Case report: A rare case of urinary myiasis induced by the fourth instar larvae of Telmatoscopus albipunctatus.

Telmatoscopus albipunctatus, a cosmopolitan fly, is widely distributed throughout moist environments. It is one of the most medically important insects (especially in urban environments) that may potentially cause myiasis. Urinary myiasis and other sites of infestation, including the intestine, nasal passages, lung, and derma, have been reported. This is the first case report of a Chinese middlescent woman infected with T. albipunctatus in Guangzhou, China. In the present report, a 50-year-old woman came to The Third Affiliated Hospital of Southern Medical University, Guangzhou, China, because larvae were found when urinating in the morning; this had occurred every two days within the past two months. She complained of frequent micturition and urgency. Urine tests indicated that all indexes were normal except for slight urinary tract infection. Subsequently, the larvae were sent to the diagnostic section for parasitic infection in the Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China. The stereoscopic microscope and transmission electron microscope were used for morphological observation. On this basis, the cytochrome oxidase subunit 1 (COX1) gene was specifically amplified by PCR. Sequence analysis of the PCR product and phylogenetic analysis were used to identify the species. Morphological analysis combined with molecular biology methods indicated that the insect was the fourth instar larvae of T. albipunctatus. Our results show that this was a case of a 50-year-old woman infected with T. albipunctatus larvae in her urinary tract, and the findings suggest that clinicians should be vigilant for this infection.