Case Report: Re-Emergence of Cochliomyia hominivorax in Costa Rica: Report of a Human Myiasis Case 23 Years after Elimination

Daniela P. Venegas-Montero Laboratorio Clínico, Hospital Juana Pirola, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica;

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María J. Alfaro-Vellanero Laboratorio Clínico, Hospital Juana Pirola, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica;

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Diana Rojas-Araya Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;
Sección de Entomología Médica, Facultad de Microbiología, Universidad de Costa Rica, San Jose, Costa Rica

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Ólger Calderón-Arguedas Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;
Sección de Entomología Médica, Facultad de Microbiología, Universidad de Costa Rica, San Jose, Costa Rica

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Cinthya M. Vargas-Castro Laboratorio Clínico, Hospital Juana Pirola, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica;

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Andrés Baldioceda-Villarreal Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;
Sección de Entomología Médica, Facultad de Microbiología, Universidad de Costa Rica, San Jose, Costa Rica

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Luis Enrique Chaves-González Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;
Sección de Entomología Médica, Facultad de Microbiología, Universidad de Costa Rica, San Jose, Costa Rica

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Jacqueline Camacho-Leandro Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;

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Adriana Troyo Laboratorio de Investigación en Vectores, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica;
Sección de Entomología Médica, Facultad de Microbiología, Universidad de Costa Rica, San Jose, Costa Rica

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ABSTRACT.

The New World screwworm, Cochliomyia hominivorax Coquerel (Diptera: Calliphoridae), was officially eliminated from Costa Rica in 2000, but it was reintroduced in 2023. A myiasis by C. hominivorax in a 71-year-old man with a 4-month history of foot hyperkeratosis and interdigital ulcers is reported. The myiasis was detected before sampling for bacterial culture. Approximately 160 first- and second-instar larvae were recovered and identified as C. hominivorax. Morphological identification was based mainly on characteristics of the cephalopharyngeal skeleton, spiracles, and pigmented dorsal tracheal trunks. Sequencing of a cytochrome c oxidase subunit I gene fragment confirmed the identity. The ulcers healed after extraction of the larvae and ciprofloxacin treatment of a concurrent Staphylococcus aureus and Pseudomonas aeruginosa infection. Given the reintroduction of C. hominivorax in Costa Rica and the risk of northward expansion, this report highlights its impact on public health and calls for awareness among clinicians and healthcare practitioners.

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Author Notes

Financial support: Universidad de Costa Rica Vicerrectory of Social Action project ED-548: Diagnosis of Ectoparasitic Arthropods and Public Health Importance Groups and Vicerrectory of Investigation project B5735-21: Medical Entomology Collection.

Current contact information: Daniela P. Venegas-Montero, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica, E-mail: dvenegasm@ccss.sa.cr. María J. Alfaro-Vellanero and Cinthya M. Vargas-Castro, Laboratorio Clínico, Hospital Juana Pirola, Caja Costarricense de Seguro Social, Puntarenas, Costa Rica, E-mails: mjalfarov@ccss.sa.cr and cvargasc@ccss.sa.cr. Diana Rojas-Araya, Ólger Calderón-Arguedas, Andrés Baldioceda-Villarreal, Luis Enrique Chaves-González, and Adriana Troyo, Departamento de Parasitología, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica, E-mails: diana.rojas_a@ucr.ac.cr, olger.calderon@ucr.ac.cr, andres.baldioceda@ucr.ac.cr, luisenrique.chaves@ucr.ac.cr, and adriana.troyo@ucr.ac.cr. Jacqueline Camacho-Leandro, Centro de Investigación en Enfermedades Tropicales, Universidad de Costa Rica, San Jose, Costa Rica, E-mail: jacqueline.camacholeandro@ucr.ac.cr.

Address correspondence to Adriana Troyo, Sección de Entomología Médica, Departamento de Parasitología, Facultad de Microbiología, Universidad de Costa Rica, Sede Rodrigo Facio, San Pedro, San José 11501-2060, Costa Rica. E-mail: adriana.troyo@ucr.ac.cr
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