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Nasal Myiasis in an Intensive Care Unit Linked to Hospital-Wide Mouse Infestation
Richard Beckendorf, MD;
Stephen A. Klotz, MD;
Nancy Hinkle, PhD;
William Bartholomew, PhD
Arch Intern Med. 2002;162:638-640.
A large city hospital experienced an infestation of mice combated in
part by broadcasting poisoned baits. Months later there was an invasion of
flies into the hospital, and 2 comatose patients in an intensive care unit
contracted nasal maggots. Adult flies were trapped and maggots removed from
the nares of the second patient. These were identified as the green blowfly
(Phaenicia sericata). Recent downsizing of hospital
personnel had led to the unintended and unrecognized loss of housekeeping
services in the canteen food storage areas. A mouse infestation of the hospital
occurred, with the epicenter in the canteen area. This was initially addressed
by scattering poisoned bait and using rodent glue boards. The result of such
treatment was the presence of numerous mouse carcasses scattered throughout
the building attracting the green blowfly. Adult gravid female flies trapped
in the new intensive care unit (where mice were not present) laid eggs in
the fetid nasal discharge of 2 comatose patients. Live trapping of mice and
removal of carcasses led to an abatement of the fly infestation. The cause-and-effect
nature of the mouse carcasses and flies was underscored a year later when
an outbreak of P sericata occurred in the operating
department and was linked to the presence of mouse carcasses on glue boards
not removed the previous fall. Hence, the disruption or loss of 1 vital link
in hospital organization (in this case, housekeeping support) may lead to
an unintended and bizarre outcome.
From the Departments of Medicine (Drs Beckendorf and Klotz) and Pathology
(Dr Bartholomew), Veterans Affairs Medical Center, Kansas City, Mo, and University
of Kansas School of Medicine, Kansas City; and Department of Entomology, University
of California, Riverside (Dr Hinkle).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Tracheopulmonary Myiasis Caused by a Mature Third-Instar Cuterebra Larva: Case Report and Review
Cornet et al.
J. Clin. Microbiol. 2003;41:5810-5812.
ABSTRACT
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