Cases reported "Insect Bites and Stings"

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1/6. Furuncular myiasis caused by Dermatobia hominis, the human botfly.

    myiasis is a common travel-associated dermatosis. Travelers to many parts of Central and south america are susceptible to infestation by Dermatobia hominis. Despite the common name of human botfly, D hominis infests a broad range of mammals and is a severe pest to economically important farm animals in endemic regions. The adult female does not lay the eggs on the host. Instead, the adult female infests hosts indirectly by using blood-feeding arthropods to serve as phoretic vectors to transport the eggs. We present a patient who acquired Dermatobia when bitten by a day-active mosquito during a visit to guatemala. He had a locally painful, firm furuncular lesion with a central pore that drained serosanguineous exudates. The patient applied an occlusive ointment and recovered the larva after it emerged. In this report we discuss the life cycle of D hominis, the differential diagnosis, and therapeutic approaches.
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2/6. deer ked-induced occupational allergic rhinoconjunctivitis.

    BACKGROUND: deer keds (elk fly) have not previously been described as a cause of respiratory or conjunctival sensitization. OBJECTIVE: To report a case of IgE-mediated allergic rhinoconjunctivitis from occupational exposure to deer ked. methods: Skin prick testing (SPT) was performed with pollens, animal danders, mites, molds, and deer ked. The serum deer ked-specific IgE level was examined in ImmunoSpot and radioallergosorbent test assays, and deer ked IgE-binding fractions and their specificities were examined in immunoblot and immunoblot inhibition assays. Nasal provocation testing (NPT) and conjunctival provocation testing (CPT) were performed to detect the association between deer ked sensitization and rhinoconjunctival symptoms. Both SPT and NPT were performed with deer ked whole-body extract, whereas CPT was performed with deer ked wing. RESULTS: The results of SPT, NPT, and CPT were positive for deer ked. In laboratory tests, serum deer ked-specific IgE antibodies were demonstrated in radioallergosorbent test and ImmunoSpot assays. In immunoblot, IgE-binding bands were demonstrated at 17, 33, 70, and 85 kDa, which were clearly inhibited with deer ked extract but not with the control extract. CONCLUSIONS: Occupational IgE-mediated rhinoconjunctival allergy to deer ked was confirmed in this patient.
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3/6. Simulium dermatitis in man--clinical and biological features in south africa. A case report.

    Simulium bite reaction is described; the lesions were present mainly on the lower legs as palpable purpura, which persisted for 2 weeks with marked oedema and considerable discomfort. Simuliids are tiny bloodsucking flies, popularly known as blackflies or buffalo flies, belonging to the dipterous family simuliidae. They occur world-wide, breed in fast-flowing streams, and are a major animal pest. This is the first description of blackfly bites in man in the South African literature.
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4/6. Transient bradycardia during vespid venom immunotherapy.

    A woman developed generalized symptoms of hypersensitivity when she was stung requiring treatment with adrenalin. Intradermal venom skin tests showed immediate hypersensitivity to yellow hornet and white-faced hornet thus fulfilling the criteria to receive appropriate venom immunotherapy. During the course of modified rush immunotherapy with yellow hornet and white-faced hornet venoms, she developed transient but progressive bradycardia necessitating interruption of the venom immunotherapy. Transient bradycardia recurred when venom immunotherapy was resumed but it was possible to reach a maintenance dose of 100 micrograms protein for each venom. bradycardia has been reported to be induced in experimental animals by oriental hornet venom as well as other venoms, through a direct cholinergic action. It appears that a similar effect may occur in man in susceptible individuals during venom immunotherapy.
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5/6. Cockroach: the omnivorous scavenger. Potential misinterpretation of postmortem injuries.

    Interpretation of postmortem injuries, including their differentiation from those produced antemortem, may be difficult even for experienced forensic pathologists. A variety of animals or insects residing in the death environment may alter the appearance of the deceased. Dictyoptera blattaria (the cockroach) is common in the residential setting. Three cases of sudden and unexpected infant death are presented in which postmortem injuries inflicted by cockroaches initially raised concern of nonaccidental injury. The true nature of the lesions was not recognized by the people at the death scene and, in one case, observation of neck injuries raised suspicion of possible strangulation. In another, the lesions were thought to be burns of different ages. cockroaches are omnivorous scavengers that devour keratin. They will bite human flesh in both the living and dead with resultant injury. Recognition of cockroach bites will help in the evaluation of injuries discovered during child death investigations.
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6/6. Fatal anaphylaxis due to fire ant stings.

    Imported fire ants (Solenopsis invicta and Solenopsis richteri) are the source of a potentially lethal environmental hazard in the southeastern united states. Because of their resistance to natural and chemical control, fire ants can overwhelm their environment, causing destruction of land and animals. Fire ants can also cause a variety of health problems in humans, ranging from simple stings to anaphylaxis and death. We present a case of a 30-year-old woman who died of anaphylaxis following multiple fire ant stings. At autopsy, multiple skin lesions characteristic of those produced by fire ant stings were present on her arm. Postmortem blood samples were positive for imported fire ant venom-specific IgE antibodies (5654 ng/ml) and tryptase (12 ng/ml). Deaths caused by imported fire ant stings are rare but are likely to become more common as the fire ant population expands. In this report, we review deaths due to fire ant stings, discuss postmortem laboratory findings, and stress the importance of recognizing the characteristic skin lesions produced by fire ants.
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