A Case of Oral Myiasis Caused by Lucilia sericata (Diptera: Calliphoridae) in Korea

We report here a case of oral myiasis in the Republic of Korea. The patient was a 37-year-old man with a 30-year history of Becker''s muscular dystrophy. He was intubated due to dyspnea 8 days prior to admission to an intensive care unit (ICU). A few hours after the ICU admission, 43 fly larvae were found during suction of the oral cavity. All maggots were identified as the third instars of Lucilia sericata (Diptera: Calliphoridae) by morphology. We discussed on the characteristics of myiasis acquired in Korea, including the infection risk and predisposing factors.     

Myiasis of a perineal fistula

We report a case of myiasis of a rectocutaneous fistula in a subject suffering from bone metastases after surgical resection of a neoplastic bladder. The fistula was infested by maggots identified as third-instar larvae of flies belonging to the family Sarcophagidae, genus Sarcophaga. The infestation was neither intestinal nor pseudointestinal; it was probably caused by a fly ovipositing on the fistula of the patient while having wound care at home, even though the possibility that the infestation might have occurred during hospitalization cannot be ruled out.     

An aural myiasis case in a 54-year-old male farmer in Korea

A 54-year-old male farmer residing in Chunchon, Korea, complaining of blood tinged discharge and tinnitus in the left ear for two days, was examined in August 16, 1996. Otoscopic examination revealed live maggots from the ear canal. The patient did not complain of any symptoms after removal of maggots. Five maggots recovered were identified as the third stage larvae of Lucilia sericata (Diptera: Calliphoridae). This is the first record of aural myiasis in Korea.     

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.     

Subungual myiasis in a woman with psychiatric disturbance

Myiasis is caused by the invasion of tissues or organs of men and animals by dipterous larvae. The disease is infrequent in Turkey. A case of a 65-year-old woman having been initially diagnosed with chronic psychosis, and found to have a left big toe nail invaded by the larvae of Calliphora spp., is presented. A total of 17 maggots were removed from the left big toe of the patient, which were then determined as Calliphora spp. The patient has undergone surgical withdrawal of both nails of her big toes, followed by the administration of oral prophylactic antimicrobial treatment.This is the second recorded case of subungual myiasis by Calliphora spp. in Turkey. Myiasis should be considered in patients with lower personal hygiene, especially with chronic psychiatric disturbances.     

Myiasis in humans: Case reports in Northeastern Brazil including multispecies co-infestation by Sarcophagidae

Myiasis is a parasitosis characterized by an infestation of living vertebrates (humans and other animals) by Diptera larvae, whose occurrence and etiological identification are still neglected by health professionals. Here we analyzed the human myiasis cases registered from 2010 to 2018 in health care units in the municipality of Natal, Northeast region of Brazil. Specifically, we aimed to: I) analyze the medical records of cases documented from 2010 to 2017; II) list the patients predisposing factors; and III) monitor the recent cases diagnosed in health units between August 2017 and March 2018 and report the taxonomic identity of the infesting species. Our data revealed that myiases mainly affect the elderly and individuals with predisposing medical conditions (e.g. senility, filariasis). Regarding the new cases, larvae of Calliphoridae (C. hominivorax (Coquerel, 1858)) and Sarcophagidae [Sarcophaga (Liopygia) ruficornis (Fabricius, 1794), Peckia (Sarcodexia) lambens (Wiedemann, 1830), and Helicobia morionella (Aldrich, 1930)] were identified. Furthermore, this was the first report of a co-infestation with three Sarcophagidae species and also the presence of H. morionella in a human wound. These results reinforce that myiasis is an underreported parasitosis, which may underestimate the ability of previously unreported fly species to feed on living human tissues in the Neotropical Region.     

