to November 21, 2021. Keywords related to myiasis, including myiases, maggot infestations, infestation of maggot, and prevalence, were used in the search.Results: The most prevalent types of myiasis in Iran were Oestrus ovis (29.63%), Chrysomya bezziana (18.52%), and Lucilia sericata (16.67%). Eristalis tenax was the most common causal agent in accidental myiasis (42.86% (9.9–81.59)), Lucilia sericata in facultative myiasis (64.71% (38.33–85.79)), and Oestrus ovis in obligatory myiasis (51.52% (33.54–69.2)). Nasopharyngeal myiasis, dermal myiasis, urogenital myiasis, and intestinal myiasis were the most frequent types of myiasis, with prevalence rates ranging from 1.9% (45.64–76.43) to 57.14% (18.41–90.1), 50% (15.7–84.3), and 60% (14.66–94.73). Common symptoms included pain and inflammation.Conclusion: The results of this systematic review indicate a higher prevalence of myiasis infestation in Iran and will help raise awareness and draw the attention of health staff to the importance as well as some of the symptoms and predisposing factors of myiasis that could serve as a reference to prevent and control myiasis in humans and animals in Iran and even worldwide.

Cutaneous myiasis by Calliphoridae dipterans in dogs from Chad

Forensic and ecological significance of necrophagous insects: Insights from animal carcasses, human cadavers, and myiasis patients

Molecular epidemiology of the Old World screwworm fly (OWSF) in Iraq, and the genetic structure of various OWSF populations worldwide

Myiasis caused by Calliphorid and Oestrid flies constitute a major threat to the development of livestock industry in Kingdom of Saudi Arabia. Increased veterinary concerns recently paid to the frequent reports on enteric pathogens caused by the larvae of these flies. Although the importance of sheep and goats in Saudi Arabia, the geographic distribution limits of Calliphorid and Oestrid infestation in caprine livestock has never been highlighted. ArcGIS software was used to assess the spatial distribution of myiasis causing flies in Jazan Province, Saudi Arabia. Implemented Evolutionary algorithms in maximum entropy (MaxEnt) was used to predict the distribution map for myiasis causing flies. Bioclimatic and topographic data layers from Worldclim was analyzed to estimate the percent contribution of variables predicting suitable habitats of flies causing myiasis. Field validation was occurred to evaluate the habitat suitability produced by the model. The predictive ecological niche model was found high with an AUC value of 0.95 and 0.93 for train and test occurrence records, respectively, with a standard deviation equal 0.032. About eighteen variables were found to contribute in spatial predictive occurrence of myiasis causing flies. Precipitation variables enhanced the model predictive power with (57.7%) in Jackknife test. Besides, elevation, NDVI and tree cover shared reduced effect in predicting myiasis causing flies distribution.

Myiasis is a disease in livestock caused by the larvae of the fly Chrysomya bezziana . Myiasis causes economic losses due to decreased productivity and tissue damage in livestock. Treatment of myiasis is by using synthetic insecticides, but the use of synthetic insecticides has a negative impact on animals, humans, and the environment. The use of synthetic insecticides can be replaced with botanical insecticides, one of the plants that can be used as antimyiasis is kirinyuh . Kirinyuh is a plant from the Asteraceae family which has been used as a botanical insecticide. This literature study aims to determine the potential of kirinyuh leaves as antimyiasis, the compounds contained in kirinyuh leaves and the mechanism of antimyiasis. This literature study uses 30 literature collected by browsing the Google Scholar database. Five literature states that kirinyuh leaves contain secondary metabolites of flavonoids, alkaloids, saponins, tannins and terpenoids. Meanwhile, 12 literatures describe the antimyiasis activity of these secondary metabolites. Flavonoids inhibit the nervous system and interfere with energy metabolism in the insect body, alkaloids interfere with the nervous system and reduce insect appetite, saponins as antifeedants and insect growth inhibitors, tannins interfere with insect digestion and growth, and terpenoids as inhibitors of nerve transmission in insects.

This study was conducted in different region in Sulaimani province, Kurdistan Region-Iraq, from August 2021 to April 2022. Isolated randomly, 527 (3.4%) out of 15360 sheep examined had myiasis, identified three genus and sex species of flies in all locations based on morphological characteristics. Chrysomya Bezziana is found in all regions instead of Qardagh and Sharbazher, Lucilia Sericata, Calliphora Vomitoria, and Calliphora vicina were found in all regions. The prevalence rate of myiasis was found in Dukan region at 5.5% (95/1715) and the lowest rate was revealed in the Garmiyan region 2.6% (81/3160). During the seasonal distribution, the highest rate of myiasis was found in Spring (4.8%), followed by (3.8%) in the Summer and (3.4%) in the Autumn, while shows the lowest distribution in Winter (0.8%). In this study, to accurately detect flies, fresh meat was placed in several areas, observed the heavy flies landing spring season.

Chrysomya bezziana this study was carried out between October, 2021 to March 31, 2022 in six region from Al-Diwaniyah province. Observe the influence of the month and type of animal on the region's. The total number of animals infected was 33 (1) cattle, (7) lambs, and (35) sheep. Al-muhnawa had the highest rate of infestation, while Al-hamza had the lowest rate of infestation. The highest rate of infestation recorded in March ()% and the lowest in February ()%.Conventional PCR (Polymerase Chain Reaction) was used for molecular identification. A DNA extraction was performed on 50 randomly chosen larvae from the total population. The size of the PCR product (548 pb) For Chrysomya bezziana, from the infected animals larvae were taken to DNA extracted and used following targeting 16S rRNA gene product size (548 bp). There follows sequence analysis to obtain the nucleotide (16S rRNA) gene, and the sequence was recoded in the National Center for Biotechnology (NCBI) with accession numbers (ON059979, ON059980, ON059981, ON059982, ON059983, ON059984, ON059985)Iraq. This gene's homology sequence identity percentage was calculated by comparing it to another globally registered gene (NCBI).

Forensic entomology is a key means of solving crimes related to both humans and animals by estimating the minimum postmortem interval (mPMI) or minimum time of colonization (mTOC). In Sri Lanka, this is the first attempt to estimate mTOC of the myiasis-causing fly Chrysomya bezziana (Villeneuve) (Diptera: Calliphoridae) in animal wounds using accumulated degree days (ADD). This study focuses on three dog myiasis cases reported to two veterinary clinics in Peradeniya, 2015. The mTOC is calculated for all three dog cases at temperature 38.8 °C which is the normal body rectal temperature of the dog. Based on the results, all infestations were due to a single fly species, C. bezziana and the ADD calculations suggest female C. bezziana flies have laid the eggs six days prior to the removal of C. bezziana larvae from the wounds. The present study highlights the importance and application of insect evidence to solve crime cases related to myiasis.