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一名青少年肠道和泌尿道的毛蠓科幼虫假蝇蛆病:事实、谬误还是无害旁观者?

Intestinal and Urinary Pseudomyiasis by Psychodinae Larvae in an Adolescent: A Fact, Fallacy, or Harmless Spectator?

作者信息

Resende Maria M, Caniço Joana, Flores Maria M

机构信息

Department of Pediatrics, Unidade Local de Saúde da Região de Aveiro, Hospital Infante D. Pedro, Aveiro, PRT.

Department of Clinical Pathology, Unidade Local de Saúde da Região de Aveiro, Hospital Infante D. Pedro, Aveiro, PRT.

出版信息

Cureus. 2025 Jan 15;17(1):e77482. doi: 10.7759/cureus.77482. eCollection 2025 Jan.

DOI:10.7759/cureus.77482
PMID:39958136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11827872/
Abstract

Myiasis is caused by fly larvae and can be classified into obligatory, facultative, and accidental (or pseudomyiasis) forms. , a species of fly, commonly found in areas such as kitchens, toilets, and drains, has been linked to urogenital and intestinal myiasis. However, recent evidence questions its role as a true causative agent of myiasis. We report a 17-year-old female who experienced intermittent larval elimination in her stool and urine, accompanied by gastrointestinal symptoms. larvae, likely spp., were identified in both stool and urine samples collected from her home. No other relevant findings were found during the investigation. After explaining the fly's life cycle to the adolescent and her parents, they recognized the presence of a similar fly near the toilet. This led to a renovation of the sanitation facilities and isolation of the drainage system, after which larval elimination ceased with no recurrence. The breathing requirements of larvae suggest that it is unlikely they could survive, let alone develop, in the gastrointestinal or urinary tracts. Additionally, their presence has not been documented in these areas, and the suspected causative agent was not directly observed in the patient. In this case, as with similar reports, definitive conclusions are difficult to reach regarding whether these instances represent pseudomyiasis or are merely incidental findings in the environment. However, the evidence tends to favor the latter hypothesis and rules out the possibility of true myiasis. This report highlights the importance of accurately identifying the implicated species and eliminating the source of infestation to prevent recurrence.

摘要

蝇蛆病由蝇幼虫引起,可分为 obligatory、兼性和偶然(或假蝇蛆病)形式。一种常见于厨房、厕所和下水道等区域的蝇类与泌尿生殖系统和肠道蝇蛆病有关。然而,最近的证据对其作为蝇蛆病真正病原体的作用提出了质疑。我们报告一名17岁女性,她的粪便和尿液中出现间歇性幼虫排出,并伴有胃肠道症状。从她家中采集的粪便和尿液样本中均发现了可能是该蝇类物种的幼虫。调查期间未发现其他相关发现。在向这名青少年及其父母解释了这种蝇的生命周期后,他们认出厕所附近有类似的蝇。这导致了卫生设施的翻新和排水系统的隔离,此后幼虫排出停止,未再复发。该蝇幼虫的呼吸需求表明它们不太可能在胃肠道或泌尿道中存活,更不用说发育了。此外,这些区域尚未记录到它们的存在,并且在患者身上也未直接观察到疑似病原体。在这种情况下,与类似报告一样,很难就这些病例是代表假蝇蛆病还是仅仅是环境中的偶然发现得出明确结论。然而,证据倾向于支持后一种假设,并排除了真正蝇蛆病的可能性。本报告强调了准确识别相关物种并消除感染源以防止复发的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daea/11827872/15bf770a8270/cureus-0017-00000077482-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daea/11827872/15bf770a8270/cureus-0017-00000077482-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/daea/11827872/15bf770a8270/cureus-0017-00000077482-i01.jpg

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本文引用的文献

1
Psychodid flies and their implicated role in human myiasis and pseudomyiasis.双翅目蝇类及其在人体蝇蛆病和假性蝇蛆病中的作用。
J Clin Microbiol. 2024 Mar 13;62(3):e0120023. doi: 10.1128/jcm.01200-23. Epub 2024 Feb 16.
2
Investigation of pseudo-urogenital myiasis and errors in diagnosis.假性泌尿生殖道蝇蛆病及误诊原因调查。
Trop Doct. 2024 Apr;54(2):123-125. doi: 10.1177/00494755231219529. Epub 2023 Dec 12.
3
(Nematocera; Psychodidae) as the Etiologic Agent of Myiasis: True or False?(长角亚目;蛾蠓科)作为蝇蛆病的病原体:是真是假?
Diagnostics (Basel). 2022 Sep 1;12(9):2129. doi: 10.3390/diagnostics12092129.
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Myiasis.蛆病。
Clin Microbiol Rev. 2012 Jan;25(1):79-105. doi: 10.1128/CMR.00010-11.