HUMAN MYIASIS IN NON-TROPICAL REGIONS: FROM TRAVEL-ASSOCIATED TO HEALTHCARE-ASSOCIATED INFECTIONS - EPIDEMIOLOGY, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT, AND PREVENTION

Introduction: Myiasis is defined as the infestation of human tissue by the larvae of dipterous flies. While traditionally considered a tropical disease, it represents a growing dual clinical challenge in temperate regions, emerging both as an imported travel-related disease and as a severe nosocomial complication. Aim of the study: The aim of this review is to systematize current knowledge regarding the changing epidemiology, differences in clinical presentation, modern diagnostics, and strategies for the treatment and prevention of myiasis outside tropical zones. Materials and Methods: A narrative literature research was conducted using PubMed/MEDLINE and Google Scholar databases, covering the period from 2011 to 2026. A total of 40 peer-reviewed publications were selected, focusing on key reviews, epidemiological studies, and clinical case reports addressing both imported and hospital-acquired infections. Results: The findings highlight a distinct epidemiological divide. In returning travelers, furuncular myiasis is the most common presentation, typically caused by Dermatobia hominis and Cordylobia anthropophaga. In contrast, healthcare-associated (nosocomial) myiasis predominantly manifests as wound and cavitary infestations in vulnerable, bedridden patients, caused by cosmopolitan necrophagous flies (e.g., Musca domestica, Lucilia spp.). Effective management relies on occlusion methods, mechanical extraction, wound debridement, and the targeted use of ivermectin. Conclusions: Successfully managing myiasis in temperate regions requires a high index of suspicion. A detailed travel history is essential for accurate, early diagnosis in young travelers to avoid unnecessary antibiotic therapy, while rigorous wound hygiene and environmental vector control are critical to protecting bedridden patients in healthcare facilities.