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新生儿口腔蝇蛆病由红头丽蝇(双翅目:丽蝇科)幼虫引起:一例报告。

Neonatal oral myiasis caused by the larvae of Sarcophaga ruficornis (Diptera: Sarcophagidae): a case report.

机构信息

Key Laboratory of Tropical Disease Control (Sun Yat-Sen University), Ministry of Education, Guangzhou, China.

Shenzhen Children's Hospital, Shenzhen, China.

出版信息

BMC Infect Dis. 2021 Oct 15;21(1):1067. doi: 10.1186/s12879-021-06742-z.

Abstract

BACKGROUND

Myiasis is caused by dipterous larvae, and rarely affects the mouth. Diagnosis by traditional means is easy to be confused with other similar species. Here, we report a case of oral myiasis, in a 5-month-old infant who was diagnosed by morphological examination and molecular biological methods.

CASE PRESENTATION

A 5-month old infant with acute myeloid leukemia was admitted due to recurrent skin masses for more than 4 months. The infant had lip swelling, which prevented him from closing the mouth and membranes were present in his mouth and there were also oral ulcers and erosions. Ten maggots were found in the mouth and one in the ear canal with pus flowing out and were confirmed as the third stage larvae of Sarcophaga ruficornis by morphological examination and a comparison of sequence of cytochrome oxidase subunit 1 (COX1) gene. After removal of the maggots and chemotherapy, the infant 's condition was gradually improved.

CONCLUSIONS

To the best of our our knowledge, this is the first neonatal oral myiasis case reported in China and its diagnosis requires a high index of suspicion. Microscopy combined with specific DNA sequence analysis is an effective technological tool to provide rapid diagnoses of the larva specimen and cases of rare diseases, as illustrated in the current case.

摘要

背景

蝇蛆病由双翅目幼虫引起,很少影响口腔。传统诊断方法容易与其他类似物种混淆。本文报道了一例口腔蝇蛆病,患儿为 5 月龄、急性髓系白血病婴儿,经形态学检查和分子生物学方法诊断。

病例介绍

一名 5 月龄、急性髓系白血病婴儿因反复皮肤肿块超过 4 个月而入院。患儿出现口唇肿胀,导致无法闭合口腔,口腔内有膜状物,还有口腔溃疡和糜烂。口腔中发现 10 条蛆,耳内有 1 条蛆,伴有脓液流出,经形态学检查和细胞色素氧化酶亚基 1(COX1)基因序列比较,确认为红头丽蝇的 3 期幼虫。取出蛆虫并化疗后,患儿病情逐渐好转。

结论

据我们所知,这是中国首例新生儿口腔蝇蛆病病例,其诊断需要高度怀疑。显微镜检查结合特定的 DNA 序列分析是一种有效的技术工具,可对幼虫标本和罕见疾病进行快速诊断,本病例就是一个很好的例子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffe8/8518163/a5c4f459573d/12879_2021_6742_Fig1_HTML.jpg

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