Oral myiasis treated with ivermectin: case report

Abstract

Oral myiasis is a rare pathology and a risk to the patient's life. Conventional treatment is mechanical removal of the larvae (maggots) one by one, which is painful, distressing, and embarrassing both to the patient and to the dentist. We present a case report of a patient with cerebral palsy that had oral myiasis treated successfully with ivermectin. The use of this antibiotic in humans, its mechanism of action and indications are discussed.

Furuncular Myiasis Affecting the Lower Lip of a Young Patient

“…Another scheme classifies myiasis as either primary, more commonly seen in cattle, caused by larvae that feed on living tissue. It is produced by Cochliomyia hominivorax that lays hundreds of eggs on exposed wounds, with larvae hatching within 24 h or secondary, which represents the most common type in humans and is caused by flies that feed on dead tissue in patients with necrotic lesions (19,20). However, its classic classification is based on the infested tissue/ organ and includes cutaneous, oral, aural, nasopharyngeal, ocular, intestinal/enteric, rectal and urogenital types (3,4).…”

Ivermectin: enigmatic multifaceted ‘wonder’ drug continues to surprise and exceed expectations

“…A Crump with ivermectin, 51 which has also been used effectively as a noninvasive treatment for orbital myiasis, a rare and preventable ocular morbidity. 52 …”

The Use of Ivermectin in the Adjunct Treatment of Oral Cavity Myiasis

“…U slučaju zakašnjele dijagnoze i većeg broja ličinki, tkivo može biti dosta razoreno, što često zahtijeva kiruršku korekciju. Broj jajašca ličinki smatra se odlučujućim za proširenost lezije (1)(2)(3)(4)(5)(6).…”

“…However, when it happens, it is usually severe and produced by the insect Cochliomya hominivorax ("Blowfly"), which puts from 20-400 eggs on exposed wounds. Larvae outbreak occurs in 24 h. Larvae are ravenous and destroy whole tissues; they can also cause severe bleeding and are a life risk (5,9,10).…”

“…On the whole, larvae destroy vital tissues, leading to severe and even fatal hemorrhages (5). The absence of necrotic areas may eliminate the time of the lesion and therefore the number of larvae.…”