Extensive gingival myiasis - Diagnosis, treatment, and prevention

Abstract

Myiasis is a rare disease primarily caused by infestation of tissue by larvae of houseflies. Oral myiasis is still more “rare” and “unique” owing to the fact that oral cavity rarely provides the necessary habitat conducive for a larval lifecycle. Here we report a case of extensive gingival myiasis, in an 81-year-old female patient, diagnosed and treated successfully in our department. The case is discussed in relation to its clinical presentation, etiopathogenesis, management, and prognosis.

Oral Myiasis Affecting Gingiva in a Child Patient: An Uncommon Case Report

“…The oral myiasis, parasitic infestation of the human, is a rare condition, which mainly occurs in the rural areas. The flies of the order Diptera (maggots) are the main parasites affecting humans [ 1 , 6 ]. The most common causative agent of myiasis is dipteran clade Calyptratae.…”

“…Direct inoculation into wounds and ingestion of infected materials like meat are the two ways causing infestation of the maggots in the humans. For the larval development of these flies, the intermediate host is required and the flies can lay more than 500 eggs at a time directly over the diseased tissue [ 3 , 6 , 12 ]. After the gravid female flies lay eggs in the tissues, the larvae hatch in about 8–10 hours, after which they invade into the surrounding tissues and cause inflammation and discomfort to the patient [ 1 , 6 , 13 ].…”

“…The action of proteolytic enzymes released by the surrounding bacteria causes decomposition of the tissue and helps in the feeding of the maggots [ 3 , 14 ]. Larval growth causes progressive destruction and cavitation and finally forms a fibrous capsule to which they firmly adhere and cause more difficulty in dissection during surgical procedures [ 6 , 15 ]. The burrowing of the larvae causes the separation of the mucoperiosteum from the bone and mild to acute pain.…”

“…The ear, nose, eyes, lungs, skin, anus, and vagina are the most common sites affected in myiasis [ 1 , 5 ]. The oral tissues are not permanently exposed to the external environment and thus the oral cavity rarely provides a favorable environment for the growth of the larvae [ 6 , 7 ]. The predisposing factors like poor oral hygiene, presence of periodontal pockets, open bite in the anterior part, mouth breathing during sleep, ulcerative lesions, and carcinoma can be present in the patients of oral myiasis.…”

Oral myiasis in a maxillofacial trauma patient

“…Male predilection of occurrence has been noted in most literatures because of their more outdoor activities and neglecting the oral hygiene when compared to the female counterpart. [3]…”