When mites attack: domestic mites are not just allergens
Parasites & Vectors volume 7, Article number: 411 (2014)
Domestic mite species found in indoor environments and in warm or tropical regions are well known for causing allergic disorders. However, little is known about human acariasis, in which mites invade and parasitize the human body in various tissues from the gastrointestinal tract to the lung. Here, we summarize the reported cases of human acariasis of pulmonary, intestinal, oral (anaphylaxis), urinary, otic, and vaginal systems. Because the clinical symptoms of acariasis often overlap with other disease symptoms leading to frequent misdiagnosis, we highlight the need for more attention on these infections.
“Domestic mites” refers to a variety of small (0.5 mm) arthropods found living in close proximity to humans (Table 1). They include house dust mites and storage mites. Typically belonging to the family Pyroglyphidae (Analgoidea, Astigmata, Acariformes), the house dust mites are commonly found in human homes. Some other mites can be present in house dust, especially several species from the families Glycyphagidae, Aeroglyphidae Chortoglyphidae, Echimyopodidae, Tyroglyphidae, Lardoglyphidae, and Suidasiidae, as well as species of the families Tarsonemidae and Cheyletidae. The latter are typically regarded as storage mites because they occur widely in-and contribute to the deterioration in quality of—stored products like grains, foodstuffs, and Chinese medicinal herbs [1, 2]. They are also found in mattresses, pillows, and upholstery. Both the pyroglyphid mites and other mite species that are found in house dust can provoke an IgE antibody response in people worldwide [3–16]. These mites have been widely studied because their feces, eggs, and extracts from their bodies are potent allergens. Indeed, approximately 10% of the total population and 90% of asthmatic patients are allergic to domestic mites .
Although domestic mites are well known allergens, they are also responsible for other, non-allergic, symptoms in humans, called acariasis. Little is known about acariasis, in which mites invade and parasitize the human body in various tissues from the gastrointestinal tract to the lung. Mites, throughout their lives or during individual life cycle stages, commonly parasitize animals, and some free-living mites can invade a host only occasionally. When domestic mites invade a human body, it is believed to be a non-specific invasion differing from parasitization of an animal, because the non-specific invasion occurs only occasionally and lacks specific symptoms and are not caused by specific mite species; in contrast, specific invasions are caused by specific parasite species occurring in specific hosts and producing specific symptoms . To date, few reports of human acariasis have been published in English medical journals. However, acariasis has been described for pulmonary, intestinal, oral (anaphylaxis), urinary, otic, and vaginal systems. Importantly, the clinical symptoms of acariasis are non-specific and often overlap with other disease symptoms, leading to frequent misdiagnosis and, likely, many missed cases. In this review, we present the types of acariasis that have been described, and summarize the current knowledge about these little known and little-understood infestations (Table 2).
Pulmonary acariasis is a non-specific infestation of human lungs by free-living mites. In the 1930s, mites were observed in human sputum . Subsequent experiments demonstrated that free-living mites can invade animal lungs and live in the respiratory tract. Indeed, Carter et al. detected mites in sputum from 60.71% (17/28) of asthmatic patients. Interestingly, the authors thought the mites were derived from contamination of the test vessel because the detected mite species were present in dust samples from the same hospital and wards. After ruling out possible contamination, the authors repeatedly tested the sputum samples and obtained the same results. Among those 17 patients, one had severe asthma and had mites in his lungs for more than 7 months. Blood examination showed increased eosinophil numbers in all 17 patients. After treating patients with arsenic, the numbers of mites in their sputum samples increased, which showed that mites in the lungs were driven out, before the numbers of mites decreased and patients’ symptoms resolved .
Since that initial report, a number of other cases of pulmonary acariasis have been documented. In 1947, mites were detected in sputum of 3 out of 28 patients with tropical eosinophilia in East Africa . In China, Gao et al. reported for the first time that Tyrophagus and Tarsonemus were found in sputum of a bronchiectasis patient . Ryu et al. reported that a 23-year-old medical student showed a positive reaction on a skin test for Paragonimus westermani, and two Tarsonemus floricolus mites were subsequently found by sputum examination and identified morphologically. This was the first human infection with Tarsonemus reported in Korea. Further, in 2007 a new process for identifying mites in sputum was developed. Martínez-Girón R et al. demonstrated that dust mites artificially introduced into sputa could be identified after sputa were liquified with bleach and the liquid sample was observed under the microscope. Their approach offers a time- and cost-saving tool for identifying dust mites in sputum, but the test is not commonly applied in the clinic because acariasis is not well recognized.
