The first documented pediatric cutaneous pseudomyiasis case associated with a psychodid larva in Italy is reported, consistent with an incidental recovery of a psychodid larva and support an interpretation of pseudomyiasis rather than true myiasis.
Abstract
Psychodid flies are non-parasitic insects commonly found in humid domestic environments, where larvae develop in organic matter within drains. Human pseudomyiasis caused by these flies is a rare and often neglected condition, typically involving urogenital or intestinal tracts. Most cases are reported in Southeast Asia and the Middle East, while occurrences in Europe and Africa remain uncommon. This study reports the first documented pediatric cutaneous pseudomyiasis case associated with a psychodid larva in Italy. A 4-year-old girl presented with a small (0.5 cm) subcutaneous swelling on the right arm, showing dark discoloration and a protruding structure. No pruritus or systemic symptoms were observed. A partially removed larval specimen was analyzed using morphological and molecular approaches. Morphological analysis confirmed that the specimen was a dipteran larva; however, its degraded condition precluded reliable determination of the larval instar. Molecular characterization targeting the mitochondrial cytochrome c oxidase subunit I (COI) gene assigned the specimen to the genus Psychoda (family Psychodidae). These findings are consistent with an incidental recovery of a psychodid larva and support an interpretation of pseudomyiasis rather than true myiasis. This case highlights the role of interdisciplinary collaboration between pediatricians and entomologists and a One Health approach in diagnosing unusual parasitological conditions.
Human cutaneous myiasis caused by Hypoderma sinense is rarely reported and may be mistaken for common bacterial skin disease. A 3-year-old boy from a livestock-raising pastoral region of China presented with multiple painful subcutaneous nodules that had not responded to topical antibacterial treatment. Marked eosinophilia, elevated total IgE, and linear ultrasonographic structures raised suspicion of parasitic infestation. A larva was removed intact from the posterior neck lesion through a pre-existing punctum under local anesthesia. Whole-genome shotgun sequencing followed by de novo assembly generated a 16,888-bp mitochondrial contig containing a complete COI barcode region, supporting identification of the larva as H. sinense. At the one-month follow-up, the pain and subcutaneous nodules had resolved. This case highlights the importance of considering cutaneous myiasis in children from livestock-raising regions with painful, treatment-resistant subcutaneous nodules and demonstrates the diagnostic value of ultrasonography, minimally invasive larval extraction, and molecular identification.
Qiuqin Ji, Shuyao He, Sha Lai et al.· Tropical Medicine and Health· 0 citations
Background: Chromoblastomycosis is a chronic cutaneous and subcutaneous fungal infection caused by melanized or brown-pigmented fungi, most commonly Fonsecaea pedrosoi. Purpose: This case report describes an unusual instance of chromoblastomycosis caused by F. pedrosoi in a woman from South Kerala with a preceding history of a leech bite, highlighting the importance of combining clinical examination, histopathology, fungal culture, and molecular sequencing for accurate diagnosis and effective management of this rare and chronic fungal infection. Case: A 54-year-old housewife presented with a 3 × 2 cm erythematous plaque on the dorsal aspect of left hand at the site of anatomical snuffbox. She reported a history of leech bite four years back at the same site. Dark pigmented colonies were isolated on Sabouraud dextrose agar. Skin biopsy for histological analysis, revealed sclerotic bodies, and Sanger sequencing. The patient was treated with oral itraconazole for two months. Result: The diagnosis of chromoblastomycosis was confirmed through fungal culture, histopathological examination revealing sclerotic bodies, and Sanger sequencing identifying F. pedrosoi. The patient responded well to two months of oral itraconazole over two months, with no recurrence of lesions noted on follow-up. Conclusion: Accurate identification of chromoblastomycosis is crucial due to its resistance to treatment and varied clinical manifestations, which often lead to misdiagnosis. However, combining systemic antifungal therapy with physical and surgical modalities has been shown to improve outcomes such an atypical mode of transmission underscores the need for heightened clinical awareness, especially in endemic areas or among patients with unusual environmental exposures.