Informing the debate on oral health care for older people: a qualitative study of older people’s views on oral health and oral health care

doi: 10.1111/j.1741‐2358.2009.00274.x
Informing the debate on oral health care for older people: a qualitative study of older people’s views on oral health and oral health care Background: Older people represent a growing and diverse section of the population. As age increases, people are more likely to experience health and mobility problems and be at higher risk of developing oral disease. Nevertheless, few older people utilise primary oral healthcare services. It is therefore important to understand the value older people place on oral health and dental services to inform providers and planners of oral health care. This research was conducted as part of a study to identify potential ways of minimising barriers to oral health care in older people. Objectives: To explore perceptions of oral health and oral healthcare services amongst older people living in a socially deprived inner city area and how these are related to service utilisation. Methods: A qualitative approach was utilised to explore the range of issues related to older people’s perceptions of oral health and their views on health care. This involved a combination of focus groups and semi‐structured individual interviews with older people and their carers. Data analysis was conducted using the Framework approach. Results:

• ? Response: Thirty‐nine older people and/or their carers participated in focus groups.
• ? Oral health perception: Oral health was associated with the presence of natural teeth, the absence of pain, practical/social functioning, preferably supported by positive assessment by a dentist.
• ? Oral health life‐course: Older people have a long and complex dental history. Past negative experiences with oral health care, especially in childhood, strongly influenced present attitudes towards dentistry and dental personnel.
• ? Citizenship and right to health care: There was a strong perception that, as ‘British citizens’, older people should have a right to free health care and that the National Health Service (NHS) should support them in this phase of their life.

Conclusions: The oral health life‐course of older people is an important influence on their perceptions of oral health and dental attendance. They consider oral health of importance and place great emphasis on their citizenship and rights of access to state funded oral health care. This raises important issues for the funding and delivery of NHS oral health care for older people.     

Investigation of oral opportunistic pathogens in independent living elderly Japanese

doi: 10.1111/j.1741‐2358.2010.00449.x
Investigation of oral opportunistic pathogens in independent living elderly Japanese Objective: Pneumonia is reported to be associated with high morbidity in elderly and compromised individuals, with poor oral health demonstrated to be a significant risk factor for pneumonia. Several opportunistic pathogens, such as Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus, have been detected in patients with pneumonia. We investigated the prevalence of opportunistic pathogens in the oral cavity of healthy independent living Japanese elderly subjects and analysed factors related to harbouring those pathogens. Materials and methods: We studied 265 subjects, each of whom received a dental examination, during which specimens were collected with a tongue swab and examined for the presence of 10 oral opportunistic pathogens using single or multiple selective media. Furthermore, the presence of occult blood in saliva was examined using test paper strips. Results: Oral opportunistic pathogens were detected in 13.6% of the subjects. Those positive for occult blood in saliva had a significantly higher rate of harbouring the pathogens (p < 0.05). In addition, age was a significant factor for the presence of pathogenic microbes in the oral cavity (p = 0.033). Conclusion: Positive findings of occult blood in saliva and older age are suggested to be significant factors for harbouring opportunistic pathogens in the oral cavity.     

Strain persistence of invasive Candida albicans in chronic hyperplastic candidosis that underwent malignant change

Objectives: The aim of this study was to assess persistence and tissue invasion of Candida albicans strains isolated from a 65 year‐old patient with chronic hyperplastic candidosis (CHC), that subsequently developed into squamous cell carcinoma (SCC). Materials and Methods: C. albicans (n=7) were recovered from the oral cavity of the patient over seven years. Confirmation of CHC and SCC in this patient was achieved by histopathological examination of incisional biopsy tissue. DNA fingerprinting was performed on the seven isolates from the CHC patient together with a further eight isolates from patients with normal oral mucosa (n=2), chronic atrophic candidosis (n=1), SCC (n=1) and CHC (n=4). Genotyping involved the use of inter‐repeat PCR using the eukaryotic repeat primer 1251. Characterisation of the tissue invasive abilities of the isolates was achieved by infecting a commercially available reconstituted human oral epithelium (RHE; SkinEthic, Nice, France). After 24 h. C. albicans tissue invasion was assessed by histopathological examination. Results: DNA fingerprinting demonstrated strain persistence of C. albicans in the CHC patient over a seven year period despite provision of systemic antifungal therapy. The strain of C. albicans isolated from this patient was categorised as a high invader within the RHE compared to other isolates. Conclusions: Candidal strain persistence was evident in a patient with CHC over seven years. This persistence may be due to incomplete eradication from the oral cavity following antifungal therapy or subsequent recolonisation from other body sites or separate exogenous sources. The demonstration of enhanced in vitro tissue invasion by this particular strain may, in part, explain the progression to carcinoma.     

