Maggot Debridement Therapy for deletion of Leishmania sp. using Lucilia serricata larvae in Iran: Case report

Background: Leishmaniasis, one of the world s widespread zoonotic diseases, caused by a variety of intracellular protozoan parasites that target mammalian macrophages. Recent studies on the use of maggot debridement therapy (MDT) in the treatment of cutaneous leishmaniasis wounds in vitro and in animal and human hosts confirm the remarkable effect of this treatment on wound healing.Objective: The purpose of this study was to treat human cutaneous leishmaniasis wound using maggot of Lucilia serricata.Materials and Methods: A 52-year-old man with a 2.5 cm diameter infectious wound on his forearm referred to the health center of Andimeshk County, southwest Iran in June 2019. He was a rancher. His wound was sampled and sent to the Pathobiology laboratory. The Leishmania body was confirmed in the sample. The patient was afraid of the injection, so he avoided to receive Glucantime injection as the routine treatment. He was informed about the treatment and alternative therapies, and signed an informed consent form to receive maggot therapy. Ten sterile first instar larvae of L. serricata, were placed directly on the wound and bandaged with sterile gauze. After 72 hours, it was replaced by second series of larvae for three days. The parasite presence or deletion after one month of treatment from lesion smear material was tested using PCR. Patient was sent home after treatment and he was followed-up after 2 months of therapy, to check for healing of their lesions Results: Cutaneous leishmaniasis lesion on the patients’ forearm was treated using the 1st stage of L. sericata larvae within 8 days. After second larval application of three days, the wound was free of purulent secretion and symptoms of healing appeared. By this time, maggots had grown from 3-4 mm to approximately 10 mm in size. Additionally, after 1 month of treatment, Leishmania body was not detected in the sample using PCR and the location of the lesion was completely healed without leaving scar tissues at two months follow-up time after treatment.Conclusion: MDT completely natural, has no side effects and is a cost effective alternative compared to traditional treatment options for cutaneous leishmaniasis ulcers

کلیدواژه ها:

Cutaneous Leishmaniasis ، Lucilia serricata ، Maggot Debridement Therapy