Urogenital Myiasis Caused by Larvae (Diptera: Psychodidae) in Ahvaz, South Western Iran: A Case Report.

Urogenital myiasis is a rare parasitic infestation caused by larvae of the Psychoda albipennis species. The presence of larvae in the urogenital tract, along with their feeding and activity patterns, can lead to disorders of the urinary and reproductive systems. This study presents a 36-year-old male patient with the chief complaint of dysuria, hematuria, urethral discharge, and abdominal flank pain. Over an eight-month period, the subject observed the presence of mobile particles in his urine, which were described as black-grayish in color. The patient was subsequently referred to the urology outpatient clinic, where he received treatment for cystitis and/or urethritis. However, despite these treatments, the patient's symptoms remained unresolved, and the presence of larvae in his urine was observed. Following microscopic examination of the urine, the presence of viable, motile, and hairy larvae (measuring approximately 1 cm in length) was confirmed. Based on morphological characteristics, these were identified as fourth-stage larvae of the moth fly, Psychoda albipennis. In Iran, human urogenital myiasis caused by Psychoda albipennis is an infrequent infection. It appears that the primary risk factors for urogenital myiasis in this recent case were urinating in unsanitary environments, sleeping without a blanket while traveling to the Dez River in Khuzestan province, and urinating in unsanitary toilets. The administration of appropriate antiseptic medication and the consumption of sufficient quantities of water resulted in a notable reduction in patient-reported symptoms following the two-week treatment period. Urogenital myiasis is an uncommon occurrence, comprising only 0.7% of all cases of human myiasis, as reported in a few publications from Iran and elsewhere. This is the inaugural account of urogenital myiasis caused by P. albipennis in the Khuzestan province of southwestern Iran.