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Each concludes with approaches to management of pest species and prevention of arthropod-borne diseases. In addition to its value as a student textbook, the volume has appeal to a much broader audience, specialists and non-specialists alike. It provides a key reference for biologists in general, entomologists, zoologists, parasitologists, physicians, public-health personnel, veterinarians, wildlife biologists, vector biologists, military entomologists, the general public and others seeking a readable, authoritative account on this important topic.
In all cases of dermal and subdermal myiasis, it is important to remove the entire larva from the boil.
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Dead larvae, or portions of larvae, left in the skin can result in secondary bacterial infections Ocular Myiasis Ocular myiasis ophthalmomyiasis can manifest in different ways depending on the etiologic agent. One of the most common is conjunctivitis caused by the first-instar larvae of the nasal bot fly of sheep, Oestrus ovis Fig. This condition can occur worldwide, most commonly in sheep-raising regions In humans, the larvae are not known to develop beyond the first instar Hypoderma tarandi the caribou bot fly has also been implicated in ophthalmomyiasis Phormia has been reported to cause ophthalmomyiasis in hospitalized patients Finally, secondary infestations of Wohlfahrtia , Chrysomya , Cochliomyia , and Phaenicia from wound, oral, and aural myiasis can occur in the eye, often with devastating results Urinary and Intestinal Myiasis Cases of urinary and intestinal myiasis can be the most difficult cases to interpret and address More often than not, these cases are usually initiated with the patient bringing in larvae reportedly found in their feces or urine or that of a friend or family member.
In these cases, several factors should be considered to determine the validity of the infestation: identification of the larva and instar stage, dates of reported collection and presentation to the health care provider, condition of specimen, and clinical manifestations. Contamination of stools is relatively easy, and with some flies i.
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As such, it can appear that the larvae were already present in the stool. There are no known species of Diptera that can colonize the human intestinal tract 18 , and experimental evidence shows that most ingested larvae are readily killed during passage through the alimentary canal , Instead, most known cases of intestinal myiasis are thought to be the result of spurious passage of live larvae ingested in contaminated food or water 18 , Prolonged cases that have been known to last for months or years are probably due to repeated ingestion of food contaminated with fly eggs Likewise, many of the cases of suspected urinary myiasis most likely represent contamination of urine with nonparasitic species.
The most common larvae submitted are free-living species usually drain flies in the family Psychodidae and rat-tailed maggots in the family Syrphidae that breed in standing water, including toilets see Pseudoparasites, below. Still, there are reported cases of true urinary myiasis. These usually represent cases of incidental myiasis caused by the colonization of catheters, syringes used for douching, or other instruments that may be contaminated with bodily fluids desirable for saprophagous fly species 18 , The species most frequently involved in such cases are the house fly, Musca domestica , and the lesser house fly, Fannia canicularis.
Chrysomya bezziana has also been implicated in a case of urogenital myiasis in a patient with carcinoma of the cervix There are two primary species of bud bugs that infest humans, Cimex lectularius distributed worldwide and Cimex hemipterus distributed primarily in the tropics and subtropics 2. Occasionally, humans may also be fed upon by bird and bat cimicids, but this usually occurs only in the absence of the natural host i.
No species are effective vectors of disease-causing organisms in humans, although they have been found to be naturally infected with many blood-borne pathogens 2 , Inflammatory responses, however, can sometimes be severe, resulting from allergic reactions to the bugs' salivary proteins 2.
The heightened awareness in recent years due to a worldwide resurgence of infestations 3 necessitates that diagnostic technologists and microbiologists learn to recognize these bugs or be able to rule them out. Like the argasid ticks, bed bugs are intermittent feeders and do not reside on the host for prolonged lengths of time. Bed bugs are hemimetabolous; there are five nymphal stages between egg and adult, and a bed bug must take a blood meal between each molt 2 , Between feedings, they are usually hidden away under mattresses or under floor boards, etc.
Adult bed begs are 4. They are dorsoventrally flattened and have an explanate outwardly expanded and flattened pronotum. Adults are flightless and have only the remnants of wing buds. They possess well-developed eyes and antennae and have piercing-sucking mouthparts Fig. Nymphs Fig. The following key will aid in the identification of C. Mouthparts extending beyond the base of front legs Fig. Mouthparts not extending beyond the base of front legs Fig.
Fringe of setae along lateral margin of pronotum equal to, or longer than, width of the eye Fig. Fringe of setae along lateral margin of pronotum shorter than width of the eye Fig. Pronotum with anterior margin moderately excavated Fig. Pronotum with anterior margin deeply excavated Fig. Bed bugs. A Cimex lectularius. Key features of bed bugs and related cimicids. A Haematosiphon inodora venter. B Cimex sp. C Oeciacus vicarius antenna. D Cimex sp. E Bat bug Cimex sp. Very frequently, insects and other arthropods submitted to clinical diagnostic and reference laboratories represent incidental findings and are not of public health importance.