Ashna Ajimsha, Neeraja C. K., Kiran Subhash· Journal Of Vocational Health...· 0 citations
ABSTRACT Background Fungal infections are important causes of dermatological disease in companion animals and may involve a diverse range of clinically relevant fungal pathogens. Accurate identification of the causative agent is essential for appropriate diagnosis, treatment and assessment of potential zoonotic risks. Objectives This study aimed to characterize a fungal isolate from a canine cutaneous lesion in Tehran, Iran, using morphological, molecular and phylogenetic analyses. Methods Skin scrapings were aseptically collected from a dog presenting with pruritus and scaling, using sterile techniques microscopic examination and fungal culture. Microbiological observations were inconclusive for species‐level identification. Hence, target isolate was subjected to PCR amplification of the internal transcribed spacer (ITS) region using ITS1 and ITS4 universal primers. Results The ITS1–5.8S rDNA–ITS2 region was successfully amplified and sequenced using the universal ITS1 and ITS4 primers, and the sequence was deposited in the NCBI GenBank (PV082530). BLAST analysis showed 99.36% nucleotide similarity to a reference sequence of Corynascus verrucosus. In the maximum likelihood analysis placed the Iranian isolate within the broader Corynascus lineage, clustering closely with C. verrucosus reference sequences from different geographic regions. Morphological findings, particularly large, round, verrucose conidia, supported the molecular identification. Overall, the combined morphological, molecular and phylogenetic findings supported identification as C. verrucosus. Conclusions This case highlights the occurrence of an uncommon C. verrucosus isolate in a canine cutaneous lesion and demonstrates the value of integrating morphological, molecular, and phylogenetic approaches for fungal identification. The findings also emphasize the importance of cautious interpretation of molecular data when closely related fungal taxa show high sequence similarity.
Mohammad Ghahremani, A. Sharifzadeh, Iradj Ashrafi Tamai et al.· Veterinary Medicine and Scie...· 0 citations
Background & Objective
Primary cutaneous mucormycosis is an uncommon invasive fungal infection that typically occurs in immunocompromised persons. Apophysomyces elegans is a member of order Mucorales and is an emerging pathogen that can cause severe soft tissue infections in immunocompetent individuals following minor trauma. Pediatric cases in immunocompetent children are exceedingly rare.
Case Presentation
We describe a healthy boy aged 9 years who presented with a progressive painful swelling and black discoloration of the right lower limb after a minor incident outdoors. The first treatment with oral antibiotics didn't work. On examination, it was found that there was necrotic eschar with surrounding erythema and tenderness. Laboratory exams were normal and HIV testing was negative. MRI showed soft tissue involvement in the absence of bone invasion. Direct potassium hydroxide (KOH) mount showed broad aseptate hyphae and fungal culture produced the growth of Apophysomyces elegans. Urgent surgical debridement and intravenous (IV) liposomal amphotericin B were performed. He improved markedly clinically and was discharged on oral posaconazole for 6 weeks. At 3-month follow-up, there were no recurrences.
Conclusion
This case illustrates that invasive fungal infections can be encountered even in immunocompetent children after minor trauma. Prompt and aggressive combined medical-surgical management and early suspicion is vital to survival.
Kokab Jabeen, Faiqa Arshad, M. Sajid· JAIMC: Journal of Allama Iqb...· 0 citations
Background Onychomycosis is one of the most common nail disorders worldwide and is predominantly caused by dermatophytes; however, infections caused by non-dermatophyte molds are increasingly recognized as important causes of nail disease. Case presentation We present a case of a 41-year-old male from Duhok, Iraq, with a 15-year history of Crohn's Disease. He presented with progressive discoloration, nail thickening, nail deformity, pain while walking and brittleness of the affected nail that had persisted for several months. He was diagnosed with onychomycosis due to Syncephalastrum species, confirmed by KOH microscopy and characteristic culture morphology. Molecular confirmation was not available to identify to the species level. The fungus was sensitive to itraconazole, nystatin, clotrimazole, amphotericin B, miconazole, and ketoconazole, but showed resistance to fluconazole and voriconazole. He was successfully treated using IV amphotericin B, topical clotrimazole, and nail surgery. Conclusions This case demonstrates that Syncephalastrum species can cause clinically significant onychomycosis and should not automatically be dismissed as laboratory contaminants. A combination of clinical assessment, direct microscopy, culture-based identification, and antifungal susceptibility testing is essential for establishing diagnosis and guiding appropriate management.
A. A. Saadullah, R. Kwizera· Medical Mycology Case Report...· 0 citations
Background: Furuncular cutaneous myiasis caused by Cordylobia anthropophaga is a rare condition in non-endemic regions and may mimic furunculosis or skin abscesses, posing a diagnostic challenge. Case presentation: A previously healthy 24-year-old woman presented eight days after returning from Zanzibar with multiple tender erythematous nodules on the buttocks and left forearm. One larva was self-extracted, and others were removed under medical supervision. Ultrasound showed subcutaneous tracts consistent with larval infestation. Morphological analysis confirmed C. anthropophaga. The patient was treated with extraction and topical therapy. Lesions gradually resolved, leaving minimal residual marks after three months. Conclusions: Clinicians should consider furuncular myiasis in travelers returning from sub-Saharan Africa who present with boil-like nodules. Early recognition and extraction of larvae prevent complications. Traveler education on preventive measures remains essential.
Justyna Adamczuk, Katarzyna Sikorska, P. Czupryna et al.· Pathogens· 0 citations