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Abstract
Myiasis is the infestation of live humans and vertebrate animals with larvae (maggots) of Diptera (two-winged) flies. Myiasis, is a world wide issue that should concern every hospital and health care facility. The disease occurs predominantly in rural areas and is associated with poor hygenic practices. In human, the infestation may affect the skin, wounds, intestine and body cavities. When the infestation affects the skin, the myiasis is termed cutaneous, when open wounds are involved, the myiasis is known as traumatic and when boil like, lesion is termed fruncular.
Nosocomial infection is infection that is caused during or after the hospitalization, which was neither present nor incubating at the time of admission. Diagnosis is mainly clinical. The main diagnostic features are small larvae “white thread-like structure” protruding from the lesion, one or more non-healing lesions on exposed area of skin, serious or seropurulent drainage from central punctum and local symptoms. On the other hand, the goal of treatment is to remove the larvae and treat associated infection with antibiotics.
In the present study, both cases were in pre-existing wounds caused by semi-specific (facultative) myiasis-producing diptera; Calliphora and Sarcophaga spp. Both infestations were hospital acquired. As, there were predisposing factors such as infected wounds and underlying diseases as diabetes or peripheral vascular disease. The development of myiasis was facilitated by physical debility, dependency of patients, and a lengthy period of hot weather which led to prolonged open window ventilation of their rooms.
There are two components to the issue of myiais prevention. The first, is the care of at-risk patients to prevent infestation particularly related to chronic skin lesions. The second, is the environmental care that could influence the potential oocurance of myiasis.
So we can conclude that the complexity of healthcare, an aging population, and the severity of illness of many patients in hospital creates a venue in which myiasis can occur. This is especially true in summer and warm weather when flies are more widespread. Therefore, myiasis should be looked for in hospitalized patients having infected sloughy wounds.