Van Woerden  proposed that asthma in house dust mite-sensitive patients may be caused by recurrent inhalation of live dust mites that are able to live for some time in the bronchioles of the lung. The mites may provide their own food source by excreting proteolytic enzymes—including the protein Der p 1, a major allergen—that free cells from the basement membrane to increase epithelial shedding. Shed respiratory epithelial cells can then be consumed by mites. However, this loss of respiratory epithelium can provoke sensitization to the dust mite proteins and other allergens, which later results in asthma symptoms. Indeed, the association between pulmonary acariasis and asthma has been demonstrated across studies.
Several papers published in Chinese reported on the etiology, pathology, diagnosis, and treatment of pulmonary acariasis. Their work suggested that the occurrence of pulmonary acariasis is related to occupation, with individuals who work in production, processing, and storage of food and herbs having higher risks of infection [25–27]. A few reports from China indicated that the infection rate and prevalence were highest in people aged 36-45 years, the second-highest rates were in 26-35 and 16-25 year-old people [28, 29]. Further, males were more commonly infected. However, these patterns may be influenced by occupational characteristics.
There are no specific clinical manifestations that point to pulmonary acariasis, beyond detection of mites in sputum. Patients with mild cases exhibit cold-like or bronchitis-like symptoms. Patients with severe cases often appear to have tuberculosis, pleurisy, or asthma, exhibiting symptoms such as cough, increased sputum volume, chest pain, shortness of breath, fatigue, fever, irritability, blood in sputum, and hemoptysis. A few patients have a severe cough in the morning and evening, accompanied by back pain, headache, dizziness, abdominal pain, and diarrhea. Except for increased eosinophil counts, no abnormalities are detected for red blood cells, hemoglobin, platelets, or liver function. A chest x-ray may show enhanced shadow in the hilar region and increased marking in the depth. Thus, pulmonary acariasis is often misdiagnosed as bronchitis, hilar lymphadenopathy, lung fluke disease, tuberculosis, or pleurisy [30–34]. Clinicians therefore proposed that, along with chest x-ray and blood counts, occupational history can be used for differential diagnosis. Treatment for pulmonary acariasis includes organoarsenic drugs like carbarsone and acetarsol, as well as drugs like hetrazan, thiodiphenylamine, emetine, and some antibiotics [30–34].
Chen et al. reported typical nodular foci developed in the lungs of guinea pigs six days after five mite species, Aeuroglyphus ovatus, Suidasia nesbitti, Dermatophagoides farinae, Tyrophagus putrescntae, and Acarus siro, were injected into the tracheas. The foci occurred in all parts of the lobes, and were found to be yellow in fresh tissues and ranged from one to five millimeters in diameter. The pathological changes were associated mainly with bronchial and peribronchial lesions. Eosinophil infiltration was not observed in the lungs 20 days later. Multiple multinucleate giant cells grew and there was a striking formation of foreign body granuloma with the involvement of blood vessels. The parasitic mites were usually found in association with some arterioles. It was therefore demonstrated that guinea pigs offer an appropriate animal model for the study of pulmonary acariasis and that the five mites-species possess the same pathogenesis .
Intestinal acariasis is caused by ingestion of mite-contaminated foods. This invasion of the human gastrointestinal tract can cause symptoms including diarrhea, abdominal pain, and burning sensation around the anus. The first case of intestinal acariasis was reported by Hinman & Kammeier , who detected Tyrophagus longior (Tyroglyphidae) in human intestine . Three cases of intestinal acariasis were described in Spain; one of these was Suidasia mites . Several cases of diarrhea were reportedly caused by Carpoglyphus lactis, presumed to have been transmitted through contaminated imported sugar [18, 38]. Other studies have identified cases of abdominal pain, diarrhea, fatigue, and pyohemofecia attributable to Dermatophagoides farinae, D. pteronyssinus, Acarus siro, Tyrophagus putrescentiae, Carpoglyphus domesticus, Glycyphagus domesticus, G. privatus, and Tarsonemus granarius[39–41]. Interestingly, an allergic intestinal acariasis syndrome has also been described . Occasionally mite eggs, rather than (or in addition to) mites, have been found in stools [43, 44]. Indeed, Werneck et al. indicated that stool samples containing mite eggs, which were sometimes accompanied by adult mites, may often be misidentified as helminth ova, leading to erroneous treatment with far-reaching consequences .
