The first report of Ignatzschineria indica, Ignatzschineria ureiclastica and Wohlfahrtiimonas chitiniclastica Bacteremia in two patients with fly larvae-infested wounds in Scandinavia

We present the first Scandinavian cases of bacteremia caused by <i>Ignatzschineria indica, I. ureiclastica</i>, and <i>Wohlfahrtiimonas chitiniclastica</i>. Two patients with fly larvae-infested wounds were admitted to a Danish hospital in the summer of 2024. The first patient, a 62-year-old male with alcohol overuse and septic shock, had <i>W. chitiniclastica</i> and <i>I. ureiclastica</i> bacteremia, managed with piperacillin/tazobactam and ciprofloxacin. The second, a 67-year-old diabetic male with peripheral vascular disease, had <i>I. indica</i> bacteremia requiring below-knee amputation and targeted antibiotics. Both isolates were identified via MALDI-TOF mass spectrometry and whole-genome sequencing, with antibiotic "susceptibility testing" guiding therapy. Despite severe presentations, both patients survived. These cases highlight the emergence of these pathogens in Northern Europe and reinforce the importance of advanced diagnostics and personalized treatment strategies in myiasis-associated sepsis.