Gnathostoma spinigerum Infection in the Upper Lip of a Korean Woman: An Autochthonous Case in Korea

Autochthonous human gnathostomiasis had never been reported in the Republic of Korea. We report here a case of Gnathostoma spinigerum infection in a 32-year-old Korean woman, presumed to have been infected via an indigenous route. The patient had experienced a painful migratory swelling near the left nasolabial fold area of the face for a year, with movement of the swelling to the mucosal area of the upper lip 2 weeks before surgical removal of the lesion. Histopathological examinations of the extracted tissue revealed inflammation with heavy eosinophilic infiltrations and sections of a nematode suggestive of a Gnathostoma sp. larva. The larva characteristically revealed about 25 intestinal cells with multiple (3-6) nuclei in each intestinal cell consistent with the 3rd-stage larva of G. spinigerum. The patient did not have any special history of travel abroad except a recent trip, 4 months before surgery, to China where she ate only cooked food. The patient is the first recorded autochthonous case of G. spinigerum infection in Korea.     

Ophthalmomyiasis caused by a Phormia sp. (Diptera: Calliphoridae) larva in an enucleated patient

Ophthalmomyiasis rarely occurs worldwide, and has not been reported in Korea. We present here a case of ophthalmomyiasis caused by Phormia sp. fly larva in an enucleated eye of a patient. In June 2010, a 50-year-old man was admitted to Dankook University Hospital for surgical excision of a malignant melanoma located in the right auricular area. He had a clinical history of enucleation of his right eye due to squamous cell carcinoma 5 years ago. During hospitalization, foreign body sensation developed in his right eye, and close examination revealed a fly larva inside the eye, which was evacuated. The larva was proved to be Phormia sp. based on the morphology of the posterior spiracle. Subsequently, no larva was found, and the postoperative course was uneventful without any complaints of further myiasis. This is the first case of ophthalmomyiasis among the literature in Korea, and also the first myiasis case caused by Phormia sp. in Korea.     

Imported sparganosis in Canada

The first case of human sparganosis in Canada is reported in a 23-year-old woman who emigrated from Greece in 1969. Examination of a ribbon-like worm removed from a painful swelling in the neighbourhood of her right biceps muscle revealed a single larva, about 110 mm. long and 2.5 mm. wide, subsequently identified as the plerocercoid larva or sparganum of a member of the genus Spirometra. The source of this infection, acquired in Greece, may have been undercooked pork.     

Suspected intestinal myiasis due to Dryomyza formosa in a Japanese schizophrenic patient with symptoms of delusional parasitosis

A third-stage larva of Dryomyza formosa (Wiedemann) (Diptera: Dryomyzidae) was found in the fresh stool of a 27-year-old Japanese woman resident of Shiobara, 150 km north of Tokyo, on 16 November 1998. This is the first record of myiasis due to Dryomyza. Detection of this maggot (2cm long) by the patient herself was associated with her longstanding delusion of abdominal parasitosis as a symptom of chronic schizophrenia. Circumstantial evidence agreed with this being a genuine case of intestinal myiasis, apparently due to accidental ingestion of the insect, with no signs that the patient had contrived the report, nor that the maggot had invaded the stool post-defaecation. This case draws attention to the likelihood that some personality states are predisposed to noticing and reporting myiasis, when it occurs. We review other conditions (mental and physical) that are more prone to myiasis.     

Intramuscular Sparganosis in the Gastrocnemius Muscle: A Case Report

Sparganosis is a parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra. Although the destination of the larva is often a tissue or muscle in the chest, abdominal wall, extremities, eyes, brain, urinary tract, spinal canal, and scrotum, intramuscular sparganosis is uncommon and therefore is difficult to distinguish from a soft tissue tumor. We report a case of intramuscular sparganosis involving the gastrocnemius muscle in an elderly patient who was diagnosed using ultrasonography and MRI and treated by surgical excision. At approximately 1 cm near the schwannoma at the right distal sciatic nerve, several spargana worms were detected and removed.     