Both direct fecal smear and a saturated salt solution floating method can be used for detection of mites in larva, adult, live, dead, or egg stage. Zhang et al. developed an avidin-biotin system enzyme-linked immunosorbent assay (ABC-ELISA) to aid diagnosis of intestinal acariasis . Further, Li  suggested the broad-spectrum antiparasitic drug ivermectin as the first choice for treatment of human intestinal acariasis .
Oral mite anaphylaxis (Pancake Syndrome)
In 1993, Erben et al. observed the first case of systemic anaphylaxis to mite-contaminated foods; the patient was treated with 0.3 mL of 1:1000 subcutaneous epinephrine, 75 mg oral diphenhydramine, and 40 mg of prednisone, and the symptoms gradually subsided over 90 minutes . Later reports have described similar findings [48–54]. The name Pancake Syndrome derives from the commonality of patients being infected by mite-contaminated flour products. Indeed, a recent report by Takahashi et al. summarized 36 cases with oral mite anaphylaxis in Japan. Of those, 34 had ingested okonomiyaki or takoyaki, Japanese pancakes prepared at home using mixes that were previously opened and stored for months at ambient temperature. Microscopic examination of those mixes revealed contamination with mites such as Dermatophagoides farinae, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus.
Matsumoto et al. indicated that two cases who developed systemic anaphylaxis shortly after eating food contaminated by a storage mite, Tyrophagus putrescentiae, were sensitive to storage mites but not to food allergens . Similarly, Blanco et al. investigated sixteen patients with respiratory allergies to dust mites and reported three of six food challenges with contaminated flours resulted in systemic reactions. Microscopic examination of four flours implicated in allergic reactions revealed a high degree of mite contamination: Dermatophagoides farinae in one case and Thyreophagus entomophagus in three cases . Other reports identified Blomia freemani and Thyreophagus entomophagus in wheat flour as the source of anaphylaxis [51, 57]. Thus, ingestion of foods contaminated with mites may induce systemic anaphylactic reactions in patients with respiratory allergy to mites . Systemic anaphylaxis can occur after the ingestion of heated or unheated mite-contaminated foods, and the most common symptoms are breathlessness, angioedema, wheezing, and rhinorrhea, beginning between 10 and 240 minutes after eating .
Urinary acariasis results from the presence of mites in the human urinary system. The first report of mites detected in human urine was published in 1938. These mites were identified as Histiogaster of the Tyroglyphidae family of storage mites . Since then, other cases of urinary acariasis have been reported [59, 60]. One report described 7 cases with primary infection, pyelonephritis, and pyelocystitis resulting from numerous mites in the urinary sediment and, in some cases, also their eggs—some of which were motile, others were encrusted with salts . One report indicated that, in a case with a few mite eggs in the urine, a six-legged mite larva emerged after the eggs were squashed on the slide. The authors suggest that the possibility of gut or bladder mite infection should be entertained only after repeated identification of mites in urine or stool samples from a symptomatic patient with no other cause for the symptoms and where the possibilities of contamination and spurious infection have been excluded .
Interestingly, a study in China of a sampling of individuals across different occupations indicated that 3.46% (69/1994) of urine samples contained adults, larvae, or eggs of mites . Mites can damage urethral epithelia because they are good at digging. Furthermore, they can also invade loose connective tissue and small blood vessels in the urinary tract and cause localized ulcers. Undoubtedly, mites detected in urine under a microscope would contribute to diagnosis of this disease. Both chloroquine and metronidazole produce good responses for human urinary acariasis . However, the pathogenesis of urinary acariasis remains uncertain.
