What are the other Names for this Condition? (Also known as/Synonyms)

• Myiasis of the Umbilical Cord
• Neonatal Umbilical Myiasis
• Umbilical Myiasis

What is Umbilical Cord Myiasis? (Definition/Background Information)

• Myiasis is primarily a skin disease caused by several species of parasitic fly larva (of taxonomic order Diptera). The fly larvae (maggots) cause disease in humans and other vertebrate animals by feeding on the tissues. The infection is usually characterized by a painful, itchy, boil-like skin lesion that contains the parasite within it
• Umbilical Cord Myiasis may be described as an uncommon type of wound myiasis that often develops early in newborn children in the umbilical cord stump and surrounding abdominal tissue. The most common causative organism implicated is the New World screw-worm fly (Cochliomyia hominivorax)
• A wet and moist umbilical cord tissue remnant at the navel of a newborn can attract flies, especially when aided by unhygienic settings due to low socioeconomic status. Certain traditional practices of smearing native preparations on the cord stump of neonates is also a predisposing factor for Umbilical Myiasis
• Umbilical Myiasis may be treated by immobilizing the maggots and removing them via saline solution irrigation. In most cases, there is no requirement for surgery. Following its successful extraction, the wound heals, and the outcomes are mostly good unless complications, such as sepsis, develops

Who gets Umbilical Cord Myiasis? (Age and Sex Distribution)

• Umbilical Cord Myiasis is a rare fly larvae infestation of the umbilical cord in neonates
• Individuals of all racial and ethnic groups may be affected
• Geographically, Umbilical Cord Myiasis is observed in the poorer regions of the world in the continents of Asia, Africa, and South America 

What are the Risk Factors for Umbilical Cord Myiasis? (Predisposing Factors)

The following are the risk factors for Umbilical Cord Myiasis:

• Open (moist) wound at the site of the umbilical cord after the cord is shed, which is neglected or kept unclean
• Smearing native applications, such as cow dung, on the navel of newborn children as a traditional practice
• Leaving newborn children inadequately clothed (exposing the belly) and unattended
• Living in poverty and overcrowded unclean surroundings, especially in a rural background
• Unhygienic surroundings

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Umbilical Cord Myiasis? (Etiology)

Umbilical Cord Myiasis is a parasitic infection caused by the following insect larvae:

• New World screw-worm fly (Cochliomyia hominivorax)
• House fly (Musca domestica)

The parasitic insects either lay eggs or deposit their larvae in or near the warm and moist umbilicus stump that is left neglected; necrotic tissues of the umbilical cord may also attract flies to it, particularly in unclean surroundings, resulting in Umbilical Myiasis.

What are the Signs and Symptoms of Umbilical Cord Myiasis?

The signs and symptoms of Umbilical Cord Myiasis observed in newborns may include the following:

• Swelling and redness of the umbilicus
• Omphalitis or infection of the umbilical stump
• Abscess formation, with a white central plug-like spot (this spot often houses the live larva)
• Oozing of pus from abscesses or a clear fluid from the white plug
• Poor feeding and irritation
• Constant crying due to pain or itchiness
• Fever and chills may be noted

How is Umbilical Cord Myiasis Diagnosed?

Umbilical Cord Myiasis is diagnosed on the basis of the following information.

• Complete physical examination and a thorough medical history evaluation
• Assessment of signs and symptoms, including a visual examination of the lesion
• Laboratory tests: Blood tests, such as complete blood count, which may show increased white blood cells
• Imaging studies, as necessary

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Umbilical Cord Myiasis?

The complications of Umbilical Cord Myiasis may include:

• Severe emotional stress for the parents
• Severe pain and discomfort
• Secondary infection of the abscess; rupture of the abscess
• Cellulitis: Skin infection that involves the deeper skin tissues
• Severe inflammatory response to dead larvae or parts of larvae, especially during its removal
• Sepsis, which can be life-threatening

How is Umbilical Cord Myiasis Treated?

The treatment for Umbilical Cord Myiasis may involve the following measures.

• Immobilizing or killing the larvae by application of ether
• Using saline water jet to flush out the maggots
• Manual extraction of the maggots by visualizing them well
• Dressing and wound care, as required
• Surgical extraction of the larva from the region and tissue debridement is not usually considered due to risk of post-operative infection

Examination and identification of the larva following removal from skin tissues may be undertaken.

How can Umbilical Cord Myiasis be Prevented?

Umbilical Cord Myiasis may be prevented by considering the following measures:

• Ensure that the umbilical stump wound is properly treated and dressed/covered
• Place insect nets over sleeping babies
• Maintaining basic personal and community hygiene and proper sanitation is highly important, particularly in the endemic zones
• Use insect repellents to prevent the insects from entering residences
• The growth of adult flies must be effectively controlled and methods for eradication followed on a regular basis

What is the Prognosis of Umbilical Cord Myiasis? (Outcomes/Resolutions)

The prognosis of Umbilical Cord Myiasis is good, if the larvae are removed completely from the umbilicus.

• Any delay in treating the condition can result in deep-seated infections, which may even lead to sepsis due to secondary infections
• In some cases, rupture of an abscess containing the larva may lead to a severe inflammatory response 

Additional and Relevant Useful Information for Umbilical Cord Myiasis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/