Experimental skin lesions from larvae of the bot fly Dermatobia hominis

Skin biopsies from larvae of Rattus norvegicus, experimentally infested with Dermatobia hominis (Linnaeus Jr) (Diptera: Cuterebridae), were processed for histopathological studies. Two days after infestation, the first-stage larvae (L1) were located deep in the dermis, surrounded by an inflamed area infiltrated predominantly by neutrophils. On the fourth day a thin necrotic layer could be seen close to the larvae, surrounded by large numbers of neutrophils, lymphocytes, macrophages with a few eosinophils and mast cells. A small warble was formed after the fourth day, increasing in size until the seventh day, when the L1 moulted to the second-stage larva (L2). The inflammatory process continued with increasing numbers of neutrophils, macrophages, lymphocytes, eosinophils and mast cells invading the area, as well as the proliferation of fibroblasts and endothelial cells and the appearance of a few localized haemorrhages. After 18-20 days, the L2 moulted to the third-stage larva (L3), when a few plasma cells could be seen in the inflamed area. At 25-30 days there was a reduction in the necrotic layer, as well as in the number of neutrophils and lymphocytes, although large amounts of eosinophils, plasma cells, and collagen fibres were seen. The L3 usually left the host after 30 days. Two days later, the larval cavity was reduced, mast cells infiltrated the region and collagen fibre production were increased. After 7 days, an intense infiltration of plasma cells and scattered necrotic areas could be seen. A scar formed after 10 days. This study showed the laboratory rat to be a suitable model for studies of D. hominis infestation.     

Oral myiasis in an elderly patient

doi: 10.1111/j.1741‐2358.2010.00432.x Oral myiasis in an elderly patient Background: Myiasis is the invasion of living tissue of humans and other mammals by eggs or maggots of flies of the order of Diptera. It occurs mainly in the Tropics and is associated with inadequate public and personal hygiene. Oral myiases in an older man appears to be rare. Objective: To relate a case of oral myiases in a debilitated older man treated by mechanical removal of the maggots, identifying the adult insect that caused the infestation. Methods: The diagnosis of oral myiasis was established by the clinical examination and it was detected that the infestation involved only soft tissue and the sinus cavity. The patient was submitted to two mechanical removal of the visible maggots. Results: Total of 110 maggots was removed from the oral cavity of the patient and adult insects was identified as belonging to the Calliphoridae Family, Cochliomyia hominivorax species. The patient died two days after the second procedure by severe systemic complications. Conclusions: The mechanic removal and the identification of the maggots must be adopted as soon as possible to prevent further tissue damage and bacterial infection in cases of oral myiasis. Special attention should be given to the debilitated old patients that are particularly susceptible to oral myiasis infestation.     

Sebaceous lymphadenoma identified by fine needle aspiration biopsy: a case report

BACKGROUND: Sebaceous lymphadenoma of the parotid gland is a rare benign neoplasm. This is the first reported case of fine needle aspiration biopsy (FNAB) findings for sebaceous lymphadenoma of the parotid gland. CASE: A 60-year-old male presented with painless, bilateral parotid swelling noted for 5 months. The swelling was more pronounced on the right. Examination revealed bilaterally prominent parotid glands with diffuse firmness but no discrete masses. There was no evidence of facial nerve dysfunction. Laboratory evaluation was negative for infectious and autoimmune etiologies. Magnetic resonance imaging revealed bilateral cystic parotid masses. FNAB of the right parotid was obtained to assist with preoperative counseling. It revealed lymphoid and salivary gland parenchymal cells. The patient underwent a right superficial parotidectomy. The surgical specimen of the parotid mass confirmed the diagnosis of sebaceous lymphadenoma on the tissue section. The contralateral parotid mass had not been excised at this writing. CONCLUSION: This report is the first to describe the FNAB findings of the unusual benign parotid neoplasm sebaceous lymphadenoma. Though the definitive diagnosis of any parotid mass requires tissue, generally obtained via parotidectomy, an FNAB diagnosis can be useful in counseling a patient prior to definitive biopsy.     

