This week's fascinating (and somewhat gruesome) case is from Dr. Richard Bradbury. The following were seen on a bacterial culture (Chocolate/New York agar) plate after 24 hours of incubation in CO2. The specimen was pus from a perforated eardrum from a child in the Gambia. What are the possible explanations for this finding?
Answer to the Parasite Case of the Week 796: Fly larvae; clinical correlation is recommended.
As many of you noted, there are two main possibilities for this finding:
1. This is a case of aural myiasis, in which a fly laid eggs onto the patient's ear - likely in the setting of a pre-existing skin/soft tissue infection.
2. This represents contamination of the culture plate, in which the fly laid eggs on the specimen after it was collected.
In this case, examination of the patient revealed no evidence of aural myiasis, and therefore #2 is the most likely explanation.
We had a similar case of "agarmyiasis" back in 2018. I encourage you to check out the interesting comments and discussion.
Thanks again to Richard Bradbury for donating this great case!
It's the first Monday of the month and time for our case from Idzi Potters and the Institute of Tropical Medicine, Antwerp. Loranne Lambregts is a new colleague of Idzi's and contributed to this case, identifying the object of interest below that was submitted for parasite identification in their lab. It measured approximately 1.5 cm in greatest dimension and was still moving when received! Here it is pressed between two glass slides:
