Grub in the mouth: an unusual case with review of literature

Abstract

Oral myiasis is a rare disease, identified primarily in non-industrialised nations. It is caused fundamentally by the attack of larvae from Dipteran flies on the human tissues. Predisposing factors for oral myiasis are extraction wounds, destitute oral cleanliness, meagreness, mouth breathing amid rest, suppurative injuries, necrotic tissues, diabetes and perivascular infections primarily within the elderly, extreme halitosis, alcohol addiction, cerebral paralysis and components that favour prolonged mouth opening. Myiasis may have predilection to patients with mental challenges, cerebral palsy and hemiplegia due to unfortunate physical agility. The present case reports an oral myiasis in a 25-year-old woman who was mentally challenged. This condition was treated by topical application of turpentine oil with manual expulsion of hatchlings, taken after by surgical debridement and wide range antimicrobials.

Oral Myiasis in an Immunocompromised Adult Undergoing Chemotherapy: A Rare Case and Comprehensive Treatment Protocol

“…In this case, even after the complete mechanical removal of the maggots during the patient's first visit, some larvae had developed by the time of the second visit. Hence, we developed a comprehensive treatment protocol [5][6][7][8][9][10][11][12] promoting the stepwise removal of maggots, which also includes a follow-up after one week.…”

“…The standard treatment of the condition is the immediate mechanical removal of the maggots [5][6][7][8][9][10], which can be supported with antiparasitic drugs such as ivermectin 12 mg per day for three days and adjuvant clindamycin 300 mg three times per day for five days in cases with severe tissue defects or cavitated lesions involving a large number of larvae. Local application of turpentine oil should be used in minimal quantities in a controlled manner via small cotton pellets [8], as this treatment can cause tissue irritation to the patient if used in large quantities and should be avoided in patients with poor swallow reflexes.…”