Specific Immune Response of Mares and their Newborn Foals to Actinobacillus spp. Present in the Oral Cavity

Oral swab samples, serum and colostrum was taken from 15 mares and 14 of their foals, within 24 h of birth. The presence of antibody against Actinobacillus spp. isolated from the oral cavity was investigated using agar gel immunodiffusion. Antibodies against 48 out of the 77 Actinobacillus isolates from all horses in the study were present in the respective sera of 13 mares and 9 foals. In 11 mother-foal pairs, the antibody content of the foal serum was similar to that of the mare, and in 9 cases this was reflected in the antibody content of colostrum from the mare. The results indicate that an immune response to Actinobacillus spp. colonising the oral cavity is present in many adult horses and that this immune response can be transferred from mother to foal via colostrum.     

Oral health status and oral hygiene practices of patients with peptic ulcer and how these affect Helicobacter pylori eradication from the stomach

Background: Helicobacter pylori eradication from the oral cavity is more difficult than from the stomach. Thus, if the bacterium survives the antibacterial therapy in the oral cavity, it would be able to re‐infect the stomach within a few weeks. Since oral health status could correspond to oral infection with H. pylori, the aim of the study was to determine whether oral health and oral hygiene practices affect the efficacy of H. pylori eradication from the stomach. Material and Methods: The study was performed in 137 patients with peptic ulcer who had undergone a 7‐day course of eradication treatment with one of two sets of drugs: 1, omeprazole, amoxicillin, and tinidazole or 2, omeprazole, clarithromycin, and tinidazole. The efficacy of H. pylori eradication from the stomach was evaluated at the second gastroscopy 4 weeks after cessation of eradication therapy by means of two methods: rapid urease test and histology. The examination of natural dentition and prosthetic restorations as well as the assessment of hygienic procedures referring to natural dentition and dentures accompanied the second gastroscopy. Results: No association was found between the efficacy of H. pylori eradication from the stomach and the number of natural teeth, decayed teeth, use of dentures, debris index, or periodontal index. However, an association between eradication success and some oral hygiene procedures were noted. Unexpectedly, in patients treated with omeprazole, amoxicillin and tinidazole, the removal of dental prosthesis for the night and brushing the natural teeth twice a day or more reduced the efficacy of H. pylori eradication from the stomach. Conclusions: Oral health and oral hygiene practices seem unlikely to increase the efficacy of H. pylori eradication from the stomach.     

Oral health and access to dental care: a qualitative investigation among older people in the community

doi:10.1111/j.1741‐2358.2009.00320.x
Oral health and access to dental care: a qualitative investigation among older people in the community Objective: The aim of this study was to explore older persons’ beliefs and attitudes towards oral health and access to and use of dental care services. Background: As the proportion of dentate older people increases, the need and demand for dental services will rise (J Public Health Dent, 60, 2000, 276). Design: Focus groups and semi‐structured interviews were used for data collection. Setting and subjects: The study participants included 63 older people in Perth, WA. Results: Five major themes emerged from the interviews – the need for information and knowledge; accessibility of services; cost and affordability of oral care; fear and anxiety regarding dental visits and relationships with dentists. Attitudes and behaviours were slow to change in this group. Conclusion: This investigation provided important perspectives regarding oral health and dental access for older people residing in the community and demonstrated the importance of understanding this group when considering provision and use of services.     

Canine Wound Myiasis Caused by Lucilia sericata (Diptera: Calliphoridae) in Korea

Myiasis is a relatively common infection of animals kept as pets, although only 1 case of canine myiasis has been described so far in the Republic of Korea. In the present study, we report an additional case of canine wound myiasis with identification of its causative agent, Lucilia sericata. An 8-year-old male Siberian husky dog was referred with anorexia, vomiting, and diarrhea to the Chungbuk National University Veterinary Medical Center, Cheongju-si (city), Chungcheongbuk-do (province), Korea in July 2013. Physical examination indicated the patient had a deep wound filled with a maggot swarm as a left gluteal lesion. A total of 216 maggots were removed by forceps, and the wounded area was sponged with gauzes and disinfected with 70% alcohol and a povidone-iodine solution. After daily care and suturing the wound, the patient was discharged at day 19 after admission. Recovered worms possessed morphological characteristics similar to those of L. sericata, namely, a sub-cylindrical body with 6–8 lobed anterior spiracles, round shaped with a button surrounded by a peritremal ring with no gaps, and similar distances between dorsal, median, and outer papillae of the 12th segment. Additionally, cox1 partial sequences (528 bp) obtained in the present study showed 100% identity with those of L. sericata (GenBank no. {"type":"entrez-nucleotide","attrs":{"text":"KT272854.1","term_id":"992320795","term_text":"KT272854.1"}}KT272854.1). L. sericata is indicated as a pathogen of myiasis infection not only in humans, but also in animals kept as pets in Korea.     

