A case of myiasis due to SarcQPhagzimelanura. (Diptera:Sarcophagidae)in a patient suffering from pontine infarction. YuichiCHiGusAi),SatoruKAwAii),Masashi ...
The JapanSociety The Japan Society
of Medical Medical Entomology Entomology and and Zoology Zoology
of
Vol,48 (Med,Entomol.ZeoL
No,2
p,141-1431997]
Research Note
A
due to SarcQPhagzi melanura Sarcophagidae)in a patient (Diptera: suffering from pontine infarction
case
of myiasis
Yuichi CHiGusAi),Satoru KAwAii),Masashi KiRiNoKii), Hajime MATsuDAi) and Kouichi MoRiTA2)･3) Departmentofnfedicat Zoology,Doleleyo[lhiversitySchootofMbdicine, vabu,Tochigi, 321-02 ]mpan 2) DopartmentofRespiraton, Mledicine,Dolekyo Lhiiversity, Koshigtiya Hbspital, Koshigaya,Saitama,343 fopan 3) Mbrita IVIziha Ctinic, Kcxsuleabe,Saitama,344 lttpan ']
26 February 1997;Accepted:28 March (Received: Key
words:SarcQphaga nosa,
melanuru,
Proteusmirabitis
pontine
1997)
infarction, tetraplegia, Rseudomonas
aerugt-
have already reported four occurred in March 1984. Thereafter,he cases of myiasis involving the families had suffered an attack of unstable angina Sarcophagidaeand Calliphoridae. These and cardiac infarction in April 1988. Newere due to SarcophagnPeregnna (Japa- crosis of the left lower leg, probably nese name: senchi-nikubae) and S. similis caused by arteriosclerosis obliterans name: nami-nikubae) et (Japanese had developed2 years prior to this (Chigusa (ASO), al., 1994), and Lucz'tiasericata (Japanese occurrence of myiasis. The bacteria name: hirozu-kinbae)and L. illustris (Japa- domonas aerttginosa and Pbeoteusmirabilis nese name: rnidori-kinbae) et al. were detected in the necrotic (Chigusa lesion.More 1996). than 10 milky white dipteranlarvae were This time, we encountered a case of found in the lesion on July7, 1996. The wound myiasis in which the host patient maggots, 5mm long, were initiallyidenhad been suffering from tetraplegiadue to tified as 2nd instarlarvae of the family Sarcophagidae from theirdistinctivepospontine infarctionfor 12 years. The causative maggot in this case was identified as teriorspiracle. Sarcophagzz melanura The larvae collected (Japanesename: were definitively shiriguro-nikubae), making this the third identifiedas 2nd instarlarvae of Sarcophunequivocal report of human myiasis in melanura) aga melanura (Higlicophcrgella the world and Koshimizu, 1955; Miya1826) (Ito based on the morpholog(Meigen, moto et al. 1996). icalcharacteristics of the cephalopharynsclerite 1A), geal (Fig. and anterior (Fig.1B) CASE PRESENTATION and posterior(Fig. IC) spiracles. The
authors
,Rseu-
The patient, a 66-year-oldman livingin Kasukabe City,Saitama Prefecture,had a 12-year history of tetraplegia, speech impediment and bilateralcentral facialparalwhich had ysis due to pontine infarction,
DIscussloN The bases of onset necrotic lesion such enocarcinoma
(Kaniet
for as al.,
myiasis
are
a
due to ad1981), squam-
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(Kouya and 1979) and buchi and
Ueno, 1977; Hasegawa et al. traurnaor surgical wound (KineIkemura, 1972;Khan and Khan,
1985).
Greenberg (1984), Chigusa and Sugiet aL (1994) have and Chigusa yama (1987) indicated that debilitatedpersons, persons cannot drive away fiiesby themwho selves, such as neonates and patientswho are mentally disturbed or in a comatose state are predisposed to fall victim to myihave asis. Moreover, Chigusa et al. (1996) out that not only elderly or debilpointed itatedpersons, but also those with psychiatric disorders such as schizophrenia, should be protected from fiies, because of dirninishedsensitivitheir autism and/or ty, which may make it easy for fiiesto deposit eggs or larvae on the patients' body surface or orifices. The present patient had been suffering from tetraplegia, i.e.unable to change his posture by himself, since suffering a pontine infarctionin March 1984. Therefore, he was at risk of exposure to myiasis, a$ indicated above. Additional factorsfor predisposition to myiasis in the veterinary fieldhave been studied by several investigators {Wattset al. 1979; Gherardi et al. 1981; Gherardi et al. 1983). These are dermatophi!osis,an actinomycotic diseasecaused by DermatoPhiluscongolense, and bacterialfieecerot, a superficial dermatitisinduced by moisture and
bacterial proliferation on the skin, re-
sulting
Fig.1. The anterior
of ous
