1
|
Khan HZ, Shahid SA, Bakht N, Zaidi SSN. Myiasis Encountered in Squamous Cell Carcinoma of the Oral Cavity: A Case Report. Cureus 2024; 16:e62414. [PMID: 39011201 PMCID: PMC11249050 DOI: 10.7759/cureus.62414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
Myiasis is a rare parasitic condition, caused by fly larvae infesting human tissues. Its consequences can be severe, as deafness, blindness, extensive tissue loss, and even death can occur due to the infestation. We present a case of myiasis in a 62-year-old Pakistani woman with advanced well-differentiated oral squamous cell carcinoma (OSCC) undergoing palliative chemotherapy. The patient presented with an extensive, necrotic lesion in the submental and submandibular region infested with live larvae. Management included mechanical removal over three sessions and ivermectin. Once all the larvae were eradicated, the patient was referred to the plastic surgery department for reconstruction. This case report highlights the importance of maintaining a high index of suspicion for myiasis in patients with OSCC, particularly those with extensive ulcerated lesions. Educating at-risk individuals and healthcare providers on myiasis and the importance of wound hygiene is crucial for reducing the burden of this preventable complication.
Collapse
Affiliation(s)
- Hassam Zaka Khan
- Anatomy, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Syeda Aliza Shahid
- Pathology, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Nausheen Bakht
- Epidemiology and Public Health, Armed Forces Postgraduate Medical Institute, Rawalpindi, PAK
| | | |
Collapse
|
2
|
Wai AP, Maw WW, Boonmars T. Myiasis in Ulcerated Breast Carcinoma: First Case Record in Myanmar. THE KOREAN JOURNAL OF PARASITOLOGY 2022; 60:139-141. [PMID: 35500896 PMCID: PMC9058279 DOI: 10.3347/kjp.2022.60.2.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 03/13/2022] [Indexed: 11/23/2022]
Abstract
Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.
Collapse
Affiliation(s)
- Aung Phyo Wai
- Department of Microbiology, Faculty of Medicine, Shimane University, Izumo, 693-8501,
Japan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen,
Thailand
- Corresponding author (, )
| | - Win Win Maw
- Department of Microbiology, University of Medicine 2, Yangon,
Myanmar
| | - Thidarut Boonmars
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen,
Thailand
| |
Collapse
|
3
|
Gonçalves KKN, de Araújo ESM, Barbirato DS, do Lago CAP, do Egito Vasconcelos BC. Head and neck cancer associated with myiasis. Int J Oral Maxillofac Surg 2021; 51:847-853. [PMID: 34602319 DOI: 10.1016/j.ijom.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/21/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease progression and increase its lethality due to local or systemic complications. The aim of this study was to conduct a scoping review on head and neck cancer associated with myiasis in order to answer the focal question: what are the occurrence, diagnosis, aetiology, treatment and outcomes of head and neck cancer associated with myiasis? This paper was structured based on the five-steps methodology proposed by Arksey and O'Malley (Int J Soc Res Methodol 2005;1:19-32), and followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR), OSF Registries protocol. The electronic search was performed in the MEDLINE/PubMed, Embase and SciELO.org databases for articles published up to 28 February 2021. In total, 38 articles and 56 patients were included. Most patients were male (66%), and the mean age was 66.63 years. Cases were predominantly associated with squamous or basal cell cancer. The most affected anatomical sites were the eyes, scalp, ears and oral cavity, and the most frequent type of larva was Crisomyia (13%). Manual removal of the larvae was considered the standard treatment, associated or not with antibiotics, analgesics and antiparasitic drugs.
Collapse
Affiliation(s)
- K K N Gonçalves
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - E S M de Araújo
- Faculty of Dentistry of Pernambuco, University of Pernambuco, Recife-PE, Brazil
| | - D S Barbirato
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - C A P do Lago
- Maxillofacial Surgery and Traumatology Service, Hospital da Restauração, Recife-PE, Brazil
| | - B C do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil; Department of Oral and Maxillofacial Surgery, Hospital da Restauração, Pernambuco, Brazil.
