research note a case of human nasopharyngeal myiasis caused by

2
87 Tropical Biomedicine 22(1): 87–88 (2005) Research Note A case of human nasopharyngeal myiasis caused by Chrysomya bezziana Villeneuve, 1914 (Diptera: Calliphoridae) in Malaysia Lee, H.L., Krishnasamy, M. and Jeffery, J.* Unit of Medical Entomology/IDRC, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia. *Department of Parasitology and Medical Entomology, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia. Myiasis is a pathogenic condition found in live humans and animals caused by various species of dipteran larvae (Zumpt, 1965). The first human case of myiasis in Malaysia was reported by Reid (1953) from a great toe of a patient in Malacca. Later Cheong et al. (1973) reported a cause of intestinal myiasis. Since then myiasis cases in Malaysia have been reported sporadically. Generally, myiasis can be classified according to the site of infestation, as nasopharyngeal or nasal, urogenital, cutaneous, intestinal (enteric), aural (ear) myiasis (Oothuman & Jeffery 1984; Lee & Cheong, 1985; Lee & Young, 1991; Lee, & Yong, 1991; Lee et al., 1995; Lee, 1996). Recently Roszalina & Rosalan (2002) reported on two cases of oral myiasis in cerebral palsy patients. However, reports on human myiasis in Malaysia is generally considered relatively few, probably due to a lack of awareness of the importance of flies in inducing myiasis. We report here a case of nasopharyngeal myiasis from a patient in Malaysia for the first time. CASE REPORT The patient, a 80 years old Malay woman was admitted to the Taiping District Hospital, Perak. She presented with epistaxis, throbbing temporal headache and nausea. Nasal blood clots and maggots were also recovered from the nasal cavity. A maggot was preserved in 70% alcohol and sent to the Institute for Medical Research for identification. The third instar maggot was identified as Chrysomya bezziana , based on the taxonomic characteristics outlined in Zumpt (1965). The body length of the maggot was 13 cm X 5 mm (Figure 1). Cases of human nasal myiasis has so far not been reported in Malaysia. In fact, myiasis due to Ch. bezziana is rare in Malaysia. This may be due to the habit of Ch. bezziana which is an obligatory myiasis producer in a living host. So far, only 2 myiasis cases caused by Ch. bezziana were reported in Malaysia (Lee & Cheong, 1985; Ramalingam, 1980) and one case (oral myiasis) suspected of Ch. bezziana was also reported (Roszalina & Rosalan, 2002). Clinically myiasis has been subdivided depending on the of infection or man or animal. Oral myiasis can either be primary or occasionally, secondary to nasal involvement, especially when the maggots penetrate to the paranasal sinuses (Roszalina & Rosalan, 2002).

Upload: others

Post on 12-Sep-2021

30 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Research Note A case of human nasopharyngeal myiasis caused by

87

Tropical Biomedicine 22(1): 87–88 (2005)

Research Note

A case of human nasopharyngeal myiasis caused by

Chrysomya bezziana Villeneuve, 1914 (Diptera:

Calliphoridae) in Malaysia

Lee, H.L., Krishnasamy, M. and Jeffery, J.*Unit of Medical Entomology/IDRC, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur,Malaysia. *Department of Parasitology and Medical Entomology, Universiti Kebangsaan Malaysia, Jalan RajaMuda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.

Myiasis is a pathogenic condition found inlive humans and animals caused by variousspecies of dipteran larvae (Zumpt, 1965).The first human case of myiasis inMalaysia was reported by Reid (1953) froma great toe of a patient in Malacca. LaterCheong et al. (1973) reported a cause ofintestinal myiasis. Since then myiasis casesin Malaysia have been reportedsporadically. Generally, myiasis can beclassified according to the site ofinfestation, as nasopharyngeal or nasal,urogenital, cutaneous, intestinal (enteric),aural (ear) myiasis (Oothuman & Jeffery1984; Lee & Cheong, 1985; Lee & Young,1991; Lee, & Yong, 1991; Lee et al., 1995;Lee, 1996). Recently Roszalina & Rosalan(2002) reported on two cases of oralmyiasis in cerebral palsy patients.However, reports on human myiasis inMalaysia is generally considered relativelyfew, probably due to a lack of awarenessof the importance of flies in inducingmyiasis. We report here a case ofnasopharyngeal myiasis from a patient inMalaysia for the first time.

