Wound Myiasis in Diabetic Foot Ulcer: Calliphoridae and Sar-cophagidae Family

Evren  Tileklioğlu; İbrahim  Yildiz; Fürüzan Bozkurt  Kozan; Erdoğan  Malatyali; Mustafa Bülent  Ertuğrul; Hatice  Ertabaklar

doi:10.18502/ijpa.v16i4.7881

Evren Tileklioğlu Department of Parasitology, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
İbrahim Yildiz Department of Parasitology, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
Fürüzan Bozkurt Kozan Nazlı-Selim Eren Chronic Wounds and Infections Care Unit, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
Erdoğan Malatyali Department of Parasitology, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey
Mustafa Bülent Ertuğrul Department of Infectious Diseases and Clinical Microbiology, Aydin Adnan Menderes University School of Medicine, Ay-din, Turkey
Hatice Ertabaklar Department of Parasitology, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey

DOI: https://doi.org/10.18502/ijpa.v16i4.7881

Keywords: Myiasis; Wound; Diabetic foot; Calliphoridae; Sarcophagidae

Abstract

Background: Myiasis is a parasitic infestation of tissues or body cavities of mammals with dipterous larvae. The patients with diabetic foot ulcers are more vulnerable to acquiring infestation; however, the infestation may be neglected and mistreated in some cases.

Methods: Data were collected of twelve myiasis cases with diabetic foot ulcers in Nazli-Selim Eren Chronic Wound and Infections Care Unit, Aydin, Turkey between 2017 and 2019. Demographic, clinical characteristics of the patients and clinical examination of the wound were recorded. To morphology-based identification method of the agents, the developmental stages of the maggots were examined.

Results: The cases aged between 46 and 81 years (10 males, two females). Eight of the larvae collected from wounds had Calliphoridae and four had Sarcophagidae family. The larvae were infested right/left foot sole, thumb, ankle, and mostly left toes. The number of larvae collected from the cases ranged from 2 to 48. Third-stage larvae (L3) were mostly detected. Mixed (L1-L2, L2-L3) larvae were detected in a patient. The infestations were more common in July and August. According to the score of Infectious Diseases Society of America (IDSA), ten (83%) cases had moderate and two (17%) cases were mild diabetic foot infections (DFIs).

Conclusion: Diabetic foot ulcers should be evaluated in terms of myiasis. This was the first study in our province indicating that myiasis should not be neglected and different species of flies were responsible for myiasis cases.