Nasipharyngeal Myiasis in a 60-year-old female at Chandan Hospital Lucknow

Nasipharyngeal Myiasis Treatments

Abstract Myiasis has been defined as an infestation on humans and vertebrate animals by larvae of insects, which feed themselves, for certain time, on living or dead tissues from the host or on fluid substance. The presence of larvae in the nasal cavity is called ‘Nasipharyngeal Myiasis’, which, although uncommon. Most of the cases occur in developing countries where sanitation is a public health problem. The most common cases occur during summer and in tropical climate areas due to the fact that the larvae need warm temperature to incubate. Here, we report a case of Nasipharyngeal Myiasis in a 60-year-old female, from the remote area of UP. The presence of larvae in the nasal cavity was diagnosed, which confirms it as a case of ‘Nasipharyngeal Myiasis’.

1. Introduction Nasipharyngeal Myiasis is an infestation of the skin by developing larvae (maggots) of a variety of fly species (myia is Greek for fly) within the arthropod order Diptera. Worldwide, the most common flies that cause the human infestation are Dermatobia hominis (human botfly) and Cordylobia anthropophaga (tumbu fly). In Nasopharyngeal Myiasis, the nose, sinuses, and pharynx are involved. Ophthalmomyiasis affects the eyes, orbits, and periorbital tissue, and intestinal and urogenital myiasis involves invasion of the alimentary tract or urogenital system. Myiasis from some types of larvae can be useful to the host because they help on necrotic tissue extraction. That is why larvae were used to therapeutic removal of wounds. Therefore, such larvae can lead to more complicated situations when they infect areas such as eyes, nose and ears. This case is of a female patient who had the presence of larvae in her nasal cavity; the patient was from remote area of UP, which made the diagnosis of Nasopharyngeal Myiasis more relatable as most of the cases occur in developing countries where sanitation is a public health problem. The most common cases occur during summer and in tropical climate areas due to the fact that the larvae need warm temperature to incubate.

2. Case History A 60 yrs old lady from the remote area of UP, was reported to Chandan Hospital, Lucknow, India, with the chief complaint of the presence of larvae in her nasal cavity. The patient was admitted in the hospital in isolation ward under Dr. Priyanjal Gautam. Multiple maggots were present in her nasal cavity and Nasopharynx. A provisional diagnosis of Nasopharyngeal Myiasis was given based on the clinical findings.

3. Management A rare case of Nasipharyngeal Myiasis was reported in a 60 yrs old lady from the remote area of UP. The patient (Mrs. Murti Devi) admitted in the hospital in isolation ward under Dr. Priyanjal Gautam. Soon after her admission, thorough examinations were performed and Anterior Rhinoscopy revealed multiple maggots present in her nasal cavity and Nasopharynx. She was then given Antibiotic treatment and was managed conservatively and as a result she became completely maggots free. After few days of treatment she was discharged in a satisfactory condition and was advised to stay in consultation.

4. Conclusion Nasipharyngeal Myiasis, many times, besides specific therapy to eliminate the larvae, also requires surgery approach to comprehensive removal of the paranasal sinus. Endoscopic surgery helps on visualization and surgery in such cases. Preventive procedures are also important in order to improve care with necrotic wounds and with environment where patient lives.

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