Less commonly, otoacariasis—or mite infestation in the ear—has been described. Mites were observed on the crusts taken from the radical mastoidectomy cavity and on the earwax from the external auditory canal of a female peasant in China; nearly all stages of the life cycle of the parasite were observed . Similarly, a 70-year-old man in Taiwan presented with a 2-month history of pruritus and a sense of fullness in the right ear, and otoscopic examination revealed a number of mites and mite eggs in the right external auditory canal, which were identified as the house dust mite Dermatophagoides pteronyssinus. This patient was treated with eardrops containing triamcinolone, nystatin, neomycin and gramicidin. Finally, in Thailand the external auditory canal of a 57-year-old woman was infested with >20 mites .
In what is probably a similar mechanism to that for urinary acariasis, mites can parasitize the vagina. Chang et al. described two cases of vaginal acariasis whose main symptoms were vaginal itching, increased leukorrhea, low back pain, abdominal pain, and a sensation of abdomen falling. Microscopic examination detected mites on leukorrhea smears . Both patients were treated with metronidazole (3 times every day), which resulted in resolution of the infection.
Domestic mites receive a lot of research and clinical attention because of their known allergenicity. However, their parasitic activities in humans are often overlooked. Given the existing reports, it seems likely that most cases of acariasis occur in more tropical climates and in people with occupational exposures to mites. The potential remains, though, that cases of acariasis go undiagnosed in other temperate climates. Considering the potential for misdiagnosis of acariasis, more effort should be devoted to understanding these infections, recognizing the populations most at-risk for infection, raising awareness among physicians for potential diagnosis, and identifying the best treatment options for each type of infection. This review highlights what is known about mites as human parasites, while also making clear that more work needs to be done to shed light on the occurrence of mite invasion and its associated symptoms.
Fang W, Cui YB: A survey of stored product mites of traditional Chinese medicinal materials. Pan-Pac Entomol. 2009, 85: 174-181. 10.3956/2007-42.1.
Cui YB, Li CP, Wang J, Yang QG, Tian Y: Acaroid mites (Acari: Astigmata) in Chinese medicinal herbs. Ann Trop Med Parasitol. 2003, 97: 865-873. 10.1179/000349803225002651.
Wong SF, Chong AL, Mak JW, Tan J, Ling SJ, Ho TM: Molecular identification of house dust mites and storage mites. Exp Appl Acarol. 2011, 55: 123-133. 10.1007/s10493-011-9460-6.
Sander I, Zahradnik E, Kraus G, Mayer S, Neumann HD, Fleischer C, Brüning T, Raulf-Heimsoth M: Domestic mite antigens in floor and airborne dust at workplaces in comparison to living areas: a new immunoassay to assess personal airborne allergen exposure. PLoS One. 2012, 7: e52981-10.1371/journal.pone.0052981.
Cui Y, Zhou P, Peng J, Peng M, Zhou Y, Lin Y, Liu L: Cloning, sequence analysis, and expression of cDNA coding for the major house dust mite allergen, Der f 1, in Escherichia coli. Braz J Med Biol Res. 2008, 41: 380-388.
Cui Y, Zhou Y, Ma G, Yang L, Wang Y, Shi W: Cloning, bioinformatics analysis, and expression of the dust mite allergen Der f 5 of Dermatophagoides farinae. Braz J Med Biol Res. 2012, 45: 746-752. 10.1590/S0100-879X2012007500077.
Cui Y, Zhou Y, Shi W, Ma G, Yang L, Li L: Molecular cloning, expression, sequence analyses of dust mite allergen Der f 6 and its IgE-binding reactivity with mite allergic asthma patients in southeast China. Mol Biol Rep. 2012, 39: 961-968. 10.1007/s11033-011-0822-2.
Cui YB, Zhou Y, Wang N, Teng FX, Yu LL, Bian YH, Song JX, Yang L, Zhang CB: Expression, cloning, and IgE-binding of the full-length dust mite allergen Der f 8. Immunol Res. 2014, Epub ahead of print PMID 24838264
Cui Y, Zhou Y, Ma G, Shi W, Yang L, Wang Y: Establishment of two novel ELISA methods for Dermatophagoides farinae-specific IgE detection with recombinant group 2 allergen. Ann Clin Lab Sci. 2012, 42: 392-396.
Cui YB, Cai HX, Zhou Y, Gao CX, Shi WH, Yu M, Li L: Cloning, expression, and characterization of Der f 7, an allergen of Dermatophagoides farinae from China. J Med Entomol. 2010, 47: 868-876. 10.1603/ME09180.
Cui YB, Cai HX, Li L, Zhou Y, Gao CX, Shi WH, Yu M: Cloning, sequence analysis and expression in E. coli of the group 3 allergen of Dermatophagoides farinae. Chin Med J (Engl). 2009, 122: 2657-2661.
Cui Y, Peng J, Zhou P, Peng M, Qian S: Bioinformatics studies on the group 2 allergens of Dermatophagoides farinae from China. Asian Pac J Allergy Immunol. 2007, 25: 199-206.
Cui Y: Immunoglobulin E-Binding Epitopes of Mite Allergens: From Characterization to Immunotherapy. Clin Rev Allergy Immunol. 2013, Epub ahead of print PMID 24218295
Cui Y: Structural biology of mite allergens. Mol Biol Rep. 2013, 40: 681-686. 10.1007/s11033-012-2108-8.
Cui YB, Zhou Y, Shi W, Ma G, Yang L, Yungang W: Cloning, expression, and analysis of the group 2 allergen from Dermatophagoides farinae from China. Ann Braz Acad Sci. 2010, 82: 1-11. 10.1590/S0001-37652010000100001.
Cui YB, Gao CX, Zhou Y, Peng M, Lin Y, Peng JL: Phylogenetic analysis of house dust mites. Central European J Med. 2010, 5: 69-74. 10.2478/s11536-009-0106-6.
Derewenda U, Li J, Derewenda Z, Dauter Z, Mueller GA, Rule GS, Benjamin DC: The crystal structure of a major dust mite allergen Der p 2, and its biological implications. J Mol Biol. 2002, 318: 189-197. 10.1016/S0022-2836(02)00027-X.
Wen TH: Non-specific mite infestation. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2005, 23: 374-378.
Carter HF, Wedd G, D’Abrera VSE: The occurrence of mites (Acarina) in human sputum and their possible significance. Indian Med Gaz. 1944, 79: 163-168.
Wilson HT: Tropical eosinophilia in East Africa. Br Med J. 1947, 1: 801-804. 10.1136/bmj.1.4509.801.
Gao JM, Liu MH, Wei BX: A case of mites in patients with respiratory disease and observation on its life cycle and resistance. China Med J. 1956, 30: 1048-1052.
Ryu JS, Ree HI, Min DY, Ahn MH: A human case of house dust mite Tarsonemus floricolus collected from sputum. Korean J Parasitol. 2003, 41: 171-173. 10.3347/kjp.2003.41.3.171.
Martinez-Giron R, van Woerden HC, Ribas-Barcelo A: Experimental method for isolating and identifying dust mites from sputum in pulmonary acariasis. Exp Appl Acarol. 2007, 42: 55-59. 10.1007/s10493-007-9076-z.
van Woerden H: Dust mites living in human lungs–the cause of asthma?. Med Hypotheses. 2004, 63: 193-197. 10.1016/j.mehy.2004.02.047.
Li CP: An epidemiological survey of pulmonary acariasis in different occupations. Chin Occup Med. 2000, 27: 23-25.
Zhao YQ, Zhen TM, Cheng P, Deng XL, Sun CH, Wang HW, Wang JX: Investigation and control of pulmonary acariasis pathogeny and its epidemic status. Chin J Hygienic Insecticides Equipments. 2007, 13: 435-438.
Zhao YQ, Deng XL, Zhen TM, Cheng P, Sun CH, Gong MQ, Wang HW, Wen GX, Qou JX, Wang HF, Liu LJ: Pathogeny and epidemic status of pulmonary acariasis of Shandong Province, China. J Pathogen Biol. 2009, 4: 43-45.
Zhang XL, Liu JM, Zhang MS, Xia LZ, Xia LL: A survey on etiology and epidemiology of human pulmonary acariasis in Shenzheng City. Chin J Parasitic Dis Control. 1993, 6: 236-237.
Wang HH, Zhao FH, Wang DQ, Zhao GJ, Cheng WC: Epidemiological survey on pulmonary acariasis in different occupations. Chin J Parasit Dis Con. 2003, 16: 1-
Liu YC, Guo YH: Progress in pulmonary acariasis. Chin J Parasitic Dis Control. 1997, 10: 307-308.
Li CP, Chen XB: Progress in human pulmonary acariasis. Acta Academiae Medicinae Bengbu. 1986, 11: 56-60.
Liu H, Ning YQ: 18 cases of pulmonary acariasis. Anthol Med. 2001, 2001: 4-
Chen XB, Sun X, Hu S: Clinical features of human pulmonary acariasis and its treatment. Clin Med Sci. 1991, 11: 101-102.
Li CP, Liang G: A summary of symptoms of human pulmonary acariasis and its treatment. J Qiqihar Med Coll. 1991, 12: 177-179.
Chen XB, Zhang SF, Sun X, Hu SF, Yao M, Guo CL: Pathological observation of experimental pulmonary acariasis. J Bengbu Med Coll. 1990, 15: 179-182.
Hinman E, Kampmeier RH: Intestinal acariasis due to Tyroguphas longior Gavais. Amer J Trop Med. 1934, 1934: 355-
Martinez Maranon R, Hoffmann A: 3 cases of human intestinal mite infestation in the South of Veracruz. Rev Invest Salud Publica. 1976, 36: 187-201.
Zhou HF: Carpoglyphus lactis and intestinal acariasis. Jiangsu Medical Journal. 1986, 12: 44-
Li CP, Wang J: Intestinal acariasis in Anhui Province. World J Gastroenterol. 2000, 6: 597-600.
Zhao XQ: A case of intestinal acariasis. Jiangsu Med J. 1984, 10: 29-
Li CP, Wang KX, Xu GX, Li L, Wang J, Li ZD: An epidemiological survey of intestinal acariasis. Chines J Parasitol Parasitic Dis. 1996, 14: 63-65.
Scala G: House-dust mite ingestion can induce allergic intestinal syndrome. Allergy. 1995, 50: 517-519. 10.1111/j.1398-9995.1995.tb01189.x.
Uga S, Kimura D, Kimura K, Margono SS: Intestinal parasitic infections in Bekasi district, West Java, Indonesia and a comparison of the infection rates determined by different techniques for fecal examination. Southeast Asian J Trop Med Public Health. 2002, 33: 462-467.
Werneck JS, Carniato T, Gabriel A, Tufik S, Andrade SS: Mites in clinical stool specimens: potential misidentification as helminth eggs. Trans R Soc Trop Med Hyg. 2007, 101: 1154-1156. 10.1016/j.trstmh.2007.07.006.
Zhang RB, Huang Y, Li CP, Cui YB: Diagnosis of intestinal acariasis with avidin-biotin system enzyme-linked immunosorbent assay. World J Gastroenterol. 2004, 10: 1369-1371.
Li CP: Treatment of human intestinal acariasis. World Chinese J Digestol. 2000, 8: 919-920.
Erben AM, Rodriguez JL, McCullough J, Ownby DR: Anaphylaxis after ingestion of beignets contaminated with Dermatophagoides farinae. J Allergy Clin Immunol. 1993, 92: 846-849. 10.1016/0091-6749(93)90062-K.
Castillo S, Sanchez-Borges M, Capriles A, Suarez-Chacon R, Caballero F, Fernandez-Caldas E: Systemic anaphylaxis after ingestion of mite-contaminated flour. J Allergy Clin Immunol. 1995, 95: 304-
Matsumoto T, Hisano T, Hamaguchi M, Miike T: Systemic anaphylaxis after eating storage-mite-contaminated food. Int Arch Allergy Immunol. 1996, 109: 197-200. 10.1159/000237220.
Sanchez-Borges M, Capriles-Hulett A, Fernandez-Caldas E, Suarez-Chacon R, Caballero F, Castillo S, Sotillo E: Mite-contaminated foods as a cause of anaphylaxis. J Allergy Clin Immunol. 1997, 99: 738-743. 10.1016/S0091-6749(97)80005-X.
Wen DC, Shyur SD, Ho CM, Chiang YC, Huang LH, Lin MT, Yang HC, Liang PH: Systemic anaphylaxis after the ingestion of pancake contaminated with the storage mite Blomia freemani. Ann Allergy Asthma Immunol. 2005, 95: 612-614. 10.1016/S1081-1206(10)61027-7.
