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Intestinal myiasis in a baby attending a public health clinic
Insights
A baby with intestinal myiasis, a fly larvae infestation, was misdiagnosed twice for pinworms. The condition was identified as Muscina stabulans fly larvae, likely from contaminated bananas.
Area of Science:
- Medical Entomology
- Parasitology
- Public Health
Background:
- Intestinal myiasis is rare, particularly in infants.
- Misdiagnosis can occur due to similar symptoms with other parasitic infections.
Observation:
- An asymptomatic 12-month-old infant presented with persistent
- worms
- in stool despite presumptive pinworm treatment.
- Two stool samples confirmed the presence of fly larvae.
Findings:
- Larvae were identified as Muscina stabulans (false stable fly).
- No other family members were infected.
- Over-ripened bananas stored in a hanging basket were the suspected source.
Implications:
- Highlights the importance of accurate diagnosis in pediatric gastrointestinal complaints.
- Emphasizes environmental control and food hygiene in preventing myiasis.
- Encourages healthcare providers, especially nurse practitioners, to recognize and report myiasis cases.
Abstract:
This article describes a case of intestinal myiasis--the presence of fly larvae in the intestines--in a 12-month-old baby. The asymptomatic child was twice treated by her physician for a presumptive diagnosis of pinworm infection. The mother continued to see "worms" in the child's stool and brought her to a public health primary care clinic where she was evaluated by nurse practitioners. Larvae (maggots) of the false stable fly, Muscina stabulans, were identified in each of two stool specimens collected on different days. Examination of stool specimens from other family members showed no larvae. The likely source of the child's infection was over-ripened bananas, which were kept in a hanging basket. No pharmacologic treatment was prescribed, but the parents were instructed to cover the fruit and wash it before consumption. Nurse practitioners are encouraged to report suspected cases of myiasis and to work with patients, their families and public health personnel in order to confirm the diagnosis, identify the source and make suggestions to prevent further infestation.