Dermatobiasis (or South American miase) is an obligate mias, the development of which is provoked by the larva of the Dermatobia hominis. A characteristic feature of the disease is the appearance in the skin of the purulent node around the larva growing under the skin.
Causes of the dermatobiasis
The development of the South American miase is provoked by the ingress of the larvae of the human gadfly onto the skin. The female attaches its eggs to the bodies of various insects (such as mosquitoes, mites, horseflies), and when they sit on a man, these larvae detach from the carrier and fall under the skin. Dermatobiasis is most common in countries with tropical climates.
With dermatobiasis on the skin, inflammation is observed in the form of a tumor-like formation, as well as subcutaneous abscesses that have fistulous holes on the surface. The disease manifests itself in the form of a subcutaneous node resembling a carbuncle, measuring 2-3 cm in diameter.
Symptoms of the dermatobiasis
In the place where the larva penetrated under the skin, there is an abscess, which later opens, forming a hole in the skin, through which the air will enter the larva. After opening, a purulent-serous fluid is released from the abscess.
This larva ripens for 2.5 months, growing in the process to 2.5 cm in length. Pupation usually occurs outside the human body. In the process of "gestation" a person feels a slight pain in the location of the larva.
Complications and consequences
Complication of the disease can be the development of secondary infection. In the case of development of purulent complications, systemic antibiotics or antimicrobial ointments are used for treatment.
Diagnostics of the dermatobiasis
Diagnosis of dermatobiasis is carried out by studying the epidemiological anamnesis of the patient. In addition, it also turns out whether he was recently in places where the disease is common. Dermatobiasis is diagnosed on the basis of clinical picture - after detection in the skin of a purulent abscess, which has a hole. The lesion is carefully examined through a magnifying glass using side lighting. This makes it possible to detect the movement of larvae in the wound, which are placed in the form of colonies.
Differential diagnosis of the disease is carried out with furunculosis.
Dermatobiasis is treated by removing the larvae from the skin. For this, the lesion is first washed with disinfecting solutions (this may be furatsilin, potassium permanganate, etc.).
To make the larva easier to remove, a few drops of some sterile oil should be dripped into the hole - this will block the air to the parasite, which will force it to surface. In this case, it will be easily captured with a clamp or tweezers and pulled out. The cavity, freed from the larva, is treated with disinfectants and covered with an aseptic dressing.
Modern medicine recommends, before the procedure for removing the larvae, to perform treatment using the antiparasitic agent ivermectin. This is especially necessary if the patient has concomitant HIV infection.
Ivermectin should be consumed before meals, drinking plenty of medicine with water. Enough two-time intake of 1-2 doses of the drug with a 1-2-week interval between use. Upon completion of the treatment course, you must undergo a mandatory follow-up examination. Among the side effects of the drug: dizziness and drowsiness, worsening concentration, severe brain disorders, fainting, and general deterioration in health. Among the contra-indications of the drug is the period of pregnancy planning, bearing of the child, and also lactation; therapy with the use of medicinal herbs, medicines or dietary supplements; allergic reactions, weak immunity or the presence of asthma; when visiting regions with a high risk of infection with non-helminthic diseases.
In the case of dermatobiasis, alternative treatment can be used. For example, there is a recipe with birch tar and sulfur. It is necessary to take 4 boxes. Tar and mix them with sulfur (6 g) and petroleum jelly (3 lodges). The resulting ointment to smear the lesion on the skin.
Preventive maintenance of disease consists in observance of sanitary-and-hygienic norms. Being in tropical countries, you need to treat on time the ulcers arising on the body, purulent wounds and abscesses, regularly change dressings and sanitize injuries with the help of antiseptic solutions. It should also be borne in mind that the vectors of infectious diseases are actively attracted by the smell of pus. During your stay in South or Central America, you should use repellents, and wear clothes that help prevent bites of ticks or mosquitoes.
Dermatobiasis, provided that the necessary treatment is started on time, is eliminated quickly and without life-threatening consequences.
Last update: 26.06.2018
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Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"