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We report a case of human Oestrus ovis nasal myiasis in Greece, in which pupation occurred within the human host. Ten larvae in various stages of development and 1 puparium were expelled or extracted from the patient's maxillary sinus. Diagnosis was confirmed through morphologic identification and by PCR, followed by DNA sequencing.

Myiasis caused by the sheep nasal botfly is endemic in countries where sheep and goats are largely reared, while humans serve as incidental hosts. Ophthalmomyiasis in humans caused by Oestrus ovis is documented globally but is most prevalent in Mediterranean countries, highlighting the significance of this myiasis as a neglected disease. A thorough questionnaire covering frequency of disease occurrence, seasonal patterns, and management of O. ovis was forwarded to clinicians in Italy gathering data from 100 respondents across diverse regional and occupational backgrounds. Majority of respondents were from endemic areas of the Southern Italy and main islands, like Sardinia (52%) and Sicily (42%), with 81% representing physicians. Notably, 31% of physicians reported treating ophthalmomyiasis cases, while 80% expressed interest in further information. Seasonal trends revealed a peak during summer (χ² = 29.429, df = 4, p < 0.001), notably among outdoor workers in contact with farm animals (χ ² = 18.059, df = 2, p < 0.001). Diagnosis relied on symptoms or parasite detection, with ocular regions being the most common site of infestation. O. ovis was identified in 13% of cases (χ² = 20.368, df = 3, p < 0.05), with physicians emphasizing the importance of removing larvae painlessly to avoid complications. Finally, physicians reported the efficacy of mercuric oxide ointment and the use of topical povidone-iodine for ocular localization, combined with antibiotics and corticosteroids. Diagnostic challenges and the persistence of recurrent infestations highlight the need for enhanced disease surveillance and clinician knowledge to effectively manage and mitigate the impact of ophthalmomyiasis as it continues to emerge as a significant public health concern.

Questionnaires and clinical observations are significant components of human and veterinary epidemiology surveys, providing a comprehensive prognosis of the occurrence and prevalence of diseases. The information compiled by these two survey methods is equally important for establishing an epidemiological surveillance system for disease outbreak management. This review summarizes 57 previous surveys, including questionnaires and clinical observations on sheep myiasis globally from 1976 to 2023, with an emphasis on their methodologies and areas of findings. Overall, this review establishes a baseline understanding of the essential entomological and veterinary aspects required for designing questionnaires and clinical observation surveys on sheep myiasis. Additionally, it provides guidance for implementing future study protocols and proposes a farmer-based approach that integrates these techniques to achieve improved outcomes in mitigating sheep myiasis.

Myiasis is a rare ectoparasitic infestation characterized by the invasion of living tissue by fly larvae of the order Diptera. While larvae typically target wounded skin, ocular, nasopharyngeal, and gastrointestinal regions, oral myiasis is a less frequently reported but clinically significant site of infestation. Herein, we report a case of oral myiasis in a 68-year-old male patient who was intubated and managed in the intensive care unit following a high-altitude fall resulting in a Type III odontoid fracture. A tracheostomy was subsequently performed and during routine replacement of a nasogastric tube, multiple motile larvae were observed in the oral cavity. The larvae were mechanically removed, and the affected area was thoroughly irrigated with a sodium bicarbonate solution. Parasitological examination, including both macroscopic and microscopic analysis, identified the larvae as third-instar forms of the family. Despite ongoing intensive supportive care, the patient developed sepsis and multiorgan failure, culminating in cardiopulmonary arrest and death. This case suggests that oral myiasis may occur even under strict adherence to standard infection control measures. It highlights the necessity for individualized risk assessment and the implementation of advanced, targeted prevention strategies in vulnerable intensive care unit populations, considering the complex interplay of host, environmental, and systemic factors.

We report a case of a suspected intestinal myiasis of a child from Southeast Argentina. Diptera larvae were sampled by a physician from the nappy worn by the child and submitted for examination and identification to the Laboratorio de Artrópodos (Universidad Nacional de Mar del Plata). Based on diagnosis of the anterior and posterior spiracles and mouthparts, the larvae were identified as the false stable fly Muscina stabulans (Fallén, 1817) (Diptera: Muscidae). A comparison of diagnostic characters between Argentinean and European third instars of this species is presented. Muscina stabulans is a prevalent species in the district of General Pueyrredón, Buenos Aires province, where the case occurred. Its abundance in the area coincidentally peaked at the time of the infestation. This is the 1st report of M. stabulans as a suspect of intestinal myiasis for the whole of the southern cone of South America (Chile and Argentina).

Background Myiasis is the infestation of living vertebrates by larvae (“maggots”) of dipterous flies. These include the Gasterophilus species (Oestridae). Their larvae are obligate endoparasites of equids, and their third instar larvae remain in specific areas of the gastrointestinal tract for many months. Non-equids are unsuitable hosts for Gasterophilus spp. However, their larvae have occasionally been found in the digestive tracts of carnivores and scavengers; this is known as accidental myiasis. Methods A gray wolf ( Canis lupus ) hunted near a settlement in northern Kazakhstan in February 2023 was necropsied. Its stomach, which was otherwise empty, contained four cylindrical, cream-coloured maggots, approximately 15 mm long, attached to the gastric mucosa. Results The maggots were identified morphologically as second and third instar Gasterophilus larvae and molecularly as Gasterophilus pecorum . Conclusion This is the first reported case of accidental gastric myiasis in wolves. The causative species, Gasterophilus pecorum , is a common parasite of equids in Asian countries. The larvae must have survived the ingestion process intact and remained attached to the wolf’s stomach wall with cephalopharyngeal hooks for a prolonged period of time, lasting from more than half a day to several days.

