Case report
Cutaneous Myiasis: Diagnosis, Treatment, and Prevention

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Report of a Case

A healthy 44-year-old male patient was referred to our department by the general practitioner who had first received the patient. The patient reported a history of persistent infraorbital swelling and erythema that had appeared 3 weeks beforehand during a fishing trip in northwestern Quebec, Canada. At that time, the patient had noted a raised “pimple” below his left eye. Within a few days, the lesion became larger, painful, and occasionally began to drain a sero-purulent material (Fig 1). He

Human Myiasis in Canada: Review of the Literature

We reviewed biology (BIOSIS) and medicine databases (MEDLINE) on myiasis acquired in Canada, or acquired overseas but diagnosed in Canada. Gyorkos11 reviewed Canadian cases of myiasis before 1977 (the first case was in 1875). We consulted most of the references in her review, summarized the data (Table 1), and added 4 more cases found before 1977.2, 13, 14, 15 We also added cases that were reported since that time (1977-2006; Table 1, numbers in bold). Gyorkos found 60 cases of myiasis.

Discussion

Three reasons lead us to believe that the parasite involved in the reported case was Wohlfahrtia vigil. First, the sore had the form of a furuncle, and there was no sign of any wound or necrotic tissue that could have attracted flies before the invasion by the maggot; therefore, facultative parasitic flies that breed typically in decaying organic matter could almost certainly be excluded. Obligatory parasites that generally use wounds or mucous membranes as entry point (screwworms Cochliomyia

Acknowledgments

We thank Scott Brooks (Agriculture and Agri-Food Canada) and Brad Sinclair (Canadian Food Inspection Agency) for comments on a previous version of the manuscript, and Thomas Pape (Natural History Museum of Denmark) for his opinion on the identity of the parasite.

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