These specimens are usually anthropophilic species preferring to reside near or with humans rather than with other animals and are not parasitic in nature. Patients encounter them in their homes and may associate them with an ailment or condition. It would not be practical, or even possible, to discuss here all of the potential organisms that one may encounter. Instead, only the more commonly encountered groups seen in diagnostic laboratories are discussed here. These include earthworms, horsehair gordid worms, drain fly larvae, rat-tailed maggots, psocids commonly called booklice , and carpet beetle larvae.
Free-Living Fly Larvae Many species of Diptera are aquatic in the larval stage, and several breed in sewage and standing water including in sinks, drains, and toilets, both in a biofilm layer that may occur under the rim or within the water itself. Patients will often present larvae collected from their toilets and bath tubs with the concern that they were shed in their stool or urine.
These flies are usually saprophagous — , and there is no true evidence of them causing pathology in the human host. The most common fly larvae seen in these scenarios are drain flies Psychodidae and rat-tailed maggots Syrphidae. Unfortunately, after an identification is made, it is not uncommon for case reports to be published — , perpetuating the belief that these flies cause clinical disease in humans. Many of the free-living aquatic fly larvae can be readily separated from myiasis-causing calliphorids and oesterids by the presence of a distinct head capsule Fig.
Rat-tailed maggots are easily recognized by their very elongated respiratory siphons Fig. Whenever larvae are stated to have been collected from stool or urine, one must weigh all aspects of the case in addition to the identification before reporting.
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The larvae may also be forwarded to a professional entomologist or reference laboratory for further identification. A Rat-tailed maggot arrow, respiratory siphon. B Horsehair worm. C Psocid booklouse. D Psychodid fly larva red arrow, head capsule; black arrow, respiratory siphon. E Earthworms arrow, clitellum. F Dermestid carpet beetle larva.
Earthworms Earthworms are annelids segmented worms , which are occasionally submitted to laboratories for identification although more often for suspected nematode rather than arthropod identification.
Earthworms can be of public health concern but as intermediate or paratenic hosts for parasites following ingestion rather than as parasitic agents themselves. Earthworms are saprophytes and do not cause pathological manifestations in humans. Earthworms are easily recognized by being segmented and having setae on each body segment and the presence of a clitellum Fig.
Horsehair Worms Horsehair worms Nematomorpha are parasitic animals morphologically similar to nematodes. Adults are free living and aquatic, but larvae are parasitic on insects , Occasionally, adults may be found in tub basins and toilets and, like psychodid and syrphid fly larvae, may be mistaken for intestinal or urogenital parasites and submitted to diagnostic laboratories for confirmation. There are scattered reports in the literature of infection in humans , , but these are most certainly due to incidental findings and not true infection.
Horsehair worms are extremely long and slender Fig. The posterior ends of several genera are lobed Psocids Booklice While related to the parasitic lice , , booklice are saprophagous and not of public health concern.
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They are ubiquitous and occur in most homes. Booklice feed on a variety of organic materials, including molds, cereals, pollen, dead insects, and glue used in the bindings of books 19 , and may be nuisance pests indoors. They have been implicated as a source of household allergies , They are morphologically diverse, but most of the species seen in homes, and thus submitted to diagnostic laboratories, are dorsoventrally flattened and wingless and have enlarged heads, long antennae, and often enlarged hind femora Fig.
They may be confused with bed bug nymphs but have chewing mouthparts and more than five antennal segments Carpet Beetle Larvae The larvae of carpet beetles family Dermestidae are common cosmopolitan nuisance pests in households. They are scavengers on dried protein material, including dead insects, dry animal feeds, smoked fish and meat, feathers, silk, and fur, and may be pests in granaries While cases of contact dermatitis with carpet beetle larvae are documented , , they are not parasitic on the human host and do not feed on living tissues.https://es.oxicagosinun.tk
Members of the genus Dermestes can serve as intermediate hosts for the cestodes Hymenolepis diminuta and H. Dermestid larvae are usually readily recognized among household pests by having a defined head capsule, three pairs of functional legs, and long dense setae Fig. They are also usually found with their food source dried food, biological specimen collections, carpeting, and clothing. A variety of insects and other arthropods may be submitted to clinical and reference diagnostic laboratories for identification, and it is therefore important for bench microbiologists and medical technologists to recognize the more common groups of public health concern and to know how to report them.
Ultimately, it is the responsibility of the medical director to determine the extent of identification required to best serve the clinical needs of their patients. In any given case, if the morphological features are ambiguous, or the confidence level or expertise is insufficient, specimens should be forwarded to other organizations for diagnostic assistance, including public health agencies state public health entomologist , local extension services, or local universities or museums with active entomology programs and a reference collection. Blaine A.
Mathison , B. He received his B. His chief academic areas lie in diagnostic Parasitology and Medical Entomology but he also has an extensive background in Bacteriology and Mycology and serves as the Webmaster for the DPDx website. He also teaches diagnostic morphology workshops for Parasitology and Medical Entomology. Mathison has published several papers on many topics, including reports of uncommon and exotic parasites in the human host and various areas of Entomology.