A RARE FINDING OF DISTAL PENILE FURUNCULAR MYIASIS IN A CHILD OF A NIGERIAN HEALTH CARE WORKER

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K.I Egbuchulem¹, H.D. Ogundipe¹, D.I. Olulana^1,2, T.O. Ojediran¹

1. Division of Paediatric Surgery, Department of Surgery, University College Hospital, Ibadan.
2. Department of Surgery, University of Ibadan, Ibadan, Nigeria.

Abstract

Introduction: Myiasis is the infestation of tissues of humans and other living vertebrates with the larva of flies, and it can affect any part of the body. Cutaneous myiasis is the commonest form of presentation. Furuncular myiasis which is a sub-type of cutaneous myiasis typifies the presentation in this index patient. It is commonly caused by Cordylobia anthropophaga in Sub-Saharan African countries including Nigeria. It commonly occurs among rural dwellers, as well as people of low socio-economic and poor educational status. Case presentation: We present a case of balanitis from distal penile myiasis in a 3 year 8-month-old male child of a health worker in a tertiary hospital in Nigeria.

Conclusion: It is believed that with adequate knowledge, measures such as good hygiene and proper drying and ironing of underwear are helpful

Keywords: Cordylobia spp., Furuncular, Health worker, Myiasis

Introduction

Myiasis is the infestation of tissues of humans and other living vertebrates with the larva of two-winged flies, and it can affect any part of the body1 When affecting the skin, it is termed cutaneous myiasis and it is the commonest form of presentation2 Cutaneous myiasis has three major variants; wound myiasis, creeping (migratory) eruption, and furuncular myiasis in which the larvae penetrate and develop within the skin. The flies that are likely to produce specific types of cutaneous myiasis are outlined in Table 1. Furuncular myiasis is commonly caused by Dermatobia hominis in South America while Cordylobia anthropophaga is responsible for most cases in Sub-Saharan Africa or in those with recent travel history to Sub-Saharan Africa. Furuncular myiasis by Cordylobia anthropophaga usually affects areas covered by clothes such as the trunk, buttocks, and thighs but penile myiasis is rare. It commonly occurs among rural dwellers or people with low socio-economic status and poor educational
background. We present a case of balanitis from distal penile myiasis in a three year, eight months old male child of a health worker who works in a tertiary health care facility in an urban centre.

CASE PRESENTATION
A 3 year 8-month-old male was brought by father to the outpatient clinic on account of a day history of painful distal penile swelling. Penile shaft swelling was associated with severe pain, worse with contact but no discharge. There was no dysuria, fever or associated scrotal swelling. There was no prior history of trauma or insect bite. No history of prior urethral instrumentation or catheterization. No history suggestive of sexual abuse. He had left inguinal herniorrhaphy one year prior to presentation. Father is health personnel – ward assistant, and a staff of a tertiary health facility in an urban area in Southwest Nigeria.