Hara A, Fukahori S, Nakata H, Fukushima C, Matsuse H, Kohno S: A case of anaphylaxis caused by mite-contaminated Okonomi-yaki. Arerugi. 2006, 55: 574-577.
Tay SY, Tham E, Yeo CT, Yi FC, Chen JY, Cheong N, Chua KY, Lee BW: Anaphylaxis following the ingestion of flour contaminated by house dust mites–a report of two cases from Singapore. Asian Pac J Allergy Immunol. 2008, 26: 165-170.
Adachi YS, Itazawa T, Okabe Y, Higuchi O, Ito Y, Adachi Y: A case of mite-ingestion-associated exercise- induced anaphylaxis mimicking wheat-dependent exercise-induced anaphylaxis. Int Arch Allergy Immunol. 2013, 162: 181-183. 10.1159/000351778.
Takahashi K, Taniguchi M, Fukutomi Y, Sekiya K, Watai K, Mitsui C, Tanimoto H, Oshikata C, Tsuburai T, Tsurikisawa N, Minoguchi K, Nakajima H, Akiyama K: Oral mite anaphylaxis caused by mite-contaminated okonomiyaki/ pancake-mix in Japan: 8 case reports and a review of 28 reported cases. Allergol Int. 2014, 63: 51-56. 10.2332/allergolint.13-OA-0575.
Blanco C, Quiralte J, Castillo R, Delgado J, Arteaga C, Barber D, Carrillo T: Anaphylaxis after ingestion of wheat flour contaminated with mites. J Allergy Clin Immunol. 1997, 99: 308-313. 10.1016/S0091-6749(97)70047-2.
Iglesias-Souto J, Sanchez-Machin I, Iraola V, Poza P, Gonzalez R, Matheu V: Oral mite anaphylaxis by Thyreophagus entomophagus in a child: a case report. Clin Mol Allergy. 2009, 7: 10-10.1186/1476-7961-7-10.
McCulloch AE: Acariasis of the Urinary Tract Caused by Histogaster. Can Med Assoc J. 1938, 38: 351-352.
Blazquez A, Bellvert F: Vesical infestation by mites. Arch Esp Urol. 1962, 16: 37-40.
Fossati C: on a Case of the Presence of Acarids in Urinary Sediment. Acta Med Ital Med Trop Subtrop Gastroenterol. 1963, 18: 219-221.
Pitariu T, Popescu IG, Banescu O: Acarids of pathological significance in urine. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Bacteriol Virusol Parazitol Epidemiol. 1979, 24: 55-59.
Dini LA, Frean JA: Clinical significance of mites in urine. J Clin Microbiol. 2005, 43: 6200-6201. 10.1128/JCM.43.12.6200-6201.2005.
Li CP, Cui YB, Wang J, Yang QG, Tian Y: Acaroid mite, intestinal and urinary acariasis. World J Gastroenterol. 2003, 9: 874-877.
Liu AQ, Jing WD, Li F: Infestation and multiplication of Acarids in the radical mastoidectomy cavity and the external auditory canal (a case report). J Bethune Medical University. 1985, 11: 97-99.
Liao EC, Chang KC: Images in clinical medicine. Mites in the external auditory canal. N Engl J Med. 2012, 367: e19-10.1056/NEJMicm1010983.
Samung Y, Apiwathnasorn C, Wonglakorn S, Phayakkaphon A: The first reported case of mites, Suidasia pontifica, in the external ear canal of a Thai agricultural worker. J Trop Mol Parasitol. 2006, 29: 65-67.
Chang DP, Hu XY, Yu NC: Two cases of vaginal acariasis. People’s Military Surgeon. 1998, 41: 117-
This work was supported by National Sciences Foundation of China (NSFC 30060166, NSFC81001330, NSFC31272369).
The author declares that He has no competing interest.
About this article
Cite this article
Cui, Y. When mites attack: domestic mites are not just allergens. Parasites Vectors 7, 411 (2014). https://doi.org/10.1186/1756-3305-7-411
- Human acariasis
- Pulmonary acariasis
- Intestinal acariasis
- Urinary acariasis
- Oral mite anaphylaxis (Pancake Syndrome)
- Vaginal acariasis