ABSTRACT Cerebral myiasis is an exceptionally rare condition caused by infestation with dipteran larvae, with only 20 cases reported in the literature to date. A 78-year-old man presented with anorexia, vomiting, and fever. Physical examination revealed a 7 × 8 cm ulcerated scalp lesion with a necrotic base, purulent discharge, a foul odor, and numerous larvae. Computed tomography demonstrated an osteolytic frontal bone defect accompanied by pneumocephalus and subcutaneous emphysema. The larvae were manually removed, an iodoform dressing was applied, and intravenous ceftriaxone therapy was initiated. Progressive neurological decline prompted repeat imaging, which revealed frontal and parietal cerebritis with abscess formation. Surgical debridement was performed to remove necrotic tissue. Histopathological analysis showed moderately differentiated squamous cell carcinoma with acute osteomyelitis, and cultures yielded multidrug-resistant Pseudomonas aeruginosa. Despite targeted antibiotic therapy and intensive supportive care, the patient died. This case highlights the significant morbidity and mortality associated with cerebral myiasis, particularly when complicated by underlying malignancy and multidrug-resistant infection. Early recognition, prompt surgical intervention, and pathogen-directed antimicrobial therapy are crucial, while comprehensive multidisciplinary management remains essential to optimize outcomes in this life-threatening condition.

Myiasis due to parasitic fly larvae (maggots) can have major consequences for animal health and welfare. The European hedgehog Erinaceus europaeus is frequently presented in rehabilitation centres and veterinary practices due to health problems, including myiasis. In the present study, 557 hedgehogs presented at wildlife rehabilitation centres in Northern Germany during 2018-2021 were examined for the presence of dipteran eggs and larvae. Overall, 15.6% of animals carried fly eggs and/or larvae. Four different dipteran species were identified by PCR and sequencing of the internal transcribed spacer 2 (ITS-2) region. Lucilia sericata was detected on 25.3% [22/87] of affected hedgehogs, followed by Calliphora vicina (12.6% [11/87]), Lucilia ampullacea (11.5% [10/87]) and Lucilia caesar (9.2% [8/87]). Myiasis prevalence was significantly higher during the summer compared to spring and autumn. Fly eggs were found all over the body, while larvae were detected most frequently in the body's natural orifices and in wounds. Regarding rehabilitation success, myiasis occurred significantly more frequently in animals that died or were euthanized compared to those released back into the wild. Although the high death rate probably arose in combination with underlying disease, this illustrates that myiasis represents a serious health issue that should be diagnosed and treated immediately.

Introduced parasites threaten native host species that lack effective defenses. Such parasites increase the risk of extinction, particularly in small host populations like those on islands. If some host species are tolerant to introduced parasites, this could amplify the risk of the parasite to vulnerable host species. Recently, the introduced parasitic nest fly Philornis downsi has been implicated in the decline of Darwin's finch populations in the Galápagos Islands. In some years, 100% of finch nests fail due to P. downsi; however, other common host species nesting near Darwin's finches, such as the endemic Galápagos mockingbird (Mimus parvulus), appear to be less affected by P. downsi. We compared effects of P. downsi on mockingbirds and medium ground finches (Geospiza fortis) on Santa Cruz Island in the Galápagos. We experimentally manipulated the abundance of P. downsi in nests of mockingbirds and finches to measure the direct effect of the parasite on the reproductive success of each species of host. We also compared immunological and behavioral responses by each species of host to the fly. Although nests of the two host species had similar parasite densities, flies decreased the fitness of finches but not mockingbirds. Neither host species had a significant antibody‐mediated immune response to P. downsi. Moreover, finches showed no significant increase in begging, parental provisioning, or plasma glucose levels in response to the flies. In contrast, parasitized mockingbird nestlings begged more than nonparasitized mockingbird nestlings. Greater begging was correlated with increased parental provisioning behavior, which appeared to compensate for parasite damage. The results of our study suggest that finches are negatively affected by P. downsi because they do not have such behavioral mechanisms for energy compensation. In contrast, mockingbirds are capable of compensation, making them tolerant hosts, and a possible indirect threat to Darwin's finches.

We review epidemiological and clinical data on human myiasis from Ecuador, based on data from the Ministry of Public Health (MPH) and a review of the available literature for clinical cases. The larvae of four flies, Dermatobia hominis, Cochliomyia hominivorax, Sarcophaga haemorrhoidalis, and Lucilia eximia, were identified as the causative agents in 39 reported clinical cases. The obligate D. hominis, causing furuncular lesions, caused 17 (43.5%) cases distributed along the tropical Pacific coast and the Amazon regions. The facultative C. hominivorax was identified in 15 (38%) clinical cases, infesting wound and cavitary lesions including orbital, nasal, aural and vaginal, and occurred in both subtropical and Andean regions. C. hominivorax was also identified in a nosocomial hospital-acquired wound. Single infestations were reported for S. haemorrhoidalis and L. eximia. Of the 39 clinical cases, 8 (21%) occurred in tourists. Ivermectin, when it became available, was used to treat furuncular, wound, and cavitary lesions successfully. MPH data for 2013-2015 registered 2,187 cases of which 54% were reported in men; 46% occurred in the tropical Pacific coast, 30% in the temperate Andes, 24% in the tropical Amazon, and 0.2% in the Galapagos Islands. The highest annual incidence was reported in the Amazon (23 cases/100,000 population), followed by Coast (5.1/100,000) and Andes (4.7/100,000). Human myiasis is a neglected and understudied ectoparasitic infestation, being endemic in both temperate and tropical regions of Ecuador. Improved education and awareness among populations living in, visitors to, and health personnel working in high-risk regions, is required for improved epidemiological surveillance, prevention, and correct diagnosis and treatment.