array:24 [
  "pii" => "S1578219014001206"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2014.04.014"
  "estado" => "S300"
  "fechaPublicacion" => "2014-06-01"
  "aid" => "886"
  "copyright" => "Elsevier España, S.L. and AEDV"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 0
  "subdocumento" => "cor"
  "cita" => "Actas Dermosifiliogr. 2014;105:522-4"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1990
    "formatos" => array:3 [
      "EPUB" => 37
      "HTML" => 1431
      "PDF" => 522
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731013002895"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2013.07.005"
      "estado" => "S300"
      "fechaPublicacion" => "2014-06-01"
      "aid" => "886"
      "copyright" => "Elsevier España, S.L. y AEDV"
      "documento" => "simple-article"
      "crossmark" => 0
      "subdocumento" => "cor"
      "cita" => "Actas Dermosifiliogr. 2014;105:522-4"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2213
        "formatos" => array:3 [
          "EPUB" => 2
          "HTML" => 1420
          "PDF" => 791
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Miasis cut&#225;nea no importada por <span class="elsevierStyleItalic">Chrysomya bezziana</span>"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "522"
            "paginaFinal" => "524"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Autochthonous Cutaneous Myiasis Due to <span class="elsevierStyleItalic">Chrysomya bezziana</span>"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1111
                "Ancho" => 1667
                "Tamanyo" => 386356
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#218;lcera en regi&#243;n gemelar izquierda de superficie eritematosa&#44; de aspecto mamelonado y con exudaci&#243;n abundante&#46; Obs&#233;rvese en la superficie de la lesi&#243;n la presencia de varias larvas&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Aguado Lobo, A&#46; Hern&#225;ndez-N&#250;&#241;ez, M&#46; Isabel Garc&#237;a-Arata, J&#46; Borbujo"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Aguado Lobo"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Hern&#225;ndez-N&#250;&#241;ez"
              ]
              2 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Isabel Garc&#237;a-Arata"
              ]
              3 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Borbujo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219014001206"
          "doi" => "10.1016/j.adengl.2014.04.014"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014001206?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731013002895?idApp=UINPBA000044"
      "url" => "/00017310/0000010500000005/v1_201405270041/S0001731013002895/v1_201405270041/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S157821901400119X"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.04.013"
    "estado" => "S300"
    "fechaPublicacion" => "2014-06-01"
    "aid" => "885"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2014;105:524-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2107
      "formatos" => array:3 [
        "EPUB" => 43
        "HTML" => 1534
        "PDF" => 530
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
      "titulo" => "Type 2 Mosaicism in Familial Glomangiomatosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "524"
          "paginaFinal" => "525"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Mosaicismo tipo 2 en glomangiomatosis familiar"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 661
              "Ancho" => 997
              "Tamanyo" => 102326
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Segmentally distributed bluish plaque extending from the right groin along the medial aspect of the right thigh and leg to the right foot&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; de la Fuente, A&#46; Hern&#225;ndez-Mart&#237;n, R&#46; Happle, A&#46; Torrelo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "de la Fuente"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Hern&#225;ndez-Mart&#237;n"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Happle"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Torrelo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731013002883"
        "doi" => "10.1016/j.ad.2013.08.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731013002883?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901400119X?idApp=UINPBA000044"
    "url" => "/15782190/0000010500000005/v1_201405281018/S157821901400119X/v1_201405281018/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219014001140"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.04.008"
    "estado" => "S300"
    "fechaPublicacion" => "2014-06-01"
    "aid" => "887"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2014;105:520-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2152
      "formatos" => array:3 [
        "EPUB" => 43
        "HTML" => 1674
        "PDF" => 435
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
      "titulo" => "Unresectable Angiosarcoma Treated With Bevacizumab and Paclitaxel"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "520"
          "paginaFinal" => "522"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Angiosarcoma irresecable tratado con bevacizumab y paclitaxel"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 928
              "Ancho" => 901
              "Tamanyo" => 128939