Characterization of antibiotic resistance determinants in oral biofilms

Oral biofilms contain numerous antibiotic resistance determinants that can be transferred within or outside of the oral cavity. The aim of this study was to evaluate the prevalence and the relative level of antibiotic resistance determinants from oral biofilms. Oral biofilm samples that were collected from healthy subjects and periodontitis patients were subjected to qualitative and quantitative analyses for selected antibiotic resistance determinants using PCR. The prevalence of tet(Q), tet(M), cfxA, and bla _TEM was very high both in the patient and the healthy subject group, with a tendency toward higher values in the patient group, with the exception of erm(F), which was more prevalent in the healthy group. The two extended spectrum β-lactam (ESBL) resistance determinants bla _SHV and bla _TEM showed a dramatic difference, as bla _TEM was present in all of the samples and bla _SHV was not found at all. The aacA-aphD, vanA, and mecA genes were rarely detected, suggesting that they are not common in oral bacteria. A quantitative PCR analysis showed that the relative amount of resistance determinants present in oral biofilms of the patient group was much greater than that of the healthy group, exhibiting 17-, 13-, 145-, and 3-fold increases for tet(Q), tet(M), erm(F), and cfxA, respectively. The results of this study suggest that the oral antibiotic resistome is more diverse and abundant in periodontitis patients than in healthy subjects, suggesting that there is a difference in the diversity and distribution of antibiotic resistance in oral biofilms associated with health and disease.     

Temporal patterns of genetic and phenotypic variation in the epidemiologically important drone fly, Eristalis tenax

Eristalis tenax L. (Diptera: Syrphidae) is commonly known as the drone fly (adult) or rat‐tailed maggot (immature). Both adults and immature stages are identified as potential mechanical vectors of mycobacterial pathogens, and early‐stage maggots cause accidental myiasis. We compared four samples from Mount Fru?ka Gora, Serbia, with the aim of obtaining insights into the temporal variations and sexual dimorphism in the species. This integrative approach was based on allozyme loci, morphometric wing parameters (shape and size) and abdominal colour patterns. Consistent sexual dimorphism was observed, indicating that male specimens had lighter abdomens and smaller and narrower wings than females. The distribution of genetic diversity at polymorphic loci indicated genetic divergence among collection dates. Landmark‐based geometric morphometrics revealed, contrary to the lack of divergence in wing size, significant wing shape variation throughout the year. In addition, temporal changes in the frequencies of the abdominal patterns observed are likely to relate to the biology of the species and ecological factors in the locality. Hence, the present study expands our knowledge of the genetic diversity and phenotypic plasticity of E. tenax. The quantification of such variability represents a step towards the evaluation of the adaptive potential of this species of medical and epidemiological importance.     

Observations on myiasis by the calliphorids, Bufolucilia silvarum and Bufolucilia elongata, in wood frogs, Rana sylvatica, from southeastern Wisconsin

Larvae of certain species of blowflies (Calliphoridae) can cause myiasis in frogs and toads, but there are few reports from North American amphibians. Of these, most are from toads (bufonids). In this study, we observe primary myiasis in a population of juvenile wood frogs, Rana sylvatica, collected on 22-23 August 2003, from southeastern Wisconsin and compare our observations with previous studies on myiasis from toads. Two (5%) of 39 frogs were infected by the blow fly Bufolucilia silvarum, with an intensity of 28 and 31, whereas 1 (2.5%) of 39 frogs was infected by the blow fly Bufolucilia elongata with an intensity of 14. We found that (1) B. silvarum lay eggs on healthy wood frogs, (2) eggs hatch, with first-instar maggots penetrating under the skin, (3) maggots develop to mature third instars within 13-16 hr of egg hatching, (4) maggots kill the host within 7-47 hr of egg hatching, and (5) maggots consume the entire frog carcass reducing it to bones within 42-59 hr of egg hatching. Our observations on the time of death and how quickly carcasses of wood frogs were consumed by these maggots compared with previous studies on toads suggest that finding infected juvenile wood frogs may be uncommon. Therefore, myiasis by these flies on wood frogs and other small terrestrial anurans may be a phenomenon that is much more common than is currently observed. This is the first report of B. silvarum and B. elongata causing myiasis in wood frogs.     

