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Practice

Imported and locally acquired human myiasis in Canada: a report of two cases

Derek R. MacFadden, Brittany Waller, Gil Wizen and Andrea K. Boggild
CMAJ March 03, 2015 187 (4) 272-275; DOI: https://doi.org/10.1503/cmaj.140660
Derek R. MacFadden
Department of Medicine (MacFadden, Waller, Boggild), University of Toronto, Toronto, Ont.; Department of Biology (Wizen), University of Toronto at Mississauga, Ont.; Tropical Disease Unit, Toronto General Hospital and Public Health Ontario Laboratories, Public Health Ontario (Boggild), Toronto, Ont.
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Brittany Waller
Department of Medicine (MacFadden, Waller, Boggild), University of Toronto, Toronto, Ont.; Department of Biology (Wizen), University of Toronto at Mississauga, Ont.; Tropical Disease Unit, Toronto General Hospital and Public Health Ontario Laboratories, Public Health Ontario (Boggild), Toronto, Ont.
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Gil Wizen
Department of Medicine (MacFadden, Waller, Boggild), University of Toronto, Toronto, Ont.; Department of Biology (Wizen), University of Toronto at Mississauga, Ont.; Tropical Disease Unit, Toronto General Hospital and Public Health Ontario Laboratories, Public Health Ontario (Boggild), Toronto, Ont.
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Andrea K. Boggild
Department of Medicine (MacFadden, Waller, Boggild), University of Toronto, Toronto, Ont.; Department of Biology (Wizen), University of Toronto at Mississauga, Ont.; Tropical Disease Unit, Toronto General Hospital and Public Health Ontario Laboratories, Public Health Ontario (Boggild), Toronto, Ont.
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  • For correspondence: andrea.boggild@utoronto.ca
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    Figure 1:

    (A) Myiasis caused by Cuterebra species in an otherwise healthy 45-year-old woman. Note the periocular erythema, punctum (arrow) and serosanguinous drainage. (B) An intact, live larva was extruded manually from the periocular lesion.

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    Figure 2:

    Myiasis caused by Dermatobia hominis in a 33-year-old man. Three domiciles were noted on the patient’s anterior chest wall after he returned from Belize.

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    Figure 3:

    Travel-acquired myiasis caused by Dermatobia hominis in a 33-year-old man. Individual domiciles were visible on the patient’s anterior chest (A–C), with erythema and visible puncta. Intact larvae post extraction measured 2.77 mm (D), 3.87 mm (E), 5.67 mm (F), 12.74 mm (H) and 14.25 mm (I). Note the radial spines on the surface of the organisms. (G) A presumed sixth larval nodule, which closed spontaneously. The larval spiracles can be seen through the punctum.

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    Box 1: Differential diagnosis of nodular lesions in the returning traveller7
    DiseasePathogenRegionClinical features
    Furuncular myiasisDermatobia hominis, Cordylobia spp., Cuterebra spp., Hypoderma spp., Wohlfahrtia spp., othersGlobalOne or more nodules with central puncta; may have sensation of movement or lancinating pain
    FurunculosisStaphylococcus aureus, Pseudomonas aeruginosa, polymicrobial infectionGlobalCutaneous abscesses that can be associated with adjacent cellulitis
    TungiasisTunga penetrans (sand flea)South and Central America, Africa, IndiaSmall papule with black centre that can become inflamed; typically invades the feet, including the heel and toes
    Nodular lymphangitisSporothrix schenckii. Mycobacterium spp., Nocardia spp.GlobalNodular lesions with spread via lymphatics with associated lymphangitis; classically sporotrichoid or lymphocuticular spread
    Cutaneous leishmaniasisLeishmania spp.South and Central America, Middle East, Saharan Africa, South Central AsiaTypically ulcerative but can present as nodular or verrucous plaques
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Canadian Medical Association Journal: 187 (4)
CMAJ
Vol. 187, Issue 4
3 Mar 2015
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Imported and locally acquired human myiasis in Canada: a report of two cases
Derek R. MacFadden, Brittany Waller, Gil Wizen, Andrea K. Boggild
CMAJ Mar 2015, 187 (4) 272-275; DOI: 10.1503/cmaj.140660

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Imported and locally acquired human myiasis in Canada: a report of two cases
Derek R. MacFadden, Brittany Waller, Gil Wizen, Andrea K. Boggild
CMAJ Mar 2015, 187 (4) 272-275; DOI: 10.1503/cmaj.140660
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