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Erythematous violaceous tumor with a 4-cm diameter and peripheral macular lesions&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46;V&#46; Nespereira-Jato, C&#46; Pe&#241;a-Panabad, M&#46; Quind&#243;s-Varela, J&#46; Garc&#237;a-Silva"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "M&#46;V&#46;"
              "apellidos" => "Nespereira-Jato"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Pe&#241;a-Panabad"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Quind&#243;s-Varela"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Garc&#237;a-Silva"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731013003153"
        "doi" => "10.1016/j.ad.2013.08.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731013003153?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014001140?idApp=UINPBA000044"
    "url" => "/15782190/0000010500000005/v1_201405281018/S1578219014001140/v1_201405281018/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Autochthonous Cutaneous Myiasis Due to <span class="elsevierStyleItalic">Chrysomya bezziana</span>"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "522"
        "paginaFinal" => "524"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Aguado Lobo, A&#46; Hern&#225;ndez-N&#250;&#241;ez, M&#46; Isabel Garc&#237;a-Arata, J&#46; Borbujo"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Aguado Lobo"
            "email" => array:1 [
              0 => "martaaguadolobo&#64;yahoo&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Hern&#225;ndez-N&#250;&#241;ez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Isabel Garc&#237;a-Arata"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Borbujo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a Hospital Universitario de Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Microbiolog&#237;a&#44; Hospital Universitario de Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Miasis cut&#225;nea no importada por <span class="elsevierStyleItalic">Chrysomya bezziana</span>"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 667
            "Ancho" => 1002
            "Tamanyo" => 190006
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer on the left calf&#46; Note the erythematous surface&#44; which is papilliform in appearance&#44; and abundant exudate&#46; Several larvae can be seen on the surface of the lesion&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Myiasis is a parasitic infestation of the tissues or organs of vertebrates &#40;including humans&#41; produced by the larvae of different species of fly &#40;Diptera&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> It is classified according to the association between the parasite and the host and is described as obligatory&#44; facultative&#44; or accidental&#46; It can also be classified according to the anatomic site of infestation as cutaneous&#44; intestinal&#44; or cavitary myiasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> Clinically&#44; cutaneous myiasis is divided into furuncular&#44; migratory&#44; and wound forms&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> Incidence is higher in tropical countries with a humid climate and a low socioeconomic level&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a case of autochthonous cutaneous myiasis caused by <span class="elsevierStyleItalic">Chrysomya bezziana</span>&#44; a species that is exceptional in Europe&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was a 56-year-old man with a personal history of obesity&#44; occasional alcohol consumption&#44; arterial hypertension&#44; sleep apnea-hypopnea syndrome&#44; and extrinsic asthma&#46; He was a heterozygous carrier of the PT20210A mutation&#44; although he had no history of thrombosis&#46; He had a vascular ulcer on the left leg that first appeared 10 months previously&#46; Live larvae were detected during local care of the ulcer at his health center&#44; from where he was referred to the emergency department&#46; The patient had a good general status and denied having traveled abroad&#44; recent contact with animals&#44; or trips to the countryside&#46; Physical examination revealed signs of chronic lymphedema in both legs&#46; An ulcer was observed on his left calf&#46; It measured 15<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>cm&#44; had an erythematous surface&#44; and was papilliform in appearance&#46; It was also friable&#44; with malodorous exudate &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Several mobile Diptera larvae were identified on the lesion&#46; These were whitish in color and in 1<span class="elsevierStyleHsp" style=""></span>cm in length&#46; They were eliminated mechanically and sent to the microbiology service for identification&#46; The lesion was washed with saline solution and treated with an occlusive dressing of unscented pure petroleum jelly&#44; and the patient was referred to the vascular surgery service&#46; Macroscopically&#44; the larvae extracted were identified as <span class="elsevierStyleItalic">C bezziana</span>&#59; microscopically&#44; subtle spine bands were visible around the body and the peritreme of the open posterior spiracle&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In developed countries&#44; cutaneous wound myiasis is associated with poor hygiene&#44; advanced age&#44; psychiatric conditions&#44; alcoholism&#44; diabetes mellitus&#44; and occlusive vascular disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The 3 species that produce this form of myiasis throughout the world are <span class="elsevierStyleItalic">Cochliomyia hominivorax</span> &#40;New