Maggots In Oral Cavity (Oral Myiasis): A Case Report

Oral myiasis is a relatively rare and uncommon clinical condition arising from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. This condition may be observed in suppurative oral lesions, alcoholism, senility and also maintaining poor oral hygiene by patients during orthodontic treatment, invasion and growth of larvae during and after maxillofacial injuries. The current article presents with management of oral myiasis during orthodontic treatment, and in oral and maxillofacial injuries.

Furuncular myiasis by Wohlfahrtia magnifica (Diptera: Sarcophagidae) in a healthy child

Rationale: Human myiasis is the invasion of tissue or organs by fly larvae. This could be obligatory, facultative, or accidental. Patient concerns: A 4-year-old Saudi boy complained of fever over the past three days with multiple inflamed painful dermal furuncles and worms-like discharge. Diagnosis: Furuncular obligatory myiasis caused by Wohlfahrtia magnifica. Interventions: Maggots were removed for identification. The wounds were cleaned with antiseptic dressings. Topical and oral antibiotics were applied. Outcomes: Seven days later, the wounds completely healed. Lessons: Although several reports correlated human myiasis with old age, low health status, mental retardation, and low socioeconomic status, but the patient in our case was a healthy child from a family with good socioeconomic status, good hygiene, no history of diseases or mental disability, but traveled to a village where the climate is suitable for fly breeding.

Effects of Layered Clothing on the Post-mortem Decomposition of Rat Carcasses on Grass Bushes and Dead Leaves (Kesan Pakaian Berlapis Terhadap Penguraian Postmortem Bangkai Tikus di atas Dedaun Rumput yang Telah Mati) / Jurnal Sains Kesihatan Malaysia

@#A post-mortem decomposition is defined by the evaluation of the physical and chemical changes of a cadaver or a carcass in order to estimate the cause of death and the time of death. The purpose of this study is not to replicate a real crime scene but to enhance knowledge of the effects of clothing in a decomposition process, mainly, the effects of layered cotton clothing on the post-mortem decomposition of adult female rat carcasses. Fifteen rats were divided into three groups: control, one-layered and two-layered clothed. The control subjects were unclothed and used to compare the post-mortem changes with the clothed subjects, one-layered and two-layered rat carcasses. All subjects were placed outdoor, 2.5 meters away from each other on grass bushes and dead leaves. Ambient temperature and humidity were recorded to observe if it associates with the post-mortem changes of the rats. Insect activity on each subject was observed. Post-mortem changes were measured using the Total Body Score system. The results showed that the control group underwent a faster decomposition compared to the clothed groups. The different layers of clothing did not show a vast difference in post-mortem changes. The ambient temperature of 28°C influences the post-mortem decomposition. The decomposition was rapid under the dominance of maggots compared to ants as ant colonies delayed the decomposition process. The study gave the knowledge of the effect of clothing in decomposition of female rats in forensic science.

Nasal myiasis presented with palatal perforation: a Case report

Myiasis is rare disease of nose. In this case report we present a 47 years female with nasal myiasis along with palatal perforation which was managed conservatively with antibiotics, manual removal of maggots and planned for closure of oro-nasal fistula later. Later on the bleeding was gradually controlled. Patient was advised for imaging of nose and paranasal sinuses. The imaging showed soft tissues densities in the bilateral nasal cavity with erosion of nasal septum, hard palate and soft palate with oronasal fistula formation.

Umbilical Myiasis – A Rare Case In Rohilkhand Region Of Uttar Pradesh.

Myiasis is an infection of live mammalian tissue by the larval forms of dipteran flies, usually infects domestic and wild animal but human may be affected sometimes. Although adult cases have been reported, neonatal myiasis is a rare condition. Umbilical myiasis is very rare in newborns with few reported cases in the literature.

Ultra Structure of the Mid-Gut of the Third Instar Larvae of Sarcophaga Aegyptiaca (Diptera: Sarcophagidae).

The mid-gut of third instar larvae of Sarcophag aegyptiaca was divided into anterior, middle and posterior mid-gut regions. A well-developed peritrophic membrane appeared in the apical part of the anterior and middle portions of mid-gut while it is absent from the posterior portion. The microvilli differs in 3 portions, appeared as apical membrane in the anterior portion, sparse in middle portion to long slender compact microvilli in posterior portion. Numerous organelles were observed throughout the cytoplasm of the 3 portions; lipid spheres, rough endoplasmic reticulum, seceretory vesicles and mitochondria. A large apically nucleus appeared in the 3 portion of mid-gut. A basal labyrinth was observed in both anterior and posterior regions of mid-gut while it was absent in middle portion of mid-gut. Thin basement membrane was observed in the 3 portions of mid-gut of third instar larvae of Sarcophag aegyptiaca.