Myiasis in Ulcerated Breast Carcinoma: First Case Record in Myanmar

Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.     

Indwelling catheter and vanishing intracardiac mass

A 36-year-old male was admitted for painful swelling of his right upper extremity. He had had an indwelling port-a-cath placed in his right subclavian vein eight months prior to admission. On admission the patient was afebrile and his vital signs were normal. His right upper extremity was swollen, erythematous and tender. Blood leucocyte count was normal and D-Dimer was elevated. Venous Doppler examination showed partial thrombosis of the distal right subclavian vein. Removal of the port-a-cath by interventional radiology was scheduled.     

Invasion of paranasal sinuses by Aspergillus oryzae

A 24-year-old male patient receiving chemotherapy for acute promyelocytic leukemia developed fever, right periorbital swelling and mild right proptosis. A head scan showed opacification of the right maxillary and ethmoid sinuses with adjacent soft tissue swelling. Biopsy of the nasal mucosa demonstrated the typical septate hyphae of Aspergillus species which was later shown on culture to be Aspergillus oryzae. A. oryzae has only rarely been reported in human disease and there is confusion as to its precise identification and role. We would like to confirm the pathogenicity of A. oryzae with this uncommon presentation of aspergillosis and also emphasize the need to take adequate and multiple cultures in suspected cases so that the possibility of species identification will be maximized.     

Morphology and the central nervous system of <Emphasis Type="Italic">Eratigena atrica</Emphasis> affected by a complex anomaly in the anterior part of the prosoma

Spider embryogenesis is affected by a range of environmental factors. Any sudden, drastic change in the environment may impair spider development, leading to various body deformities. In the present study, we analyze changes in the morphology and structure of the central nervous system of an Eratigena atrica larva, obtained in a teratological experiment in which embryos were exposed to alternating temperatures of 14 and 32 °C for the first 10 days. The studied larva had three pedipalps on the right side of the prosoma (polymely), two of which were fused along their entire length (total heterosymely). In addition, there was a short, club-shaped stump between the pedipalps. Histological analysis confirmed major changes in the structure of the subesophageal ganglion, i.e., the fusion of all three ganglia of pedipalps.     

First Report of Myiasis Caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in a Diabetic Foot Ulcer Patient in Argentina

Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucumán Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female''s oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease.     

Fine structure of the eyes of Pseudoceros canadensis (Turbellaria,Polycladida)

Summary The cerebral and epidermal ocelli of the Müller's larva and the cerebral and tentacular eyes of the adult turbellarian Pseudoceros canadensis were studied by electron microscopy. The right cerebral ocellus of the larva consists of one cup-shaped pigmented cell and three sensory cells that bear microvilli. The left cerebral eye of the larva has the above named cells plus a sensory cell with many cilia. Evolutionary significance is attributed to the presence of both ciliary and microvillar photoreceptors in an eye of a flatworm. The one epidermal ocellus of the larva is composed of two cells: a cup-shaped pigmented one bearing flattened cilia, the presumed photoreceptors, and a cell above the cup that adds a few nonciliary lamellae to the stack of ciliary ones from the pigmented cell. The adult eyes contain only microvillar receptors; cilia were not observed.     

Myiase préputiale: à propos d’une observation

We report a case of preputial myiasis in a child who presented with painful penile swelling suggestive of balanoposthitis. Treatment consisted of manual extraction of the worm followed by circumcision. Parasitologic study of the worm revealed a stage-three larva of Cordylobia anthropophaga. Through this case report and a review of the literature, we discuss the epidemiologic, diagnostic and therapeutic features of this disease.     