| |
Collapse
|
4
|
Cuestas D, Pedraza J, Herrera H, Motta A, Cuestas A, Forero Y, Porras R, Urrea F, Galvis D, Galvis I, Bernal MA, Alvarado MV, Bula R, Velasquez O, Villalba D, Lamus S, Ariza G, Bayona N, Gutierrez A, Segura A, Patiño M, Perafan A, Ramirez-Rodriguez S, Rolon M. Cutaneous myiasis in skin cancer and malignant wounds: a systematic review. Int J Dermatol 2021; 60:1529-1546. [PMID: 34363696 DOI: 10.1111/ijd.15672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/14/2021] [Accepted: 04/22/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cutaneous myiasis in patients with malignant wounds or skin cancer is a rare and undesirable event with limited epidemiological data. A subregister of reports, lack of education in the population, inadequate empirical treatments, and medical underestimation are components of a public health problem that threatens patients' lives. METHODS We conducted a systematic review of the literature of cutaneous myiasis associated with malignant wounds and skin cancer, characterizing sociodemographic variables, risk factors, clinical and histological features, and treatment. Additionally, we present a demonstrative case with the adequate taxonomic evaluation. DISCUSSION Cutaneous myiasis is an underestimated and poorly managed infestation, which can generate severe complications in oncological patients. This is the first systematic review in the literature about this clinical scenario, which provides information to the physician and clinical researcher about the epidemiological gaps and what has been published so far. CONCLUSIONS Findings from the current review have helped to display the sociodemographic, epidemiological, and clinical behavior of myiasis in skin cancer and malignant wounds. Its contribution to the greater tumor tissue destruction is clear; however, more studies are required. The therapeutic management in these patients is equally clarified.
Collapse
Affiliation(s)
- Daniel Cuestas
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,ESTUDIODERMA®, Bogotá, Colombia
| | - John Pedraza
- Dermatology Program, Fundacion Universitaria Sanitas, Bogotá, Colombia
| | - Hugo Herrera
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Adriana Motta
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Andrés Cuestas
- ESTUDIODERMA®, Bogotá, Colombia.,Clinical and Enginnering Research-Statistical Analysis, Predicto Artificial Intelligence Techonologies LLC, Austin, TX, USA
| | - Yency Forero
- Internal Medicine Program, Universidad de La Sabana, Chía, Colombia
| | - Ricardo Porras
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Fernando Urrea
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Dany Galvis
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Ingrid Galvis
- Special Training in Radiology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Rosa Bula
- Clinical Research, Universidad del Sinú, Cartagena, Colombia
| | - Oscar Velasquez
- Dermatology Program, Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Sergio Lamus
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Gabriel Ariza
- Clinical Research, Universidad de La Sabana, Chía, Colombia
| | - Natalia Bayona
- Clinical Research, Universidad del Rosario, Bogotá, Colombia
| | - Ana Gutierrez
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | - Alexandra Segura
- Grupo de Investigación en Ciencias Biomédicas UPTC - GICBUPTC, Grupo de Investigación en Medicina Veterinaria y Zootecnia GIDIMEVETZ, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Colombia
| | - Monica Patiño
- Clinical Research, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Alejandra Perafan
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia
| | | | - Mariam Rolon
- Dermatology Program, Universidad El Bosque, Bogotá, Colombia.,Dermatology Service, Hospital Simon Bolivar, Bogotá, Colombia.,Dermatopathology Department, Hospital Simon Bolívar, Bogotá, Colombia
| |
Collapse
|
5
|
Dos Passos JBS, Coelho LV, de Arruda JAA, Silva LVDO, do Valle IB, Santos MDS, de Figueiredo EL, Abreu LG, Mesquita RA. Oral myiasis: Analysis of cases reported in the English literature from 1990 to 2020. SPECIAL CARE IN DENTISTRY 2020; 41:20-31. [PMID: 33125723 DOI: 10.1111/scd.12533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 01/19/2023]
Abstract
Myiasis is an infection caused by the deposition of fly larvae in tissues, and its involvement in the human oral cavity is uncommon. Herein, we have performed a data analysis of published cases of oral myiasis. A search was performed in PubMed, Ovid, Web of Science, Scopus, and LILACS. Geographic distribution, demographic data, associated factors, clinical features, fly types, treatment, and presence of sequelae were analyzed. A total of 122 articles reported the cases of 157 infected individuals. The most affected countries were India (41%) and Brazil (29.5%). Male predominance (67.5%) and a mean of 41.9 years of age were observed. The gingiva (29%) was the most affected site, followed by palate (25%) and lip (21%). There were different forms and combinations of treatments: manual removal of larvae and surgical debridement, application of asphyxiating substances, antibiotic therapy, and use of ivermectin. The condition predominantly affects individuals with neurological and/or locomotor disabilities, of low socioeconomic status, with poor oral hygiene and chemical dependence and individuals with previous injuries or with the absence of lip sealing. The establishment of a standard treatment protocol, enabling comparison in future studies and providing uniformity in treatment strategies offered by health services is strongly recommended.