Effectiveness of bone cleaning process using chemical and entomology approaches: time and cost

Skeletal examination is an important aspect of forensic pathology practice, requiring effective bone cleaning with minimal artefact. This study was conducted to compare between chemical and entomology methods of bone cleaning. Ten subjects between 20 and 40 years old who underwent uncomplicated medico-legal autopsies at the Institute of Forensic Medicine Malaysia were randomly chosen for this descriptive cross sectional study. The sternum bone was divided into 4 parts, each part subjected to a different cleaning method, being two chemical approaches i.e. laundry detergent and a combination of 6% hydrogen peroxide and powder sodium bicarbonate and two entomology approaches using 2nd instar maggots of Chrysomyia rufifacies and Ophyra spinigera. A scoring system for grading the outcome of cleaning was used. The effectiveness of the methods was evaluated based on average weight reduction per day and median number of days to achieve the average score of less than 1.5 within 12 days of the bone cleaning process. Using maggots was the most time-effective and costeffective method, achieving an average weight reduction of 1.4 gm per day, a median of 11.3 days to achieve the desired score and an average cost of MYR 4.10 per case to reach the desired score within 12 days. This conclusion was supported by blind validation by forensic specialists achieving a 77.8% preference for maggots. Emission scanning electron microscopy evaluation also revealed that maggots especially Chrysomyia rufifacies preserved the original condition of the bones better allowing improved elucidation of bone injuries in future real cases.

Invasive intestinal myiasis in a young male presenting as fungating rectal mass: An unusual presentation.

Intestinal myiasis is usually an accidental phenomenon which is transient and asymptomatic. It occurs due to intake of contaminated food or water containing fly larvae or eggs. We report a case of invasive intestinal myiasis presenting with complaint of pain, blood-mixed mucous discharge per rectum along with passage of maggots in stool. On proctoscopy an irregular fungating rectal growth with maggots was detected in rectum and anal canal. Excision of growth with diversion colostomy was done. On histopathology numerous variable-sized larvae in different stages of development were detected throughout the inflamed and necrosed bowel wall. No tumor was seen. With maintenance of proper hygiene, vermicide anti inflammatory and purgatives were given. Patient became alright after colostomy closure. The symptomatic presentation as a mass lesion and necessity for surgical intervention prompted us to report this rare case.

Flies blown disease - Oral myiasis.

Myiasis, a term first introduced by Hope (1840), refers to the invasion of tissues and organs of animals and human wounds and certain body cavities by the dipteran larvae which manifests as subcutaneous furunculoid or boillike lesions. Oral myiasis is a rare pathology and a risk to the patient's life. Higher incidence is seen in rural areas affecting the tropical and sub-tropical zones of Africa and America. Myiasis affecting the oro-dental complex is rare. Here is a case report of oral myiasis in an 18-year-old male patient who is mentally challenged with anterior open bite, incompetent lips, and periodontal disease. The lesion was treated with turpentine oil, which forced larvae out and irrigated with normal saline solution. Follow-up examination revealed complete remission and healing of the lesion.

Efficacy of maggot debridement therapy in the treatment of diabetic foot ulcers / 中华内分泌代谢杂志

Maggot debridement therapy(MDT)and conventional therapy were applied to diabetic foot ulcers(DFUs)with Wagner 2-4 respectively. The results showed that the prognosis was better in MDT group than in conventional therapy group. The reduction of circumference, square and volume of DFUs, healing rate of DFUs, decrease in number of bacterial species, and cost of antibiotics were all improved in the former group. The results suggest that MDT offers a fresh and effective method in the treatment of DFUs.

Oral Myiasis - A Case Report.

Myiasis is the invasion of the tissues and organs of human beings by fly larvae. This phenomenon is well documented in the skin, especially among animals and people in poorly developed and developing countries. When the tissues of oral cavity are invaded by the parasitic larvae of flies, the condition is called as oral Myiasis. It is a rare condition caused by several species of dipteran fly larvae and may be secondary to serious medical and dental conditions. We here by report a rare case of oral myiasis involving the palate in a 43yrs old female non diabetic patient with mouth breathing and poorly debilitated with compromised periodontal condition and discussing the management of the same.

