Clinical etiology of myiasis in ENT: a reterograde period - interval study

Abstract

Myi asis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. Aims: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence , nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. Materials & methods: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. Results & Conclusions: Atrophic turbinates was the commonest pathological finding in nose in 30% of cases. Significant change seen was in the age group 51 and above with a rise of 30%. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5%. Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.

Nasal myiasis by Chrysomya bezziana

“…2 C. bezziana females lay 150-500 eggs at sites of wounds or in body orifices, which hatch after 18-24 h. Eggs can be inadvertently transferred to other sites by the patient's own fingers. 3 On hatching, maggots penetrate deep into the host tissues. The larvae feed on the host tissue for five to seven days while they complete their development.…”

Maggot Infestation: Various Treatment Modalities

“…The low oxygen levels in the gut usually will kill the maggots, but some survive intact because their outer layers are resistant to digestive enzymes. 4…”

Myiasis of the head-neck region: a grossly underreported entity in the practice of otorhinolaryngology

“…Hope when he reported about this condition in 1840. 1 It is derived from the Greek word "myia" meaning fly and denotes a parasitic infestation of live human or vertebrate animal host by dipterous larvae of flies which feed on host tissues or fluids. 2 It may affect any part of the body including the skin, eyes, nose, ear, anus, vagina and oral cavity.…”

“…3 In the discipline of otolaryngology, the earliest references in the modern medical literature have mostly mentioned about maggot infestation of the nose as it is probably the most commonly involved area of the headneck region. 1 This condition was however known to mankind even in the medieval times and had originally been thought to be a form of divine punishment as noted in Hindu mythological works. It was thought to develop as a result of the sins committed by a person or as a result of the wrath of saints.…”

“…7 Though it said to occur throughout the year, the cases tend to peak in the post-monsoon period between October and December. 1 There is a lot of debate from an entomological point of view regarding the specific species of flies that causes myiasis but a couple of factors appear to play a role a common role in its pathogenesis. 4 Firstly, the presence of fetid discharge from the nose or any other infected area in the body tends to attract the flies.…”