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Wound Myiasis in Urban and Suburban United States
Ronald A. Sherman, MD, MSc, DTM&H
Arch Intern Med. 2000;160:2004-2014.
Background The epidemiologic characteristics of human myiasis in the United States remain undefined.
Objective To describe the most common clinical conditions associated with human myiasis and the causative maggot species.
Methods Multicenter, prospective observational study of urban and suburban patients who were infested with maggots.
Results Forty-two cases of US-acquired myiasis were collected from 20 participating centers. Most infestations occurred within preexisting wounds. No cases of tissue invasion were recorded. Host age averaged 60 years, with a male-female ratio of 5.5:1. Homelessness, alcoholism, and peripheral vascular disease were frequent cofactors. Two patients (5%) were hospitalized at the time of their infestation. The most common species was Phaenicia sericata (green blowfly; family: Calliphoridae). Other blowflies, flesh flies (Sarcophagidae), and humpbacked flies (Phoridae) also were identified. In 6 cases, 2 coinfesting species were identified.
Conclusions Results of this prospective study of myiasis differ significantly from those of our analysis of previously published reports and suggest that most cases of human myiasis are caused by noninvasive blowflies laying eggs in preexisting wounds. Five percent of infestations were nosocomially acquired and not necessarily associated with patient neglect.
From the Department of Medicine, University of California, Irvine, and Medical Service, Veterans Affairs Medical Center, Long Beach, Calif.
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