Surgical Maggots

Surgical maggots have been used successfully for wound debridement over the past millennium. At Johns Hopkins University in 1929, Baer introduced maggots into the wounds of 21 patients with chronic intractable osteomyelitis. The development of methicillin-resistant Staphlococcus aureus has been a major impetus to resurgent interest in maggot debridement. In January of 2004, the US Food and Drug Administration gave Dr. Ronald Sherman permission to produce and market surgical maggots for debriding non-healing necrotic skin and soft tissue wounds. Given an uncooperative patient with non-healing wounds, our medical team obtained insectary-reared sterile surgical maggots, Phaenicia sericata, to promote debridement of necrotic tissue and development of granulation tissue.

Utilization of house fly-maggots, a feed supplement in the production of broiler chickens.

Recent studies have suggested the utilization of maggots as a feed supplement for enhanced broiler performance. Maggots, which are a major dietary source of protein, appear during the biodegradation of chicken droppings using house flies. The objective of the present study was to investigate the effect of maggot supplementation on the meat quality and growth performance of broiler chickens. A total of 600 one-dayold male commercial broiler chicks (Ross) were randomly assigned into 5 treatment groups consisting of 40 replicates of 3 birds. The birds were fed either a basal diet or the basal diet supplemented with 5.0, 10.0, 15.0 and 20.0% maggots. Overall, broiler chicken performance was influenced by the optimal amino acid profile; high protein (63.99%) and essential amino acid content (29.46%), or high protein digestibility (98.50%) of the maggots. Maggot supplementation caused linear increases in live weight gain but not the feed conversion ratio. The diets of 10 and 15% maggots was the most efficient in terms of average weight gain for the 4-5 week old broiler chickens(p<0.05). It also significantly increased dressing percentage, breast muscle, and thigh muscle (p<0.05). No differences were observed for liver, abdominal fat, or meat color, and the crude protein contents of breast muscle were constant. However, in the maggot-fed broilers, breast muscle lysine and tryptophan levels increased significantly as compared to the birds fed the basal diet (p<0.05). These results indicate that feeding diets containing 10 to 15% maggots in chicken dropping after biodegradation can improve the carcass quality and growth performance of broiler chickens.

Nasal Myiasis

BACKGROUND: Nasal myiasis is very distressing condition of the nose that occurs among patients with atrophic rhinitis. This condition is frequently found among those belonging to the lower socioeconomic status suffering from bad nasal hygienic conditions. A retrospective study was done of 58 cases of patients admitted for nasal myiasis. All the patients belonged to the lower socio- economic class and suffered from poor hygienic condition. The majority of the patients were over the age of 60 years and male female ratio was 1 : 1.5 .The primary complaints of this condition were epistaxis, foul smelling nasal discharge, passage of worms from the nose and pain. The majority of the patients were suffering from primary atrophic rhinitis and a few from the secondary atrophic rhinitis due to syphilis and leprosy. TREATMENT: As a first step of treatment, the maggots were removed manually and endoscopically. All the patients became maggot free in 2-3 days time. Alkaline nasal douching was then started along with 25% glucose in glycerine nasal drop. Complications such as septal perforation, saddling nose, palatal perforation were observed in a few cases. The incomplete closure of nose (modified Young's operation) was performed in a few cases. CONCLUSION: Manual and endoscopic removal should be done repeatedly. Antimeningitis prophylaxis should be started at once. And, to prevent recurrence, mosquito net should be used while sleeping, and incomplete closure of both the nasal cavity (modified Young's operation) should be carried out.

Synchronous use of maggots and diatoms in decomposed bodies.

The use of maggots and diatoms conjointly has proved to be an important factor in the medicolegal cases referred with advance decomposition. In practice it is quite much difficult to determine Post Mortem Interval (PMI) and as well as to ascertain ante-mortem drowning factor in the bodies, which are being recovered with advance putrefaction. However the analysis of co-existing evidences associated with corpses viz: Maggots and diatoms may reveal to draw fairly sound inferences, relating to PMI and drowning mode of death as well, especially in the decomposed bodies. Otherwise, it would not be possible to solve the cases of this nature. The present paper enumerates the two case studies recently reported in year 2003 emphasizing about the medicolegal application of both the evidences simultaneously in the cases with advance decomposition.

Subdermal myiasis caused by maggots of chrysomyia bezziana.

Subdermal myasis due to the maggots of Chrysomyia Bezziana was reports from an Eastern province of Thailand namely Srakeaw. The patient was a 41 year old Thai female farmer whom underwent total thyroidectomy following the diagnosis of thyroid cancer about seven years ago. The tracheostomy was again adult female C. Bezziana deposited the eggs onto the rim of tracheostomy would about one week before the patient had severe pain. Myiasis due to C. Bezziana had previously been reported from the Southern provinces namely Trang, Yala and Satun. The present report was a case from another location and confirmed the exisyence of the fly in Thailand.