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Myiasis in Travelers.

Tamar Lachish¹, Enbal Marhoom², Kosta Y Mumcuoglu³

¹Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel.

Journal of Travel Medicine

|April 2, 2015

Summary

Cutaneous myiasis is common in travelers returning from tropical regions, particularly from Latin America. Complete larval extraction is key to treatment, often avoiding antibiotics and preventing secondary infections.

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Area of Science:

Tropical medicine
Dermatology
Infectious diseases

Background:

Cutaneous myiasis is frequently diagnosed in travelers returning from tropical areas.
Localized furuncular myiasis, caused by Dermatobia hominis and Cordylobia anthropophaga, is most common.
Limited data exist on the clinical course and outcomes of myiasis in this population.

Purpose of the Study:

To analyze the largest case series of myiasis in ill returning travelers.
To describe the epidemiology, clinical presentation, and treatment outcomes.
To inform preventive strategies for travelers.

Main Methods:

Retrospective observational study (1999-2014) of patients in Israeli post-travel clinics.
Data collected on exposure, travel, clinical symptoms, treatment, and larval identification.
Analysis of 90 myiasis cases among 6,867 ill travelers.

Main Results:

Myiasis diagnosed in 6.3% of travelers with dermatologic complaints.
Most cases (80%) acquired in Latin America, primarily Bolivia (Madidi National Park).
Manual extraction sufficed in 76% of cases; 24% required surgery. Only one secondary infection occurred.

Conclusions:

Myiasis is a significant dermatologic complaint in returning travelers, often imported from Latin America.
Complete larval extraction is the primary treatment, negating the need for antibiotics in most cases.
Myiasis is preventable; travelers require destination-specific preventive information.