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Human myiasis in patients with diabetic foot: 18 cases

Serhat Uysal1, Anil Murat Ozturk, Meltem Tasbakan

  • 1Serhat Uysal, Infectious Diseases and Clinical Microbiology,, Ministry of Health, Republic of Turkey,, Seyfi Demirsoy State Hospital,, Infectious Diseases and Clinical Microbiology Service,, Diabetic Foot Clinic, Buca, Izmir, 35390, Turkey, T: 902-32425252, drserhatuysal@gmail.com, ORCID: http://orcid.org/0000-0002-4294.5999.

Annals of Saudi Medicine
|June 1, 2018
PubMed
Abstract

Insights

Myiasis infestation in diabetic foot ulcers is uncommon but serious, often requiring amputation and leading to mortality. Lucilia sericata was the most common cause, highlighting the need for improved hygiene and surgical intervention.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Podiatry

Background:

  • Diabetic foot ulcers are prone to infections, with myiasis being a rare but severe complication.
  • Limited case reports necessitate further data on human myiasis in diabetic foot patients.

Purpose of the Study:

  • To evaluate the clinical characteristics of human myiasis in patients presenting with diabetic foot complications.
  • To identify common etiological agents and associated outcomes in this patient cohort.

Main Methods:

  • A case series approach was employed at a tertiary referral healthcare institution and a dedicated diabetic foot center.
  • Data were collected from patients admitted between June 2012 and July 2017 with diabetic foot infections complicated by myiasis.
  • Key outcomes assessed included bacterial infection rates, causative agents, amputation rates, and mortality.

Main Results:

  • The study included 18 patients, with 44.4% being female. Most patients (88.9%) had moderate-to-severe infections and necrotic tissue.
  • Lucilia sericata larvae were the most frequently identified parasitic agents (27.8% second-stage, 38.9% third-stage).
  • All patients presented with bacterial infections; 66.7% required amputation, and 16.7% died. Myiasis prevalence increased in warmer months (May-July).

Conclusions:

  • This series represents the largest reported cohort of diabetic foot myiasis, with Lucilia sericata identified as the predominant parasite.
  • All cases involved bacterial soft tissue infections, necessitating radical surgical intervention due to poor hygiene.
  • Diabetic foot myiasis is more prevalent during spring and summer, underscoring the need for vigilance and timely management.

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