M. Abdel-Dayem, R. Al Zou'bi, S. Aleesa, A. Katebeh-Bader, Z. Amr

Wound Myiasis Caused by the Common Green Bottle Fly,
Lucilia Sericata: Report of a Case at the
Royal Medical Services - Jordan
Muna M. Abdel-Dayem MSc*, Renad M. Al Zou'bi BSc*, Saleh K. Aleesa BSc*,
Ahmad Katebeh-Bader PhD**, Zuhair S. Amr PhD^
ABSTRACT
We report a case of wound myiasis caused by the Green Bottle Fly, Lucilia sericata, following an open heart
surgery for a 61 year-old male that was acquired at his place of residence after wound dressing.
Key words: Myiasis, Lucilia sericata, Jordan
JRMS June 2012; 19(2): 82-84
Introduction
Myiasis is defined as the infestation of tissues or
organs by the larval stages of dipetran larvae. (1)
Several forms of myiasis have been reported from
human and animals including dermal, gastric,
urogential, aural, ophthalmic and other rare forms.
In Jordan, ophthalmomyiasis due to the Sheep
Botfly, Oestrus ovis (2) and intestinal myiasis due to
the Green Bottle fly, Lucilla cuprina, have been
reported. (3) Also, cases of furuncular and cutaneous
myiasis have been reported among Jordanian
Military personnel serving abroad. (4,5) Wound
infestation by larval stages of Lucilia sericata after
hospital discharge was reported on several
occasions. It was reported from Iran (6) and Turkey. (7)
In this communication, we report the first case of
wound myiasis caused by Lucilia sericata post
operation in Jordan.
Case History
A 61 year-old male, diabetic, retired army soldier,
was admitted to the surgical ward at the Royal
Medical Services Center in Amman for coronary
artery bypass. The surgical procedure included an
incision along the length of the patient's left leg. The
surgery was performed on the 10 th of May 2011, and
the postoperative course was uneventful. The patient
was discharged afterwards. A local nurse visited him
at home to change the dressing. Later, he noted the
presence of "worms" in the wound (Fig. 1). The
patient was re-admitted again about a month after
discharge. On the 5 th of June 2011, a total of seven
larvae were recovered from the wound, and 13
others were recovered the following day. The
patient’s residence was visited and was found to be
surrounded by cattle and chicken farms. Adult
Lucilia sericata were observed and collected from
the vicinity of the patient's house.
Laboratory findings
Recovered larvae were fixed in 70% ethyl alcohol
and sent to the Jordan University of Science &
Technology for identification. Microscopic
examination of the spiracles and the anterior hooks
revealed that these larvae represent third and fourth
instar larvae of the common green bottle fly, Lucilia
sericata (Figure 2). They measured between 8.2-13.2
mm (average 11 mm).
*Prince Iman Center for Research and Laboratory Sciences, King Hussian Medical Center (KHMC) Amman-Jordan
** Faculty of Agriculture, Department of Plant Protection, the University of Jordan, Amman-Jordan
^ Department of Biology, Jordan University of Science & Technology, (JUST) Irbid-Jordan
Correspondence should be addressed to Dr. Z. S. Amr, Department of Biology (JUST), E-mail:amrz@just.edu.jo
Manuscript received September 14, 2011. Accepted March 8, 2012
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Fig.1: Larvae of Lucilia sericata in the open wound after
changing the dressing
Discussion
Lucilia sericata is a common fly found in rural
areas close to animal farms. Larvae are primarily
deposited in carrions. The adult stage of the
common green bottle fly was found near the house
of the patient. In Kuwait, Lucilia sericata, was
recovered from nostrils of a patient treated for head
injury, while another patient with multiple fractures
of the pelvis and the right tibia showed myiasis
caused by Megaselia scalaris, while both were in a
hospital. (8) In the Czech Republic, larvae were found
in the oral cavity, nose, paranasal sinuses and
enucleated eye-socket in a serious road traffic
accident patient while in the hospital. (9) Cases of
aural myiasis due to Lucilia sericata were reported
from Poland and Iran. (10,11)
Wound infestation by larval stages of Lucilia
sericata after hospital discharge was reported on
several occasions. In Turkey, 97 larvae were
recovered from a wound for a breast cancer
patient. (7) Thirty-eight larvae were removed from a
hand wound from a patient in Iran. (6) In Bahía
Blanca, Argentina, out of 17 clinical cases of
myiasis, four were attributed to Lucila sericata,
causing variable forms of traumatic myiasis. (12) The
Green Bottle Fly was the major cause for wound
myiasis in urban and suburban areas in the United
States, and was most common among the homeless
and alcoholics, and peripheral vascular disease
patients. (13) More incidences were reviewed by
Derraik et al. (14)
Conclusion
This is the first report of wound infestation by the
common green bottle fly in Jordan. Care should be
Fig. 2: A. Third and fourth instar larvae of Lucilia sericata
recovered from the wound. B. Spiracles of Lucilia sericata
taken while changing wound dressings to prevent
infestation of open wounds by the larval stages of
this fly. Window screens in houses and hospitals
and control of the common green fly may reduce the
risk of this rare form of wound infestation.
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