Use of oral ivermectin in a patient with destructive rhino-orbital myiasis

Ectoparasitic infestations are highly prevalent in resource-poor populations throughout the world and are associated with considerable morbidity. Reliable data on the epidemiology, immunology, and therapy of ectoparasitic infestations and on the biology of the parasites remain scarce. The control of parasitic skin diseases, such as scabies, pediculosis, tungiasis, myiasis, and cutaneous larva migrans in endemic areas remains a challenge. Using appropriate study designs, it is imperative to increase further the knowledge on the various aspects of the parasites and the infestations they cause.

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“…Several authors have successfully used oral and topical ivermectin in furuncular as well as cavity myiasis [63,64].…”

Section: Therapymentioning

confidence: 99%

Ectoparasitic infestations

Heukelbach

Walton²,

Feldmeier³

2005

Curr Infect Dis Rep

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“…The most common site for oral myiasis was anterior part of maxilla or the upper lip and associated tissues. Few cases involved the mandible 15,16 and orbital 17 regions.…”

Section: Discussionmentioning

confidence: 99%

Oral Myiasis—A Pauper's Affection: Case Reports and a Review of 62 Cases

Mistry¹,

Mistry²,

Kokal³

2017

Journal of Contemporary Dentistry

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Oral myiasis is a rare disease caused by infestation of larvae of certain dipteran flies. It is reported mostly in developing, tropical countries. The warm and humid climate along with local factors, such as poor oral hygiene and neglect forms a conducive environment for larvae and predisposes toward the disease. This disease often manifests in patients with low socioeconomic backgrounds, debilitating condition, and poor living conditions. Herein, we describe a series of three cases of different presentations of oral and facial myiasis and also discuss the predisposing factors and challenges in the treatment by reviewing a list of 62 cases in recent literature.Through this review and reports, we hope to spread awareness regarding the not so uncommon, but easily preventable disease of oral myiasis and initiate proper research in this neglected section of disease.

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“…3 Use of Ivermectin has also been reported for Ophthalmomyiasis treatment. 4 In extreme cases, the larvae can cause destruction beyond the orbit with mucosal sinuses and intracranial invasion which can be life threatening. In cases of extensive orbital myiasis and those associated with malignancy exenteration may be required to prevent intracranial extension of the tissue destruction.…”

Section: Discussionmentioning

confidence: 99%

Orbital Myiasis

Kanakpur¹

2017

DJO

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A 60 year old female patient presented to the out patient department with complaints of worms crawling out of a wound below the right eye, associated with pain and foul smelling discharge since 2 months. On careful history taking and seeing her old photographs, the patient had a black coloured lesion below the right eyelid since 5 years for which she had applied some herbal medication (Figure 1). On examination of the right orbit, hundreds of maggots were seen crawling out of an ulcerative, foul smelling, fungating lesion, extending from the medial canthus up to the lateral orbital wall involving the floor, measuring about 12x4cm ( Figure 2). The visual acuity of the right eye was 6/60 with a normal anterior segment and fundus. Ocular movements were totally restricted. The left eye was normal. Guaze pieces soaked in medical turpentine oil were placed throughout the lesion and the maggots which crept out were removed manually by forceps (Figure 3). This was done on three consecutive days till the lesion was totally free of maggots. After a week of daily dressing ,the ulcerated lesion healed with granulation tissue (Figure 4). Broad spectrum antibiotics were given. Protein supplements and multivitamin injections were given as the general condition of the patient was very poor. Haematological and biochemical investigations revealed leucocytosis and hypoalbuminemia. Contrast CT of paranasal sinuses and orbit revealed bilateral maxillary, ethmoid and sphenoidal sinusitis, osteomyelitis of right lamina papyracea and right orbital and periorbital cellulitis, but no evidence of intracranial spread ( Figure 5). Biopsy from the margins of the lesion was sent for histopathology. The collected larvae were sent to entomology for identification. Histopathological diagnosis confirmed Basal cell carcinoma (BCC) ( Figure 6) and larvae morphologically resembled oestrus ovis larvae. After consulting the oncosurgeon, wide local excision with exenteration of the right orbit was planned but the patient refused the surgery. DiscussionBCC most frequently arises from the lower eyelid, followed in relative frequency by medial canthus, upper eyelid and lateral canthus. It is a slowly growing, locally invasive

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Use of oral ivermectin in a patient with destructive rhino-orbital myiasis

Cited by 22 publications

References 8 publications

Ectoparasitic infestations

Ectoparasitic infestations

Oral Myiasis—A Pauper's Affection: Case Reports and a Review of 62 Cases

Orbital Myiasis

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