cephalopharyngeal
spiracle
{B)and
sclerite
posterior spiracle
(A), (C)
Sarcophagametanura,
cell
(Hasegawaet al., 1979;
carcinoma
Shitara, 1989)
and
basal
cell carcinoma
in
a
matted
band
of
discoloured
fleece(Gherardi et al. 1981). Fleece rot is by Rseudomonas caused predominantly aeruginosa (Wattset al., 1979). The present patient's necrotic lesionof the leg was contaminated with Pseudomonas aeruginosa and Roteus mirabilis. Gherardi et al. suggested that dermatophilosis and (1983) in atfleece rot interact synergistically tracting blowfiiesand their subsequent Therefore,itisassumed that oviposition. atwas the fly, SarcQPhaga melanura, through the tracted to the leg lesion synergistic effects of the presence of the and bacteria
The
authors
their metabolites. emphasize
that
clinicians
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143
pay special
should
patients are bacteria ．
wounds
when
nated
with
to myiasis
attention
of
contami
−
Japan．ハ厘敏 ’α 福 2dL／1， 93：612−614 （inJapanese ＞． ture， Ito， S ． and D ， Koshimizu （1955） Acase of intestinal J． Tohyo Wom myiasis ．
’ s Med
θn
Coll． ，25： 133 − 136
in Japanese）， （
AcKNowLEDGEMENT We
Kani ， A ． O ． Nakamura ， H ． Ono K ． Nagase ， T ． Totani ， ， T ， Morishita K ． Kouya and S ． Iwata ， 1981）Acase （ ，
Sat− are particularly grateful to Dr ．
Shinonaga，Department
Medical ZQology Tokyo Medical and Dental Uni − versity for his valuable guidance with fly identification and sincere encouragement ． also wish to thank Ms ， Yuko Morita We ジ Dokkyo University School of Medicine for her assistance with management of the oshi
，
of
，
，
patient ．
of of myiasis for papillary adenocarcinoma parotid − ． Acta De gland η natoL Kyoto 76 ： 173 177 ． （ ） ， Khan ， M ． A ． J． and R ． Khan J． （1985 ） Phor7nia 7 勿 α
Meigen ）（Diptera：Calliphoridae a causative agent ， （ ） of urogenital myiasis of an infant in Karachi， Sanit ZooL， 36 ： 271−274 ． Pakistan ．ノPn， ／． Kinebuchi， S ． and L Ikemura 1972 ） Myiasis． fpn， f， （ − in Japanese）． ，26 331 339 （ Clin．1）ermatol ． Kouya ，M ，And A ．Ueno （1977 ） Acase of human of a patient suffering from basal cell carci − myiasis Tokyo ），19 ： 465 −468 （in noma ． Rinsho Derma ．（ ． Japanese） Miyamoto ， K ． S ． Shinonaga ， M ． Iwasa ， T ． Takahashi 、 and A ．Nunomura （1996 ） Two cases of facultative myiasis due to Genus Sarco Case reports ． ρhaga − Med ． Entomol ．Zool． ，47 ：179 181， Shitara cell carcinoma ，A ． （1989）Acase of squamous with myiasis ． Rinsho Derma ．（Tokyo ）， 311842 −843 in Japanese） ． （ Watts，工 E ． ， M ． D ， Murray and N ． P ． H ． Graham （ 1979 〕 ；
REFERENCES
：
：
myiasis
The blowfly strike probiem of sheep
in New
South
，55 ：325−334． Wales ．Aust．Vet． J．
摘
要
脳 梗塞患 者 に 発生 した に よ る ハ
リグロ
シ
ニ
クバ
エ
症
エ
千 種 雄 一 〕 川 合 覚 ） 桐 木 雅 史 1） 1｝ 2 3 松 田 肇 守 田 浩 一 ）・） 1
1
L
獨 協 医 科 大 学 医 動 物学 教 室 （〒 321 −02 栃 木 県 下 都 賀 郡 壬 生 町北 小 林 880 ） 2 ｝獨 協 医科 大 学 越 谷 病 院 呼 吸 器 内 科 （〒 343 越 谷 市 南越 谷 2− 1−50 ） 3｝ 守 田 内科 医院 （〒 344 春 日 部 市 南 2 −6−27 ）
「
：
K ． G ， John− ，
，
Gherardi， S ． G ． N ． Monzu S ． S ． Suther 【 ， and son and G ． M ． Robertson association 1981 The （ ） of sheep between body strike and dermatophilosis under controlled conditions ． ノ lust ． Vet ． ． ， ノ 57 ；268− 271 ． Gherardi， S． G． S ， S ， Sutherland N ， Monzu and K ． G ． ， ， Johnson 1983 Field observations on （ ） body strike affected with dermatophilosis and 且eece − in sheep − rot ． Aust ． レ et ， L ， 60 ： 27 28 ． ノ Greenberg，B ．（1984 ） Two cases of human myiasis − by Phaenicia s 万 ’ （ Diptera： Calliphor caused idae in Chicago ） area hospitals．ノl Med ， Entomol ． ， 21： 615 ． Hasegawa ，H ． H． Sekikawa ， K． ， Oka and M ．Hosokawa 1979 ｝Acase of human myiasis in Niigata 一 Prefec （
due to Lucilia sericata and Med ． Entomol ， Diptera： Calliphoridae ， 五 ．班 μ5 屠 8 （ ） Zool ． ，47 ： 73 − 76 ， cases of wQund
Chigusa， Y ． and K ． Sugiyama 1987）Acase report of （ − due to Phaeniciasericata （ Diptera： Calli myiasis ．ノニAichi ノ吻 4，こfniv．Assoc． phoridae ） ，15 655 −658 in Japanese with English sunlmary ， （ ） Chigusa，Y ． ，K ，Tanaka ，H ．Yokoi，H ．Matsuda ，Y ． Y． Ikadatsu and K ． Baba （1994 ） Two cases Sasaki， of Qtomyiasis caused by Sarcophaga peregrina and S ． similis Diptera ： Sarcophagidae ．Jpn，∫ Sanit． （ ＞ Zoot． ，45 153 − 157 ． Chigusa， Y ． M ． Kirinoki， H ． Yokoi ， H ． Matsuda ， K ， ， A ， Yanadori and S ． Yamazaki 1996） Two Okada ， 〔
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