A Case of Anisakidosis Caused by Pseudoterranova decipiens Larva

Pseudoterranova decipiens larva is a rare cause of anisakiasis. Indeed, prior to the present study, there had been only 12 reports of larval P. decipiens infection in the Republic of Korea. In June 2011, an anisakid larva, 32.1 mm in length and 0.88 mm in width, and finally identified as the third stage larva of P. decipiens owing to the presence of an intestinal cecum but lacking ventricular appendage, was discovered in a 61-year-old woman during the course of endoscopy executed as a part of routine physical examinations. The patient had eaten raw a rockfish 13 hr prior to the endoscopy, but showed no symptoms of anisakiasis. This paper is the 13th report of P. decipiens infection in Korea.     

Cerebral fat embolism.

An unusual presentation of fat embolism is reported. Forty-eight hours after severe trauma to her legs the patient became stuporous and her right arm weak. A computerized tomography scan showed diffuse brain swelling. Although the petechiae, thrombocytopenia and lipuria characteristic of the fat embolism syndrome were present, at no time was there any evidence of pulmonary involvement.     

A cracking complication: Displacement of existing clavicle fracture complicating subcutaneous implantable cardioverter defibrillator implantation

An 18 year old male with an incompletely healed clavicle fracture presented with unexplained syncope. Subsequent investigations were consistent with a diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). A subcutaneous implantable cardioverter-defibrillator (S-ICD) was successfully implanted and defibrillation threshold (DFT) testing performed as per standard protocol. Shortly following the procedure, the patient complained of pain and swelling over the left clavicle. A radiograph revealed aggravation and displacement of the underlying clavicle fracture. Surgical reduction and internal fixation was performed one week later.     

Viviparous development in Botrylloides (Compound Ascidians)

The mode of sexual reproduction and embryogenesis was compared in 3 species of Botrylloides: B. simodensis, B. lenis, and B. violaceus. In all species, a testis and an egg (occasionally 2 eggs), the former being anterior to the latter, mature in the mantle on either side of a zooid. The egg is surrounded by 2 follicular layers and is attached by a vesicular follicle stalk (oviduct) to the atrial brood pouch. The egg is ovulated into the brood pouch, where it is fertilized and undergoes embryogenesis. The egg of B. simodensis is heavily yolked and measures about 180 μm in diameter. The course of embryogenesis in this species is that typical of ascidians. A mature tadpole larva is produced and shed in about 5 days; then, the mother zooid degenerates. The larva is smallest of the three species and has 8 ampullae. The metamorphosed oozooid bears a single bud on the right side only. Extraembryonic nutrition seems to be very limited. Both Botrylloides lenis and B. violaceus are species which display extreme examples of viviparity. Their eggs are devoid of yolk granules, measuring about 90 μm in diameter in the former species and 60 μm in the latter. The course of embryogenesis is similar in these 2 species. The neurula stage is characterized by a spherical vesicular shape owing to precocious differentiation of the embryonic pharynx, whose ectoderm becomes vacuolated. At the posterior end of the neurula, the mesodermal cells are located in a mass, from which the tail is extended later. In B. lenis, embryogenesis takes about 20 days. At the neurula stage of the embryo, the mother zooid becomes a mantle sac as a result of visceral disintegration. During further embryogenesis, the growth of buds of successive generations in the colony is characteristically arrested. A swimming larva of this species is somewhat larger than that of B. simodensis. It has 14–24 ampullae, and the oozooid carries a single bud on its right side. In B. violaceus, the gestation period lasts for more than a month. At the early gastrula stage of the embryo, the body of the mother zooid fully disintegrates. Only the brood pouch bearing the embryo survives and remains connected with the colonial vascular system. In this species, sexual reproduction does not affect the growth of buds in the colony. The swimming larva is gigantic, being furnished with 24–34 ampullae, and the oozooid always bears 3 buds, 2 on the right side and one on the left side.