[Made in Germany-Climate change and traumatic myiasis]

In tropical regions traumatic myiasis has long been recognized as a surgical complication. As a result of climate change pathogenic flies are migrating to more northern climates making this condition increasingly more prevalent in Europe.

Currently, no data from Germany exist regarding the patient-related risk factors, incidence, clinical course and expected complications. This case series aims to fill that gap. Additionally, a relationship with weather data is discussed.

This retrospective case analysis of six patients discusses the risk factors, systemic septic complications, treatment protocols, length of hospital stay and weather data.

The median patient age was 60.5 years with an average of 4 pre-existing conditions. Risk factors included male gender (67%), socioeconomic disadvantage (84%), poor personal hygiene (67%), arterial hypertension (84%), alcoholism (50%) and lower extremity injuries (100%, 67% fracture-related). The mean hospital stay was 49 ± 25.39 days. All cases showed evidence of a bacterial superinfection. Of the admitted cases 100% underwent surgery and 80% additionally received antibiotic treatment. Amputation was required in 33% of cases. No patients required intensive care treatment for septicemia. All cases occurred in late spring and summer. On the day of admission the median daytime temperature was 20.6 °C and 14.6 °C at night with a median humidity of 66.6%. Daytime temperatures were higher on the day of admission than in the preceding week and month. There were no statistically significant differences in humidity between the three time points.

Traumatic myiasis has arrived in Europe. Temperature spikes and possibly humidity peaks, could trigger larval hatching and thereby favor the clinical presentation.