Treatment of nasal myiasis with ivermectin irrigation

Abstract

We describe a case of nasal myiasis due to in a 97-year-old Peruvian farmer with a previously undiagnosed mucocutaneous leishmaniasis. Initial attempts to remove the fly larvae using manual extraction with a toothed forceps and normal saline irrigation were unsuccessful. On subsequent nasal irrigation with ivermectin solution, the patient self-expulsed approximately 50 larvae within 15 min. He also received a course of oral ivermectin. A post-treatment CT scan revealed clear sinuses. Here, we propose that ivermectin irrigation is a simple and effective treatment for nasal myiasis.

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“…In a particular case, even surgical removal of the larvae might need [15] . Treatment of nasal myiasis includes local and systemic, that ones is complementary to another [10] , [16] . 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] .…”

“…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] .…”

An uncommon intranasal foreign body

“…Furthermore, Ivermectin decreases the risk of complications and remains a therapeutic option that can be used 4 , especially in patients with deep-seated involvement, neurological complications and in cases were local treatments fail to control the disease. 13,14 Good personal hygiene practices, rinsing foods and proper dumpster management are simple and effective preventive measures. Other methods such as adequate sanitation, field management, mosquito nets and repellents can decrease the incidence of emerging cases especially in endemic areas.…”

Propuestas De Quimioprofilaxis Para El Covid 19.

“…La semivida plasmática es 12 horas y la de sus metabolitos tres días. (29) Nitazoxanida (N-[nitrotiazolil] salicilamida)- Antiparasitario sintético oral de amplio espectro al parecer interfiere en la reacción de transferencia electrónica que depende de la enzima PFOR, esencial en el metabolismo anaerobio.  Después de ingerida es hidrolizada rápidamente hasta formar su metabolito activo tizoxanida, La biodisponibilidad después de ingerir una dosis es excelente y en término de 1 a 4 h concentraciones plasmáticas máximas de los metabolitos.…”