IMPORTED FURUNCULAR MYIASIS IN THE REPUBLIC OF NORTH MACEDONIA - A THREE CASE STUDY
Date Issued
2024
Author(s)
Jusufovski, Emilijan
Nikolic, Jadranka
Abstract
Introduction: Furuncular myiasis is a parasite disease most commonly found in tropical regions.
It is the most widespread clinical manifestation of myiasis that occurs when larvae of various
species of flies penetrate the skin and cause cutaneous lesions. Objective: To present cases of
imported furuncular myiasis acquired during a stay in Africa. As far as we know, these are the
first cases reported in the Republic of North Macedonia. Case report: We present a group of
three patients with myiasis acquired during a journey to Tanzania. The symptoms occurred three
days after being bitten by hairy flies, and manifested with sporadic papular lesions accompanied
by pain and itching. They contacted our hospital 6 days after being bitten. During examination of
all three patients, on the bitten spot, several papulonodular, indurated, separated lesions, with
centrally positioned eschar, localized on the upper, lower extremities and glutes were noted. On
the sixth day of symptom appearance, the patients had sensations of subcutaneous movements in
skin lesions, dropping out of the eschar and a beginning of larvae coming out from the nodular
changes. All cutaneous changes were treated by a plastic surgeon by extirpation of larvae from
them. Favorable clinical course followed, with a complete regression of the local findings.
Larvae have been forwarded to the Microbiology and Parasitology Institute with myiasis
confirmation. Conclusion: In patients with cutaneous papulonodular changes returning from
tropical regions it is necessary to include myiasis in differential diagnostic consideration.
It is the most widespread clinical manifestation of myiasis that occurs when larvae of various
species of flies penetrate the skin and cause cutaneous lesions. Objective: To present cases of
imported furuncular myiasis acquired during a stay in Africa. As far as we know, these are the
first cases reported in the Republic of North Macedonia. Case report: We present a group of
three patients with myiasis acquired during a journey to Tanzania. The symptoms occurred three
days after being bitten by hairy flies, and manifested with sporadic papular lesions accompanied
by pain and itching. They contacted our hospital 6 days after being bitten. During examination of
all three patients, on the bitten spot, several papulonodular, indurated, separated lesions, with
centrally positioned eschar, localized on the upper, lower extremities and glutes were noted. On
the sixth day of symptom appearance, the patients had sensations of subcutaneous movements in
skin lesions, dropping out of the eschar and a beginning of larvae coming out from the nodular
changes. All cutaneous changes were treated by a plastic surgeon by extirpation of larvae from
them. Favorable clinical course followed, with a complete regression of the local findings.
Larvae have been forwarded to the Microbiology and Parasitology Institute with myiasis
confirmation. Conclusion: In patients with cutaneous papulonodular changes returning from
tropical regions it is necessary to include myiasis in differential diagnostic consideration.
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