A case of urogenital myiasis caused by Chrysomya bezziana (Diptera: Calliphoridae) was diagnosed in a 76-year old patient who had carcinoma of the rectum. A total of 35 larvae were obtained from ulcers near the external genitalia and urethra opening. Larvae pupated within 1 to 2 days and 6 days later emerged as adult males. These were identified as Chrysomya bezziana. Female flies possibly attracted by the fetid odour, laid eggs in the existing lesions in the urogenital area, the larvae invading and feeding on living tissue. Lack of personal hygiene was the contributing factor for the cause of urogenital myiasis in this patient.
Schistosomiasis is a widely prevalent disease in the world and usually involves the gastro-intestinal and urinary tract. The involvement of the female genital tract has been well-established in S. haematobium infections and is rare with S. japonicum infections. This case involves a Filipino female who was admitted to the University Hospital Kuala Lumpur for right iliac fossa pain and was diagnosed initially as acute appendicitis. Ultrasound showed a multi-septated pelvic cyst leading to a provisional diagnosis of ovarian torsion. Intraoperatively a right parovarian cyst was detected and removed. Histology revealed a congested cyst wall with areas of haemorrhage with several viable and calcified eggs of S. japonicum measuring 85 microns x 62 microns. Within the cystic cavity blood admixed with eggs were seen. Confirmation was carried out by using the indirect haemagglutination (IHA) test. This is a first report of upper genital schistosomiasis mimicking an ovarian tumour.