World screw-worm&#41;&#44; and <span class="elsevierStyleItalic">C bezziana</span> &#40;Old World screw-worm&#41;&#8212;both from the Calliphoridae family&#8212;and <span class="elsevierStyleItalic">Wohlfahrtia magnifica</span>&#44; which belongs to the Sarcophagidae family&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> Most cases of autochthonous myiasis reported in Spain involve various species of the Sarcophagidae family &#40;flesh fly&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The parasite <span class="elsevierStyleItalic">C bezziana</span> is distributed in tropical and subtropical areas of Africa&#44; southeast Asia&#44; India&#44; and the Middle East&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a> It produces an obligatory form of myiasis that affects various domestic animals &#40;cattle&#44; horses&#44; and pets&#41; and&#44; occasionally&#44; humans&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a> An adult female can deposit hundreds of eggs on the margin of wounds&#46; The eggs hatch in 16<span class="elsevierStyleHsp" style=""></span>hours&#44; and the resultant numerous larvae feed for a week on the host&#39;s tissue&#46; They then fall to the ground and complete their biological cycle to become adults&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a> Under optimal conditions&#44; the biological cycle lasts approximately 20 days&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a> In humans&#44; <span class="elsevierStyleItalic">C bezziana</span> produces wound infestations&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> skin tumors<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#44; and cavities &#40;orbit&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> mouth&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and ear<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#41;&#44; all of which have high morbidity&#46; In severe cases&#44; the patient can present with fever&#44; a sensation of poor temperature regulation&#44; pain&#44; bacterial superinfection&#44; leukocytosis with neutrophilia&#44; or hypereosinophilia&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In a review from the year 2000&#44; the 47 species of Diptera responsible for myiasis in Spain did not include <span class="elsevierStyleItalic">C bezziana</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In the Spanish scientific literature&#44; we found only 3 cases of human myiasis caused by this species&#58; the first involved a 41-year-old Spanish man with a personal history of chronic alcoholism who developed cutaneous myiasis on chronic ulcers on the left leg that were secondary to rhabdomyolysis<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#59; the second involved a 65-year-old Spanish woman with myiasis of the ear who reported no recent trips abroad<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#59; and the third involved a 54-year-old Spanish man with myiasis on a supraglottic squamous cell carcinoma of the larynx that manifested as a tumor mass on the anterior aspect of the neck&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> International migration and climate change can explain&#44; at least in part&#44; why this species of fly is identified in countries that are not its natural habitat&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; we present a case of cutaneous myiasis on an ulcer in which <span class="elsevierStyleItalic">C bezziana</span> was identified as the causal agent&#46; To our knowledge&#44; this is the second case of autochthonous cutaneous myiasis caused by this species of fly&#46; We wish to draw attention to this uncommon entity and to the importance of correct conservation and identification of larvae as part of routine clinical practice&#44; since this condition is probably under-reported&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Aguado Lobo M&#44; Hern&#225;ndez-N&#250;&#241;ez A&#44; Isabel Garc&#237;a-Arata M&#44; Borbujo J&#46; Miasis cut&#225;nea no importada por <span class="elsevierStyleItalic">Chrysomya bezziana</span>&#46; Actas Dermosifiliogr&#46; 2014&#59;105&#58;529&#8211;530&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 667
            "Ancho" => 1002
            "Tamanyo" => 190006
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer on the left calf&#46; Note the erythematous surface&#44; which is papilliform in appearance&#44; and abundant exudate&#46; Several larvae can be seen on the surface of the lesion&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Myiasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46; Francesconi"
                            1 => "O&#46; Lupi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/CMR.00010-11"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Rev"
                        "fecha" => "2012"
                        "volumen" => "25"
                        "paginaInicial" => "79"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22232372"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous myiasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;A&#46; McGraw"
                            1 => "G&#46;W&#46; Turiansky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2008.03.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2008"
                        "volumen" => "58"
                        "paginaInicial" => "907"
                        "paginaFinal" => "926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18485982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous myiasis&#58; A review of the common types of myiasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Robbins"
