A rare and interesting case of Scarabiasis

Abstract

Scarabiasis or Canthariasis or Beetle disease is an ectoparasitic infection of the gastrointestinal tract, in which the beetles temporarily infest the digestive tract and rarely the urinary tract. Dung beetle belongs to Scarabiaediae family. It is mostly seen in children aged between 2 to 5 years, who play outdoor for prolonged hours without undergarments. It is a temporary infestation in which early stages of development of beetle takes place in the anus and the adult beetle flies, out of the anus while defecation. A boy aged 3 years and four months presented to the pediatric OPD with complaints of peri umbilical abdominal pain, vomiting, nausea, mucus in stool along with “black insects” in his stool. The clinical examination revealed that the pulse rate, blood pressure and temperature were normal. Per rectal examination and ultrasound of the abdomen was normal. Routine examination of stool and urine was also found to be normal. The beetle was identified by the medical entomologist as dung beetle belonging to family Scarabidae. This report implies that the boy had an infestation with the larvae of dung beetle in the gastro intestine. The family belonged to the high range area of Mundakayam. Agriculture is the main source of income for people and main plantation being Rubber. Natives breed cattle for their livelihood and agriculture. During contact with mud or while playing outdoors naked, he would have come into contact with the eggs or the beetle, which hatched into larvae and caused canthariasis.

Scarabiasis revisited: a case study from Sri Lanka

“…The child we report was also from a rural village. In our case, ultrasound scan of abdomen, per rectal and fecal examination were found to be normal as in previous studies [1]. Similar to this case, previous cases have also reported patients having poor appetite and abdominal cramps [1,2,3,5].…”

“…Scarabiasis is an ectoparasitic infestation of the gastrointestinal tract by coprophagous beetles. All reported scarabiasis cases to date have identified that infected children invariably belong to a lower socioeconomical background [1]. The child we report was also from a rural village.…”

“…How the adult beetles or any stage of the lifecycle enters into the human gut is still controversial. Previous studies [1,3] consider the possibility of the larval stage entering through the child's anus. However, it is doubtful that a toddler will remain complacent when a relatively large beetle with coarse limbs crawls up the anus [2].…”

“…It is seen in children living in tropical countries but is rarely reported. Scarabs are identified in the "fly away" from the anus at the time of defecation [1]. Scarabiasis is known among rural Sri Lankans as 'kurumini mandhama' (beetle marasmus) in Sinhala language [2,3].…”

A Rare Case of Gastrointestinal Canthariasis Caused by Alphitobius Diaperinus

“…[1][2][3][4] Gastrointestinal canthariasis is a common infestation in the paediatric age group often leading parents to seek medical attention. [5][6][7][8][9][10] The clinical presentation of canthariasis is usually broad and often unspecific posing a diagnostic challenge to the treating physician leading to empirical treatment with anthelmintics. Stored food materials, dry fruits, breakfast cereals, or precooked cereals have long been considered to serve as a microhabitat for both adult and larval stages of beetles, thus providing a suitable environment for the agent (beetle) and host (human) interaction.…”