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病例报告：哥斯达黎加 Cochliomyia hominivorax 的再现：消除 23 年后人类蝇蛆病病例报告。

Case Report: Re-Emergence of Cochliomyia hominivorax in Costa Rica: Report of a Human Myiasis Case 23 Years after Elimination.

机构信息

Laboratorio Clínico, Hospital Juana Pirola, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica.

Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica.

出版信息

Am J Trop Med Hyg. 2024 Sep 17;111(5):1020-1023. doi: 10.4269/ajtmh.24-0342. Print 2024 Nov 6.

DOI:10.4269/ajtmh.24-0342
PMID:39288760
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11542512/
Abstract

The New World screwworm, Cochliomyia hominivorax Coquerel (Diptera: Calliphoridae), was officially eliminated from Costa Rica in 2000, but it was reintroduced in 2023. A myiasis by C. hominivorax in a 71-year-old man with a 4-month history of foot hyperkeratosis and interdigital ulcers is reported. The myiasis was detected before sampling for bacterial culture. Approximately 160 first- and second-instar larvae were recovered and identified as C. hominivorax. Morphological identification was based mainly on characteristics of the cephalopharyngeal skeleton, spiracles, and pigmented dorsal tracheal trunks. Sequencing of a cytochrome c oxidase subunit I gene fragment confirmed the identity. The ulcers healed after extraction of the larvae and ciprofloxacin treatment of a concurrent Staphylococcus aureus and Pseudomonas aeruginosa infection. Given the reintroduction of C. hominivorax in Costa Rica and the risk of northward expansion, this report highlights its impact on public health and calls for awareness among clinicians and healthcare practitioners.

摘要

新世界螺旋蝇，又称 Cochliomyia hominivorax Coquerel（双翅目：Calliphoridae），于 2000 年在哥斯达黎加被正式消灭，但在 2023 年又再次传入。本文报告了一例由 Cochliomyia hominivorax 引起的 71 岁男性的蝇蛆病，该患者足部过度角化和趾间溃疡病史长达 4 个月。在进行细菌培养采样之前发现了蝇蛆病。共回收并鉴定出约 160 条一龄和二龄幼虫，鉴定为 Cochliomyia hominivorax。形态学鉴定主要基于头咽骨、气门和有色背气管干的特征。对细胞色素 c 氧化酶亚基 I 基因片段的测序结果证实了鉴定结果。在提取幼虫并对合并的金黄色葡萄球菌和铜绿假单胞菌感染进行环丙沙星治疗后，溃疡愈合。鉴于 Cochliomyia hominivorax 在哥斯达黎加的重新引入以及向北扩张的风险，本报告强调了其对公共卫生的影响，并呼吁临床医生和医疗保健从业者提高认识。