CASE REPORT

The patient, a 80 years old Malay woman

was admitted to the Taiping DistrictHospital, Perak. She presented withepistaxis, throbbing temporal headacheand nausea. Nasal blood clots and maggotswere also recovered from the nasal cavity.A maggot was preserved in 70% alcoholand sent to the Institute for MedicalResearch for identification. The thirdinstar maggot was identified asChrysomya bezziana, based on thetaxonomic characteristics outlined inZumpt (1965). The body length of themaggot was 13 cm X 5 mm (Figure 1).

Cases of human nasal myiasis has sofar not been reported in Malaysia. In fact,myiasis due to Ch. bezziana is rare inMalaysia. This may be due to the habit ofCh. bezziana which is an obligatorymyiasis producer in a living host. So far,only 2 myiasis cases caused by Ch.

bezziana were reported in Malaysia (Lee& Cheong, 1985; Ramalingam, 1980) andone case (oral myiasis) suspected of Ch.

bezziana was also reported (Roszalina &Rosalan, 2002). Clinically myiasis has beensubdivided depending on the of infectionor man or animal. Oral myiasis can eitherbe primary or occasionally, secondary tonasal involvement, especially when themaggots penetrate to the paranasalsinuses (Roszalina & Rosalan, 2002).

Page 2: Research Note A case of human nasopharyngeal myiasis caused by

88

Acknowledgement. The authors thank theDirector, Institute for Medical Research,Kuala Lumpur for permission to publish.Thanks are also due to Dr. Azura, HospitalTaiping, Perak for sending the maggotspecimen.

REFERENCES

Cheong, W.H., Mahadevan, S. & Lie, K.J.(1973). A case of intestinal myiasis inMalaysia. Laboratory Demonstrations.Annual Scientific Meeting. MalaysianSociety of Parasitology and TropicalMedicine. Southeast Asian Journal of

Tropical Medicine & Public Health 4:

281.Lee, H.L. & Cheong, W.H. (1985). A case

of human oral myiasis caused byChrysomya bezziana Villeneuve 1914(Diptera: Calliphoridae) in Malaysia.Journal of Malaysian Society of

Health 5: 65–66.Lee. H.L. & Yong, Y.K. (1991). Human aural

myiasis. Southeast Asian Journal of

Tropical Medicine & Public Health 22:

274–275.Lee, H.L., Chandrawathani, P., Wong, W.Y.,

Tharam, S. & Lim, W.Y. (1995). A case

of human enteric myiasis due to larvaeof Hermetia illucens (Family:Stratiomyiadae): first report inMalaysia. Malysian Journal of

Pathology 17: 109–111.Lee, H.L. (1996). A case of human

cutaneous myiasis due to Chrysomya

bezziana Villeneuve (Diptera:Calliphoridae) in Malaysia. Journal of

Bioscience 7: 90–92.Oothuman, P. & Jefferey, J. (1984). Human

myiasis in Malaysia a review. Journal

of Malaysian Society of Health 4: 53–56.

Ramalingam, S., Nurulhuda, A. & Bee, L.H.(1980). Urogenital myiasis caused byChrysomya bezziana (Diptera:Calliphoridae) in Peninsular Malaysia.Southeast Asian Journal of Tropical

Medicine & Public Health 11: 405–407.

Reid, J.A. (1953). Notes on houseflies andblowflies in Malaya. Bulletin of

Institute for Medical Research, Kuala

Lumpur 7: 26.Roszalina, R. & Rosalan, R. (2002). Oral

myiasis: case report. Malaysian

Journal of Medical Science 9: 47–50.Zumpt, F. (1965). Myiasis in man and

animals in the Old World. 1st edition,Butterworths, London. 267.

Figure 1. Maggot of Chrysomya bezziana revovered from the nasal cavityof the patient.