ARS | Publication request: MYIASIS DUE TO HYPODERMA LINEATUM INFECTION MIMICKING THE HYPEREOSINOPHILICSYNDROME

Submitted to: Mayo Clinic Proceedings
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: February 7, 2000
Publication Date: N/A

Interpretive Summary: The cattle grub is a common parasite of cattle that causes serious economic damage. Although human infestations with the cattle grub are rare, they can occur and when they occur the patient can have an impressive blood and tissue eosinophilia with a clinical condition resembling hypereosinophilic syndrome. This manuscript represents a case report of a 35 year-old rancher rwho was healthy until late March 1995 when the patient noted the gradual onset of bilateral arm and shoulder pain, and back and chest discomfort. After many diagnostic procedures and continuing health problems, the patient's diagnosis remained problematic. In mid-December 1995 the patient developed a lesion on the lower abdomen. While rubbing this lesion a worm (cattle grub larva) crawled out. Two weeks later a second larva exited from a skin lesion on the patient's back. Thereafter, the patient's symptoms rapidly disappeared. The clinical parameters associated with human ncattle grub infestation are described in great detail. A serological (blood) test was developed that allows for the rapid diagnosis of human hypodermatosis. This disease can be easily confused with both the idiopathic hypereosinophilic syndrome and the eosinophilia-myalgia syndrome. Information is provided that will allow physicians a means of diagnosis for those people in contact with cattle who develop marked eosinophilia and the constellation of findings similar to those described.

Technical Abstract: A 35-year old man developed a protracted and confusing multi-system illness characterized by pleuritis, pericarditis, myositis, serositis, and marked eosinophilia. Myiasis proved to be the cause. The clinical, radiologic, and serologic features that characterize this condition are outlined. This malady should be considered in the differential diagnosis of several hyper- -eosinophilic syndromes.