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西方皮肤科医生的疖肿性蝇蛆病:门诊治疗。

Furuncular myiasis for the Western dermatologist: treatment in outpatient consultation.

机构信息

Dermatology Department, Hôpital Andrée Rosemon, Cayenne, French Guiana.

Emergency Department, Hôpital Gabriel Martin, Saint-Paul, Réunion.

出版信息

Int J Dermatol. 2018 Feb;57(2):227-230. doi: 10.1111/ijd.13815. Epub 2017 Oct 31.

Abstract

BACKGROUND

Furuncular myiasis is likely to be seen by Western dermatologists because of the increasing number of international travelers but remains unfamiliar to most of them, who tend to refer these patients to hospitals. Different treatments have been proposed, but many of them are not achievable in outpatient consultation.

METHODS

We reported three typical cases of furuncular myiasis, according to each species involved, and proposed diagnostic and therapeutic guidelines for dermatologists in outpatient consultation.

RESULTS

One patient, complaining of an inflammatory nodule of the leg with a central punctum, was diagnosed with Dermatobia hominis infection, after a forest walk in French Guiana. One woman returned from Senegal with a nodule of the left buttock. She had been infected by a Cordylobia anthropophaga larva after drying her underwear under a mango tree. One woman living in Cameroon presented with scalp nodules, pain, fatigue, and facial edema. She had been infected by more than 40 larvae of Cordylobia rodhaini after drying her sheets under a mango tree. Manual extraction ensured complete healing in the three patients. We used neither doppler ultrasound nor occlusive dressing. Diagnosis was immediately made thanks to the typical clinical stories.

CONCLUSIONS

The diagnosis of furuncular myiasis requires only clinical skills and basic knowledge of life cycles. The treatment varies slightly depending on the species involved but is achievable in outpatient consultation and does not require occlusive dressing.

摘要

背景

由于国际旅行者数量的增加,西方皮肤科医生可能会遇到疖肿性蝇蛆病,但大多数医生对此并不熟悉,他们往往会将这些患者转介到医院。已经提出了不同的治疗方法,但其中许多方法在门诊咨询中无法实现。

方法

我们根据涉及的物种报告了三例典型的疖肿性蝇蛆病病例,并为皮肤科医生在门诊咨询中提出了诊断和治疗指南。

结果

一名患者因腿部有中央脓疱的炎症性结节就诊,在法属圭亚那的森林漫步后被诊断为狄氏曼氏蚴感染。一名妇女从塞内加尔返回时,左臀部有一个结节。她在芒果树下晾晒内衣时被嗜人按蚊幼虫感染。一名居住在喀麦隆的妇女出现头皮结节、疼痛、疲劳和面部水肿。她在芒果树下晾晒床单时被超过 40 条罗德氏栉角蝇幼虫感染。手动提取确保了三名患者完全康复。我们既没有使用多普勒超声也没有使用闭塞敷料。由于典型的临床病史,诊断立即做出。

结论

疖肿性蝇蛆病的诊断仅需要临床技能和对生命周期的基本知识。治疗方法因涉及的物种略有不同,但可在门诊咨询中进行,且不需要闭塞敷料。

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