title: Myiasis in Travelers.
abstract: BACKGROUND
  Cutaneous myiasis is a well-established diagnosis in returning travelers from tropical countries. The most common form of myiasis seen in this population is localized furuncular myiasis caused by Dermatobia hominis and Cordylobia anthropophaga. There are limited data on the disease course and outcome in travelers to tropical countries.
  
  
  METHODS
  A retrospective observational study of patients who presented with myiasis was conducted between 1999 and July 2014 in the post-travel clinics in Israel. Data regarding exposure history, travel duration, clinical presentation, treatment, and parasitological identification were collected and analyzed.
  
  
  RESULTS
  Among 6,867 ill returning Israeli travelers, 1,419 (21%) had a dermatologic complaint, 90 (6.3%) of them were diagnosed with myiasis. Myiasis was acquired in Latin America by 72 (80%) patients, mainly (54%) in the Madidi National Park, Amazonas Basin, Bolivia; 18 cases (20%) were acquired in Africa. In 76% of cases, manual extraction was sufficient to remove the larva; 24% required surgical intervention. Despite the fact that most patients did not receive antibiotic treatment, only one developed secondary infection, upon partial removal of the larva.
  
  
  CONCLUSIONS
  This is the largest myiasis case series in ill returning travelers. Myiasis is not a rare dermatologic complaint with most Israeli cases imported from Latin America and specifically the Madidi National Park in Bolivia. Treatment is based on full extraction of the larva after which no antibiotic treatment is needed. Myiasis is a preventable disease and travelers should be informed of the different preventive measures according to their travel destination.
authors.affiliation: Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Lachish
authors.affiliation: The Emergency Department, The Chaim Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Enbal
authors.initials: E
authors.lastname: Marhoom
authors.affiliation: Parasitology Unit, Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, The Hebrew University, Jerusalem, Israel.
authors.forename: Kosta Y
authors.initials: KY
authors.lastname: Mumcuoglu
authors.affiliation: Periodontology Department, Hadassah Medical Center, Jerusalem, Israel.
authors.forename: Moshik
authors.initials: M
authors.lastname: Tandlich
authors.affiliation: The Center for Geographic Medicine, The Chaim Sheba Medical Center, Tel HaShomer, Israel.|Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000209:etiology / Q000517:prevention & control*; D004175:Diptera / Q000145:classification / Q000502:physiology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007814:Larva; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009198:Myiasis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011315:Preventive Medicine / Q000379:methods; D012189:Retrospective Studies; D014195:Travel / Q000706:statistics & numerical data*; D057236:Travel Medicine / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents