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  Table of Contents    
LETTER TO EDITOR  
Year : 2013  |  Volume : 56  |  Issue : 3  |  Page : 334-335
Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation


1 Department of Microbiology, Bharati Vidyapeeth Medical College and Hospital, Sangli, Maharashtra, India
2 Department of Pathology, Bharati Vidyapeeth Medical College and Hospital, Sangli, Maharashtra, India

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Date of Web Publication24-Oct-2013
 

How to cite this article:
Udgaonkar US, Agashe SR, Shah SR, Patil SS. Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation . Indian J Pathol Microbiol 2013;56:334-5

How to cite this URL:
Udgaonkar US, Agashe SR, Shah SR, Patil SS. Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation . Indian J Pathol Microbiol [serial online] 2013 [cited 2020 Jun 4];56:334-5. Available from: http://www.ijpmonline.org/text.asp?2013/56/3/334/120425


Sir,

We read with interest the case report, "Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation" by Kumari et al. in your esteemed journal.[1] It indeed is an unusual presentation. Bloody diarrhea caused by different species, like Fannia canicularis and Sarcophaga peregrina had been described by earlier workers; [2],[3] but never presenting as fungating mass.

The case appears to be rectal myiasis, a term proposed by Zumpt. He described different species of larvae involved, namely Eristalis tenax and Sarcophaga haemorrhoidalis. He felt the condition is commonly seen in humans who live under filthy condition where the fly can deposit eggs or larvae around anus, the larvae then penetrate posterior part of anus. Eristalis tenax, the drone fly whose larva is called the rat tailed larva because of long tail like structure at the posterior end. [4] These larvae have adapted the tail for their need of oxygen as breathing organs by placing it near or outside anus.

We feel it would have been worthwhile to identify the larval species which caused such invasiveness. The larvae can also be reared to adult fly in meat and sand medium. [5] Both larvae and adult then be sent to expert entomologist for identification.

We are skeptical about the eggs in bowel wall, by arrows. [1] Eggs of fly can be lodged in mucosa for a period before developing into larvae. The microphotograph does not show mucosal lining epithelium. Probably the tissue seen is lamina propria. Since the eggs are incapable of penetration beyond mucosal epithelium, the arrow might be pointing to a retracting artifact.

There is no specific treatment for intestinal myiasis as mentioned by the authors; however a colonic wash with oral poly ethylene glycol 137.15 g dissolved in 2 L of water taken within 2 h might have helped the patient. It was found useful in our patients. [5] It is very important to counsel the patient against eating uncovered food accessible to flies. Defecation on roadside or open fields should be avoided as flies get attracted by the foul odor and lay eggs or larvae near anus and which hatch find and their way into rectum.

 
   References Top

1.Kumari M, Goel MM, Singh D. Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation. Indian J Pathol Microbiol 2012;55:384-5.  Back to cited text no. 1
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2.Karabiber H, Oguzkurt DG, Dogan DG, Aktas M, Selimoglu MA. An unusual cause of rectal bleeding: Intestinal myiasis. J Pediatr Gastroenterol Nutr 2010;51:530-1.  Back to cited text no. 2
    
3.Hasegawa S, Miwata H, Masuda S, Naruse H, Ozaki T. An infantile case of intestinal myiasis. Acta Paediatr Jpn 1992;34:87-9.  Back to cited text no. 3
    
4.Zumpt F. The problem of intestinal myiasis in humans. S Afr Med J 1963;37:305-7.  Back to cited text no. 4
    
5.Udgaonkar US, Dharamsi R, Kulkarni SA, Shah SR, Patil SS, Bhosale AL, et al. Intestinal myiasis. Indian J Med Microbiol 2012;30:332-7.  Back to cited text no. 5
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Correspondence Address:
Usha S Udgaonkar
'Karthi, 1770, Ganesh Nagar, Ambedkar Road, Sangli - 416 416, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.120425

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