                            1 => "A&#46; Khachemoune"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2010.04577.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2010"
                        "volumen" => "49"
                        "paginaInicial" => "1092"
                        "paginaFinal" => "1098"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20883399"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Miasis cut&#225;nea aut&#243;ctona por Chrysomya bezziana"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Fern&#225;ndez-Ru&#237;z"
                            1 => "E&#46; Salto"
                            2 => "R&#46; Cuesta"
                            3 => "F&#46; L&#243;pez-Medrano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2010.10.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2011"
                        "volumen" => "211"
                        "paginaInicial" => "218"
                        "paginaFinal" => "219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21419405"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Miasis cut&#225;neas sobre lesiones tumorales&#58; presentaci&#243;n de tres casos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Rubio"
                            1 => "C&#46; Ladr&#243;n de Guevara"
                            2 => "M&#46;A&#46; Mart&#237;n"
                            3 => "L&#46; Campos"
                            4 => "A&#46; Quesada"
                            5 => "M&#46; Casado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "39"
                        "paginaFinal" => "42"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16540050"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Orbital myiasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Khataminia"
                            1 => "R&#46; Aghajanzadeh"
                            2 => "B&#46; Vazirianzadeh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Ophthalmic Vis Res"
                        "fecha" => "2011"
                        "volumen" => "6"
                        "paginaInicial" => "199"
                        "paginaFinal" => "203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22454736"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chrysomya bezziana oral myiasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;G&#46;S&#46; Vijay Kumar"
                            1 => "G&#46;S&#46; Sowmya"
                            2 => "S&#46; Shivananda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Global Infect Dis"
                        "fecha" => "2011"
                        "volumen" => "3"
                        "paginaInicial" => "393"
                        "paginaFinal" => "395"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Miasis &#243;tica&#46; A prop&#243;sito de un caso"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46; Gonz&#225;lez Poggioli"
                            1 => "J&#46;C&#46; V&#225;zquez Barro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Otorrinolaringol Esp"
                        "fecha" => "2009"
                        "volumen" => "60"
                        "paginaInicial" => "213"
                        "paginaFinal" => "214"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19558911"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio de las miasis en Espa&#241;a en los &#250;ltimos cien a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;D&#46; Soler Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ars Pharmaceutica"
                        "fecha" => "2000"
                        "volumen" => "41"
                        "paginaInicial" => "19"
                        "paginaFinal" => "26"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous myiasis caused by <span class="elsevierStyleItalic">Chrysomya bezziana</span> larvae&#44; Mexico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Romero-Cabello"
                            1 => "L&#46; Calder&#243;n-Romero"
                            2 => "J&#46;T&#46; S&#225;nchez-Vega"
                            3 => "J&#46; Tay"
                            4 => "R&#46; Romero-Feregrino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3201/eid1612.100938"
                      "Revista" => array:6 [
                        "tituloSerie" => "Emerg Infect Dis"
                        "fecha" => "2010"
                        "volumen" => "16"
                        "paginaInicial" => "2014"
                        "paginaFinal" => "2015"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21122252"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010500000005/v1_201405281018/S1578219014001206/v1_201405281018/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6157"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case and Research Letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010500000005/v1_201405281018/S1578219014001206/v1_201405281018/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014001206?idApp=UINPBA000044"
]
Compartir
Información de la revista
Vol. 105. Núm. 5.
Páginas 522-524 (junio 2014)
Vol. 105. Núm. 5.
Páginas 522-524 (junio 2014)
Case and Research Letters
Acceso a texto completo
Autochthonous Cutaneous Myiasis Due to Chrysomya bezziana
Miasis cutánea no importada por Chrysomya bezziana
Visitas
6705
M. Aguado Loboa,
Autor para correspondencia
martaaguadolobo@yahoo.es

Corresponding author.
, A. Hernández-Núñeza, M. Isabel García-Aratab, J. Borbujoa
a Servicio de Dermatología Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
b Servicio de Microbiología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
Este artículo ha recibido
Información del artículo
Texto completo
Bibliografía
Descargar PDF
Estadísticas
Figuras (1)
Texto completo

Myiasis is a parasitic infestation of the tissues or organs of vertebrates (including humans) produced by the larvae of different species of fly (Diptera).1–3 It is classified according to the association between the parasite and the host and is described as obligatory, facultative, or accidental. It can also be classified according to the anatomic site of infestation as cutaneous, intestinal, or cavitary myiasis.1–3 Clinically, cutaneous myiasis is divided into furuncular, migratory, and wound forms.1–3 Incidence is higher in tropical countries with a humid climate and a low socioeconomic level.1–3

We present a case of autochthonous cutaneous myiasis caused by Chrysomya bezziana, a species that is exceptional in Europe.

The patient was a 56-year-old man with a personal history of obesity, occasional alcohol consumption, arterial hypertension, sleep apnea-hypopnea syndrome, and extrinsic asthma. He was a heterozygous carrier of the PT20210A mutation, although he had no history of thrombosis. He had a vascular ulcer on the left leg that first appeared 10 months previously. Live larvae were detected during local care of the ulcer at his health center, from where he was referred to the emergency department. The patient had a good general status and denied having traveled abroad, recent contact with animals, or trips to the countryside. Physical examination revealed signs of chronic lymphedema in both legs. An ulcer was observed on his left calf. It measured 15×8cm, had an erythematous surface, and was papilliform in appearance. It was also friable, with malodorous exudate (Fig. 1). Several mobile Diptera larvae were identified on the lesion. These were whitish in color and in 1cm in length. They were eliminated mechanically and sent to the microbiology service for identification. The lesion was washed with saline solution and treated with an occlusive dressing of unscented pure petroleum jelly, and the patient was referred to the vascular surgery service. Macroscopically, the larvae extracted were identified as C bezziana; microscopically, subtle spine bands were visible around the body and the peritreme of the open posterior spiracle.

Figure 1.

Ulcer on the left calf. Note the erythematous surface, which is papilliform in appearance, and abundant exudate. Several larvae can be seen on the surface of the lesion.

(0.18MB).

In developed countries, cutaneous wound myiasis is associated with poor hygiene, advanced age, psychiatric conditions, alcoholism, diabetes mellitus, and occlusive vascular disease.1–3

The 3 species that produce this form of myiasis throughout the world are Cochliomyia hominivorax (New World screw-worm), and C bezziana (Old World screw-worm)—both from the Calliphoridae family—and Wohlfahrtia magnifica, which belongs to the Sarcophagidae family.1–3 Most cases of autochthonous myiasis reported in Spain involve various species of the Sarcophagidae family (flesh fly).4

The parasite C bezziana is distributed in tropical and subtropical areas of Africa, southeast Asia, India, and the Middle East.1–4 It produces an obligatory form of myiasis that affects various domestic animals (cattle, horses, and pets) and, occasionally, humans.1,4 An adult female can deposit hundreds of eggs on the margin of wounds. The eggs hatch in 16hours, and the resultant numerous larvae feed for a week on the host's tissue. They then fall to the ground and complete their biological cycle to become adults.1,4 Under optimal conditions, the biological cycle lasts approximately 20 days.1,4 In humans, C bezziana produces wound infestations,4 skin tumors5, and cavities (orbit,6 mouth,7 and ear8), all of which have high morbidity. In severe cases, the patient can present with fever, a sensation of poor temperature regulation, pain, bacterial superinfection, leukocytosis with neutrophilia, or hypereosinophilia.2