A laboratory-based study for first documented case of urinary myiasis caused by larvae of Megaselia scalaris (Diptera: Phoridae) in Saudi Arabia

Megaselia scalaris (Diptera: Phoridae) is one of the medically important insects. Maggots from a urine sample of a 5-year-old Saudi girl were examined microscopically for identification. These maggots were cultured to become adult flies. Larvae and adults were identified using standard keys. Protozoan flagellates were obtained from the gut of the larvae. This is the first report of M. scalaris as a causative agent of urinary human myiasis in Saudi Arabia.     

In vitro rearing of Eucelatoria bryani: improvements and evaluation of factors affecting efficiency

In vitro rearing of Eucelatoria bryani Sabrosky (Diptera: Tachinidae) was made more efficient and economical. Absorbent cotton, used as a support to replace more expensive agar in an artificial medium, produced yields of adults equal to those reared on the agar-based medium. The weights of pupae from the cotton-supported medium were about 16% lighter than were the weights of pupae from the agar-based medium. Evaluation of diet volumes (100, 200 and 250 l) for individually reared flies revealed that highest adult yields (46.3%) were obtained when 200 l per maggot of agar-based diet were used in each well of microtiter plates; this is equivalent to 2,315 adults per liter of diet. The tachinids were small and the sizes were equal to those obtained when 10–15 maggots parasitize a single host. Costs could not be reduced by deleting free amino acids from the medium fed to older maggots because free amino acids are essential dietary ingredients for third instars of E. bryani.     

Positive and negative impact to decomposition of pig cadavers by ants (hymenoptera: Formicidae) at the Islet Yeongdo in Busan,South Korea

We observed how ants affected the decomposition process of pig cadavers. Experiments were carried out with six pig cadavers during three seasons without winter. Fifteen ant species belonging to 14 genera 3 subfamilies were recorded from pig cadavers. The species richness and species composition of ants were different significantly at bloated and decay stages from the remaining stages, regardless of season. Ant species Nylanderia flavipes, Aphaenogaster japonica, Pheidole fervida, and Ectomomyrmex javanus kept hunting a considerable amount of eggs and maggots of flies in the two stages. In particular, Lasius japonicus continually interrupted landing and ovipositing of flies and removed eggs and maggots from pig cadavers. Our observation suggests that ants may affect decomposition process of dead animals by participating in positive and negative ways by massive removal of eggs and maggots of flies.     

Relationships between Geriatric Oral Health Assessment Index scores and general physical status in community-dwelling older adults

doi: 10.1111/j.1741‐2358.2011.00597.x Relationships between Geriatric Oral Health Assessment Index scores and general physical status in community‐dwelling older adults Objective: The aim of this study was to investigate the relationships between Geriatric Oral Health Assessment Index (GOHAI) and general physical status among community‐dwelling older adults. Background: Geriatric Oral Health Assessment Index is a patient‐centred assessment of oral health for older adults. We hypothesised that GOHAI is a significant indicator of general physical status of older adults. Methods: This study included 354 adults (age, ≥65 years) living independently. Body mass index, handgrip strength and one‐leg standing time with eyes open were used to evaluate the general physical status. Spearman’s rank correlation coefficients were calculated to examine the relationships between the GOHAI scores, its three subdivided categories (physical function, psychological function and pain and discomfort) and each physical status measurement. A stepwise linear regression model was applied with each physical status measurement as the dependent variable and the GOHAI scores and its subdivisions as the principal independent variable. Results: Positive correlations were found between the GOHAI scores, its three subdivided categories and handgrip strength. The physical function category positively correlated with one‐leg standing time. The GOHAI and the pain and discomfort category scores were retained in the final models of stepwise regression for handgrip strength, and significant relationships persisted after adjustments for demographic, psychosocial, medical and dental status. Conclusion: The GOHAI scores and its pain and discomfort category score may be significant indicators of body muscle strength.