An unusual case of myiasis

Abstract

Myiasis-the feeding of fly larvae on living mammals, may have various clinical presentations depending on the tissues or organs involved. Myiasis is a common travel associated skin disorder as a consequence of short visits to developing countries. It is the fourth most common travel associated disease. The most common clinical manifestations of fly larvae infestation include inflammatory and allergic reactions. Ear, eye and respiratory tract infestations are not uncommon and the human botfly Dermatobia hominis is the most recognised causative organism. We present an unusual case report of a myiasis in the upper lip of a patient admitted under the maxillofacial team at South Manchester Hospital.

Myiasis

“…Clinical and radiologic confusion with arteriovenous (AV) malformation and hemangioma occurred in one case of preauricular myiasis (43). Pain, erythema, itchiness, small vesicles, and crusting may pose a differential diagnosis of herpes simplex (234).…”

Furuncular Myiasis Affecting the Lower Lip of a Young Patient

“…An important clinical sign of furuncular myiasis is a serosanguineous or seropurulent drainage from the central pore of the nodule, containing the caudal respiratory spiracle of the larvae (2,3,13). This clinical parameter was present in the current case and is useful to distinguish furuncular myiasis from other entities that present a yellowish secretion like epidermal cyst (keratin component) and infected hair follicle (purulent secretion).…”

“…On the other hand, furuncular myiasis may affect intact skin of healthy patients, causing a small, raised, reddish, bite-like lesion that evolves into an enlarging, pruritic, erythematous, tender nodule, associated with a sensation of movement and intermittent pain (10). Furuncular myiasis is widely described in both the dermatologic and infectious disease literature; however, very few cases previously described in English language literature of furuncular myiasis were found affecting the perioral region, involving mostly the upper lip, with no reports found for the lower lip (13,14). Furuncular myiasis is caused by various species of flies, usually distinguished by their different life cycles.…”

“…One day after the larval deposition, a small slightly reddened papule appears, and a few weeks later it expands into a dome-shaped itching and tingling nodule (8,9,13). An important clinical sign of furuncular myiasis is a serosanguineous or seropurulent drainage from the central pore of the nodule, containing the caudal respiratory spiracle of the larvae (2,3,13).…”

“…On the other hand, very few cases of furuncular myiasis caused by Dermatobia hominis in the oral and perioral regions are currently available in English language literature (13,14). Recognizing this condition in this uncommon anatomic location is very important to appropriately distinguish it from other more common differential diagnoses.…”