In a review from the year 2000, the 47 species of Diptera responsible for myiasis in Spain did not include C bezziana.9 In the Spanish scientific literature, we found only 3 cases of human myiasis caused by this species: the first involved a 41-year-old Spanish man with a personal history of chronic alcoholism who developed cutaneous myiasis on chronic ulcers on the left leg that were secondary to rhabdomyolysis4; the second involved a 65-year-old Spanish woman with myiasis of the ear who reported no recent trips abroad8; and the third involved a 54-year-old Spanish man with myiasis on a supraglottic squamous cell carcinoma of the larynx that manifested as a tumor mass on the anterior aspect of the neck.6 International migration and climate change can explain, at least in part, why this species of fly is identified in countries that are not its natural habitat.10

In conclusion, we present a case of cutaneous myiasis on an ulcer in which C bezziana was identified as the causal agent. To our knowledge, this is the second case of autochthonous cutaneous myiasis caused by this species of fly. We wish to draw attention to this uncommon entity and to the importance of correct conservation and identification of larvae as part of routine clinical practice, since this condition is probably under-reported.

References
[1]
F. Francesconi, O. Lupi.
Myiasis.
Clin Microbiol Rev, 25 (2012), pp. 79-105
[2]
T.A. McGraw, G.W. Turiansky.
Cutaneous myiasis.
J Am Acad Dermatol, 58 (2008), pp. 907-926
[3]
K. Robbins, A. Khachemoune.
Cutaneous myiasis: A review of the common types of myiasis.
Int J Dermatol, 49 (2010), pp. 1092-1098
[4]
M. Fernández-Ruíz, E. Salto, R. Cuesta, F. López-Medrano.
Miasis cutánea autóctona por Chrysomya bezziana.
Rev Clin Esp, 211 (2011), pp. 218-219
[5]
C. Rubio, C. Ladrón de Guevara, M.A. Martín, L. Campos, A. Quesada, M. Casado.
Miasis cutáneas sobre lesiones tumorales: presentación de tres casos.
Actas Dermosifiliogr, 97 (2006), pp. 39-42
[6]
G. Khataminia, R. Aghajanzadeh, B. Vazirianzadeh.
Orbital myiasis.
J Ophthalmic Vis Res, 6 (2011), pp. 199-203
[7]
V.G.S. Vijay Kumar, G.S. Sowmya, S. Shivananda.
Chrysomya bezziana oral myiasis.
J Global Infect Dis, 3 (2011), pp. 393-395
[8]
N. González Poggioli, J.C. Vázquez Barro.
Miasis ótica. A propósito de un caso.
Acta Otorrinolaringol Esp, 60 (2009), pp. 213-214
[9]
M.D. Soler Cruz.
Estudio de las miasis en España en los últimos cien años.
Ars Pharmaceutica, 41 (2000), pp. 19-26
[10]
R. Romero-Cabello, L. Calderón-Romero, J.T. Sánchez-Vega, J. Tay, R. Romero-Feregrino.
Cutaneous myiasis caused by Chrysomya bezziana larvae, Mexico.
Emerg Infect Dis, 16 (2010), pp. 2014-2015

Please cite this article as: Aguado Lobo M, Hernández-Núñez A, Isabel García-Arata M, Borbujo J. Miasis cutánea no importada por Chrysomya bezziana. Actas Dermosifiliogr. 2014;105:529–530.

Copyright © 2013. Elsevier España, S.L. and AEDV
Descargar PDF
Idiomas
Actas Dermo-Sifiliográficas
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?