Maggot Debridement Therapy in the treatment of equine cutaneous pythiosis

Not a pleasant subject but the successful treatment of a case that had not responded to prior therapy is something to be aware about. Pythosis in a very difficult disease to treat and many doctors may be slow to reach for this. The specie of fly used in this case is akin to our greenbottle fly. These species maggots ingest only compromised tissues and in the case of pythiosis also ingested infected tissues. These maggots are available as a medical device in the US, https://www.monarchlabs.com/, and other countries and can be located by searching for “lucilia source for maggots for sale”.
DrO

Adjunctive use of Maggot Debridement Therapy in the treatment of equine cutaneous pythiosis: A case report
Vet Parasitol Reg Stud Reports. 2026 Apr:69:101462. doi: 10.1016/j.vprsr.2026.101462. Epub 2026 Feb 24.
Authors
Janaína Brand Dillmann 1 , Talissa Silva Dos Santos 2 , Rafael Cardoso Dos Santos 3 , Silvia Gonzalez Monteiro 4
Affiliations

1 Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, RS, Brazil. Electronic address: medvetjana@gmail.com.
2 Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, RS, Brazil.
3 9° Regimento de Cavalaria Blindado (9° RCB), Brazil.
4 Departamento de Microbiologia e Parasitologia, Universidade Federal de Santa Maria, RS, Brazil.

PMID: 41819953
DOI: 10.1016/j.vprsr.2026.101462

Abstract

Equine cutaneous pythiosis, caused by Pythium insidiosum, is a severe disease in tropical and subtropical regions, often leading to progressive granulomatous lesions with poor response to conventional therapies. Standard treatment includes surgical excision and immunotherapy, but recurrence is common, particularly in distal limb lesions. Maggot Debridement Therapy (MDT) with disinfected Lucilia cuprina larvae provides selective debridement, microbial control, and stimulation of granulation, representing a potential adjunctive option. This report describes the successful use of MDT combined with immunotherapy in a 5-year-old Criollo mare with a refractory lesion near the left hock. Despite surgical curettage and Pitium-Vac® immunotherapy, the lesion progressed until two MDT applications were performed. Rapid debridement was achieved, with effective removal of necrotic tissue including kunkers, resolution of exudation, and stimulation of granulation tissue formation. Continued immunotherapy led to complete wound healing and hair regrowth. These findings highlight MDT as a valuable, minimally invasive adjunct in equine pythiosis management, warranting further investigation.

Keywords: Blowflies; Equine; Larvae; Lucilia cuprina; MDT; Pythium insidiosum; Wound care.

Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.