Oral myiasis in a child by the reindeer warble fly larva Hypoderma tarandi

Abstract

We describe a case of human oral myiasis by a first-stage larva of the reindeer warble fly, Hypoderma (Oedemagena) tarandi (L.) (Diptera: Oestridae), in a 12-year-old girl. In September the patient complained of erythema, swelling and conjunctivitis of the right eyelid. Symptoms subsided spontaneously but re-occurred in October. In December she presented with acute swelling of the right corner of the mouth. Later that day a living larva protruded from this swelling. The patient had been on vacation in Norway during the previous summer months.

Arthropods affecting the human eye

“…in Spain occurred in children who spent time in rural areas (Martinón et al, 1974). Case reports also suggested that infections by H. tarandi are more frequent in tourists on holidays in Northern Scandinavia than in Sami reindeer herders or in local populations from reindeer breeding areas (Faber and Hendrikx, 2006). Whether this observation is a consequence of the lack of referral to medical authorities or to the development of protective immune responses in these populations (Kearney et al, 1991;Kan et al, 2010), remains to be elucidated.…”

“…Self-cure from Hypoderma spp. larvae (i.e., abortive infection), has also been reported (Faber and Hendrikx, 2006). Immunological tests may assist indirect diagnoses.…”

“…The occurrence of OM throughout the summer months has also been associated to the habit of people to sunbathe in gardens, or next to swimming pools or beaches (Corrin et al, 1985;Stevens et al, 1991;Brisou and Menard, 2000). Indeed, most cases of human hypodermosis occur in children on holidays in the countryside (Martinón et al, 1974;Faber and Hendrikx, 2006). The age of patients may also represent a predisposing factor for IOM caused by Hypoderma spp., which has been reported as a paediatric disease, mostly affecting children between 2 and 13 years of age (Smith and Greaves, 1946), likely as a consequence of their thinner sclera (Ziemianski et al, 1980).…”

Flies and the mouth

“…Therefore, these diseases should be included in the differential diagnosis of severe oral myiasis. The number of maggots can range from one to several hundred, depending on the stage of the infection and the infective species (Figures ) …”

“…The number of maggots can range from one to several hundred, depending on the stage of the infection and the infective species (Figures 1-3). 24,27,28…”