Case Report: Nasal Myiasis in an Elderly Patient with Atrophic Rhinitis and Facial Sequelae of Leprosy

Abstract

We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.

Nasal Maggot Infection in a Patient With Nasal Non-Hodgkin’s Lymphoma

“…The signs and symptoms of nasal myiasis include nasal and/or facial pain, bloody or mucopurulent nasal secretion, epistaxis, foul smell, and anosmia, which are usually related to the presence and movement of the larvae. 13,15 The surfaces of maggots carry some bacteria that may cause nasal and nasopharynx infection. The nasal cavity is close to the sinuses, eyeballs, meninges, and skull.…”

Management of nasal myiasis and type 2 diabetes mellitus: A rare case and review article

“…Treatment of nasal myiasis consisted of mechanical removal of the larvae, surgical debridement, and the administration of broad-spectrum antibiotics [10] . There is no consensus regarding a treatment standard for nasal myiasis but the aim of the treatment is to remove the invading parasites completely [14] . The patient with nasal myiasis needs immediate hospitalization since the larva cannot be removed in a single sitting.…”

“…Systemic treatment includes broad-spectrum antibiotics while local treatment includes application of turpentine oil, ether, chloroform, mineral oil, ethyl chloride, mercuric chloride, creosote, saline, systemic butazolidine, or thiabendazole to remove larvae [11] . Ivermectin or other anthelmintics also may be used in conjunction with endoscopic removal and saline irrigation [14] , [16] .…”

“…This was by the literature stated the disease should be followed up in a shorter time and couple of sittings. Thus, quick and complete eradication of the remaining larvae was possible before it causes irreparable damage to the intranasal tissues [14] , [16] .…”

Rhinomaxillary syndrome in Hansen's disease: a clinical perspective

“…Clinical RMS could provide a standardized method for grading rhino‐maxillofacial alterations in persons affected by HD. This is important for several reasons: (i) delayed presentation means that newly diagnosed cases of HD can have rhino‐maxillofacial bone involvement for which HD treatment has mild or no effect, but corrective surgery might be an option 3 ; (ii) the health and quality‐of‐life of persons affected by HD can be compromised by rhino‐maxillofacial changes 4 ; (iii) the developmental trajectory of osteological changes as a consequence of M. leprae infection is poorly understood and, although multidrug therapy is effective in treating HD, persistent osteoarticular effects of HD‐related chronic or recurrent inflammation cannot be ruled out 5…”