Collapse
Affiliation(s)
- Juliana Bianchi Souza Dos Passos
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luiza Vale Coelho
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leni Verônica de Oliveira Silva
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabella Bittencourt do Valle
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana de Souza Santos
- Department of Morphology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Eugênia Leal de Figueiredo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
6
|
Waidyaratne G, Zhou S, O'Neil T, Marks A. Management of Wound Myiasis in the Hospice and Palliative Medicine Setting. J Palliat Med 2020; 24:797-800. [PMID: 33121325 DOI: 10.1089/jpm.2020.0441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Complex wounds are common complications in hospice and palliative medicine (HPM), especially in patients with aggressive malignancies. Myiasis, or an infestation of maggots, is a rare but significant complication of such wounds. While uncommon in the United States, many HPM patients have multiple risk factors and comorbidities that increase their vulnerability to this condition. Currently, there are no standard diagnostic or treatment guidelines for wound myiasis. In addition, common management strategies may not be easily accessible in HPM settings. We present this case of a patient with malignant squamous cell carcinoma of the neck complicated by myiasis while in hospice, and our experience diagnosing and managing her infestation. We also reflect on special considerations for HPM patients when addressing the physical and psychological symptoms of wound myiasis.
Collapse
Affiliation(s)
| | - Shiwei Zhou
- Division of Infectious Diseases, Department of Internal Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Thomas O'Neil
- Arbor Hospice and Northstar Palliative Care, Ann Arbor, Michigan, USA
| | - Adam Marks
- Division of Geriatrics and Palliative Care, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
7
|
Treatment of facial myiasis in an elderly patient with oral squamous cell carcinoma: Case report. Int J Surg Case Rep 2020; 71:260-265. [PMID: 32492640 PMCID: PMC7264952 DOI: 10.1016/j.ijscr.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/12/2020] [Accepted: 05/11/2020] [Indexed: 02/01/2023] Open
Abstract
Myiasis may develop secondary to malignant neoplasms. Surgical treatment associated with administration of Ivermectin is effective in curing myiasis. The establishment of a multiprofessional team is fundamental in the treatment of myiasis.
Myiasis is caused by the infestation of fly larvae in human tissues and it presents immunodeficiency, poor hygiene, or malignant neoplasias as predisposing chronic diseases. Objective To describe a clinical case of myiasis associated with oral squamous cell carcinoma (OSCC) in an elderly patient. Case presentation A 60-year-old male, black, smoker, and alcoholic patient with OSCC, who refused initial cancer treatment and sought hospital care with an extensive facial lesion and approximately 150 larvae in the extraoral region. The treatment was given through the administration of 6 mg of Ivermectin associated with the surgical removal of the larvae. Subsequently, palliative chemotherapy began. Discussion Myiasis can sometimes be associated with OSCC and it commonly occurs in individuals who live in unhealthy locations and present poor hygiene and low immunity. In addition to medication, the surgical removal of the larvae is important in the treatment of myiasis. Conclusion Patient adherence to cancer treatment is essential to avoid the negative evolution of the tumor. The social component linked to the development of myiasis makes it an important public health topic, as it is related directly to the lack of primary care. Surgical and drug treatments are required to cure myiasis.
Collapse
|
8
|
Jain A. Myiasis in patients with oral squamous cell carcinoma-a systematic review and protocol for management. Oral Maxillofac Surg 2019; 23:265-269. [PMID: 31119420 DOI: 10.1007/s10006-019-00757-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Oral squamous cell carcinoma results in various morbidities like pain, bleeding on provocation, loss of function, facial disfigurement, extra oral fungation, and tissue necrosis. Other than these dreadful complications, sometimes in advanced and incurable stage, the wound gets infested with maggots. Oral myiasis in association with OSCC is rare, and a very few reports have been mentioned in the literature. MATERIAL AND METHODS A literature search was performed on PubMed, Medline, and Cochrane databases on 1st November 2018 for all the articles focusing on oral myiasis in patients with oral squamous cell carcinoma. RESULTS A total number of nine cases with oral myiasis in association with OSCC have been reported till date. Out of these nine cases, five cases have been reported from India and four from Brazil. CONCLUSION Oral myiasis is a possible risk for the patient with Oral squamous cell carcinoma. Good hygiene and general cleanliness along with educating the patients must be a practice to avoid this dreadful condition.
Collapse
Affiliation(s)
- Anuj Jain
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
| |
Collapse
|