A rare case of digital myiasis

Abstract

Cutaneous myiasis is the infestation of the skin or mucous membranes by larvae of the order Diptera. Wound myiasis affect the skin with a previous lesion, and it may consume both dead and living tissue. Finger infestation is rarely a cause of death, but it may provoke considerable morbidity. Prompt wound exploration and careful total larvae removal is essential to achieve healing. In the reported case, the patient was presented in an advanced stage of the infestation, with a large area of finger necrosis and amputation, associated with cellulitis extending from the finger's base to the hand. This diagnosis helped uncover a familiar history of severe abuse and neglect. The accurate understanding and management of such injuries are important not only for the orthopaedic treatment but also for the acknowledgment of their social and forensic implications.

Myiasis of open great toe fracture wound: a rare case report

“…Living in rural areas, having a low standard of living, being in close proximity to domestic animals, homelessness, psychiatric illness, diabetes, severe handicap, alcoholism, neurological condition, abuse, and negligence are risk factors for human wound myiasis 2 , 5 , 7 , 10 . In our case, the boy from a low socio-economic background but without any other risk factor, did not inform his parents about the open fracture wound of his great toe because of fear of being scolded.…”

“…The possible complications of myiasis are local destruction, invasion into deep tissues, and secondary infection, which could result in amputation of the affected area, especially where obligatory parasites are concerned 2 , 5 , 8 . In our case, the wound was extended to the distal phalanx fracture of the right great toe, which might be the complication of myiasis.…”

“…A case report of a 41-year-old female from Brazil, following a knife injury to the second finger of her left hand was presented after 6 months in an advanced stage of the myiasis, with a large area of finger necrosis and amputation and visible live larvae, associated with cellulitis extending from the finger’s base to the hand. She was treated with surgical excision (metacarpophalangeal disarticulation) and mechanical removal of 132 live maggots 5 .…”

“…It is a well-recognized but serious medical complication of neglected wounds 1 , 3 , 4 . There are very few cases of digital wound myiasis reported till date 5 .…”

Primary Myiasis in Surgical Wound of Mandible Symphisis Fracture

“…Some authors demonstrate the correlation of the disease with several risk factors. Durão et al (2016) reported digital myiasis in a patient with psychiatric disorder [11]; Giri et al (2015) reported cerebral myiasis in a patient which neglected follow-up consultations [12]; Manjunath and Pinto (2018) reported nasal myiasis in a diabetic patient who presented with recurrent myiasis [13]; Antunes et al (2011) reported a case series of 6 patients that presented psychologic or neurological disorder [14]. At the initial clinical examination, we observed extensive dehiscence in the surgical wound, tissue destruction, necrosis, and a large amount of larvae.…”