Ectoparasites:

 Clinical  
Manifesta2ons  and  Treatment  
 Myiasis  
•  Caused  by  fly  maggots  (larvae)  
•  May  involve  cutaneous  2ssue,  body  cavi2es  or  
gut  lumen  
•  3  mechanisms;  larvae  may  directly  penetrate  
skin,  some  larvae  aCach  to  mosquitoes  and  enter  
skin,  and  some  flies  lay  their  eggs  in  wounds  
•  Treatment  consists  of  surgical  excision  
Myiasis  
 Fleas  
•  Cause  local  inflammatory  response  and  
irrita2on;  secondary  infec2on  can  occur  
•  May  also  be  vectors  of  other  diseases;  plague  
(Yersinia  pes2s),  murine  typhus  and  rural  
epidemic  typhus  (RickeCsia  typhi  and  
prowazekii),  and  bartonellosis  
 Ticks  
•  Ticks  can  be  vectors  for  many  different  
pathogens  
•  Leading  pathogens  include  relapsing  fever  
(Borrelia),  ehrlichiosis  (Ehrlichia),  babesiosis  
(Babesia),  Lyme  disease  (B.  burgdorferii),  Rocky  
Mountain  SpoCed  Fever  (RickeCsia  rickeCsii),  
tularemia  (Francisella  tularensis)  and  
anaplasmosis  (Anaplasma  phagocytophilium)  
 Lice  
•  3  species  affect  humans;  body  lice,  head  lice,  and  
crab  lice  
•  Close  physical  contact  results  in  spread  
•  Body  lice  can  transmit  typhus  (RickeCsia  
prowazekii),  trench  fever  (R.  quintana)  and  
relapsing  fever  (Borrelia  recurren2s)  
•  Lice  are  usually  treated  with  pyrethrins  
 Scabies  
•  TransmiCed  by  close  contact,  frequently  sexual  
contact  
•  Small  papule  at  entry  point,  then  may  
disseminate  
•  Disease  may  be  worse  in  immunocompromised  
hosts  
•  Treatment  with  permethrin  topically  
 Bedbugs  (Cimex  le2cularis)  
•  Live  in  areas  where  people  sleep  
•  Feed  on  human  blood  
•  Not  known  to  transmit  other  diseases  
•  Irrita2ng  bites  while  sleeping  
•  Clues-­‐  exoskeletons,  bedbugs  in  the  folds  of  
bedding,  rusty  colored  spots  on  maCress  or  
furniture,  sweet  musty  odor