Wound myiasis in urban and suburban United States.
BACKGROUND
The epidemiologic characteristics of human myiasis in the United States remain undefined.


OBJECTIVE
To describe the most common clinical conditions associated with human myiasis and the causative maggot species.


METHODS
Multicenter, prospective observational study of urban and suburban patients who were infested with maggots.


RESULTS
Forty-two cases of US-acquired myiasis were collected from 20 participating centers. Most infestations occurred within preexisting wounds. No cases of tissue invasion were recorded. Host age averaged 60 years, with a male-female ratio of 5.5:1. Homelessness, alcoholism, and peripheral vascular disease were frequent cofactors. Two patients (5%) were hospitalized at the time of their infestation. The most common species was Phaenicia sericata (green blowfly; family: Calliphoridae). Other blowflies, flesh flies (Sarcophagidae), and humpbacked flies (Phoridae) also were identified. In 6 cases, 2 coinfesting species were identified.


CONCLUSIONS
Results of this prospective study of myiasis differ significantly from those of our analysis of previously published reports and suggest that most cases of human myiasis are caused by noninvasive blowflies laying eggs in preexisting wounds. Five percent of infestations were nosocomially acquired and not necessarily associated with patient neglect.
Sherman
R A
RA
MSc, DTM&H, Department of Medicine, Room D-440, Medical Sciences Bldg, University of California, Irvine, CA 92697-4800, USA. rsherman@uci.edu.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002487:Centers for Disease Control and Prevention, U.S.; D003428:Cross Infection / Q000453:epidemiology / Q000469:parasitology; D018563:Disease Notification; D005260:Female; D006801:Humans; D007814:Larva; D008297:Male; D008875:Middle Aged; D009198:Myiasis / Q000453:epidemiology* / Q000469:parasitology*; D019370:Observation; D011446:Prospective Studies; D012307:Risk Factors; D013383:Suburban Population / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data