Oral myiasis in children

A Rare Case of Oral Myiasis Caused by Phormia regina (Meigen) (Diptera: Calliphoridae) in an Intubated Patient

Myiasis is the infestation of tissues with living larvae. Oral myiasis is an extremely rare form of the disease, with open mouth, unconsciousness, and poor oral hygiene being the predisposing factors. It is generally observed in the tropics or subtropics, as well as rural places with low socio-economic income. Mechanical removal and ivermectin are frequently used as treatments. Herein, we present a case of oral myiasis in a 69-year-old male intubated patient with myocardial infarction. Multiple larvae were observed in the mouth and mechanically removed. With the microscopic investigation, the larvae were identified as Phormia regina (Meigen) (Diptera: Calliphoridae), which is extremely rare globally. For preventing oral myiasis, good patient care, good sanitary practice for oral health, efficient treatment of dental diseases, and fly population control, usage of masks for the risk groups are recommended.

Neonatal oral myiasis caused by the larvae of Sarcophaga ruficornis (Diptera: Sarcophagidae): a case report

Background

Myiasis is caused by dipterous larvae, and rarely affects the mouth. Diagnosis by traditional means is easy to be confused with other similar species. Here, we report a case of oral myiasis, in a 5-month-old infant who was diagnosed by morphological examination and molecular biological methods.

Case presentation

A 5-month old infant with acute myeloid leukemia was admitted due to recurrent skin masses for more than 4 months. The infant had lip swelling, which prevented him from closing the mouth and membranes were present in his mouth and there were also oral ulcers and erosions. Ten maggots were found in the mouth and one in the ear canal with pus flowing out and were confirmed as the third stage larvae of Sarcophaga ruficornis by morphological examination and a comparison of sequence of cytochrome oxidase subunit 1 (COX1) gene. After removal of the maggots and chemotherapy, the infant ’s condition was gradually improved.

Conclusions

To the best of our our knowledge, this is the first neonatal oral myiasis case reported in China and its diagnosis requires a high index of suspicion. Microscopy combined with specific DNA sequence analysis is an effective technological tool to provide rapid diagnoses of the larva specimen and cases of rare diseases, as illustrated in the current case.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06742-z.

Oral myiasis affecting paediatric patients: a systematic review

INTRODUCTION

Oral myiasis is a rare condition caused by Dipteran larvae that feed on living or dead tissues, ingested food or body fluids. It affects immunocompromised individuals with low socioeconomic status or those unable to maintain proper hygiene. Cases of oral myiasis are scarce but debilitating in children. We conducted a systematic review to understand the nature of disease, its causative factors, treatment and ways to prevent the occurrence of this condition among children.

METHODOLOGY

The review was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A systematic electronic literature search was conducted on major databases using keywords in combination with Boolean Operators. Manuscripts discussing cases of oral myiasis in paediatric patients were included in the review.

RESULTS

The exhaustive literature search and evaluation of full texts revealed 32 studies that fulfilled the inclusion criteria. A total of 68 cases of oral myiasis were reported from 2 to 16 years of children, majorly involving gingiva of maxillary anterior region and palate.

CONCLUSION

The dreadful condition of myiasis can be prevented by decreasing the number of flies, maintenance of good hygiene and by educating the susceptible population. Affected children must be managed by following proper treatment regimens.

A systematic review and an individual patient data meta-analysis of ivermectin use in children weighing less than fifteen kilograms: Is it time to reconsider the current contraindication?

BACKGROUND

Oral ivermectin is a safe broad spectrum anthelminthic used for treating several neglected tropical diseases (NTDs). Currently, ivermectin use is contraindicated in children weighing less than 15 kg, restricting access to this drug for the treatment of NTDs. Here we provide an updated systematic review of the literature and we conducted an individual-level patient data (IPD) meta-analysis describing the safety of ivermectin in children weighing less than 15 kg.

METHODOLOGY/PRINCIPAL FINDINGS

A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for IPD guidelines by searching MEDLINE via PubMed, Web of Science, Ovid Embase, LILACS, Cochrane Database of Systematic Reviews, TOXLINE for all clinical trials, case series, case reports, and database entries for reports on the use of ivermectin in children weighing less than 15 kg that were published between 1 January 1980 to 25 October 2019. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42017056515. A total of 3,730 publications were identified, 97 were selected for potential inclusion, but only 17 sources describing 15 studies met the minimum criteria which consisted of known weights of children less than 15 kg linked to possible adverse events, and provided comprehensive IPD. A total of 1,088 children weighing less than 15 kg were administered oral ivermectin for one of the following indications: scabies, mass drug administration for scabies control, crusted scabies, cutaneous larva migrans, myiasis, pthiriasis, strongyloidiasis, trichuriasis, and parasitic disease of unknown origin. Overall a total of 1.4% (15/1,088) of children experienced 18 adverse events all of which were mild and self-limiting. No serious adverse events were reported.

CONCLUSIONS/SIGNIFICANCE

Existing limited data suggest that oral ivermectin in children weighing less than 15 kilograms is safe. Data from well-designed clinical trials are needed to provide further assurance.

Oral myiasis: Analysis of cases reported in the English literature from 1990 to 2020

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.

Grub in the mouth: an unusual case with review of literature

Oral myiasis is a rare disease, identified primarily in non-industrialised nations. It is caused fundamentally by the attack of larvae from Dipteran flies on the human tissues. Predisposing factors for oral myiasis are extraction wounds, destitute oral cleanliness, meagreness, mouth breathing amid rest, suppurative injuries, necrotic tissues, diabetes and perivascular infections primarily within the elderly, extreme halitosis, alcohol addiction, cerebral paralysis and components that favour prolonged mouth opening. Myiasis may have predilection to patients with mental challenges, cerebral palsy and hemiplegia due to unfortunate physical agility. The present case reports an oral myiasis in a 25-year-old woman who was mentally challenged. This condition was treated by topical application of turpentine oil with manual expulsion of hatchlings, taken after by surgical debridement and wide range antimicrobials.

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

Certain dipteran flies larvae causing invasion of the tissues and organs of the humans or other vertebrates are called as myiasis, which feed on hosts dead or living tissues. It is well documented in the skin and hot climate regions; underdeveloped countries are affected more commonly. Oral cavity is affected rarely and it can be secondary to serious medical conditions. Poor oral hygiene, alcoholism, senility, or suppurating lesions can be associated with the oral myiasis. Inflammatory and allergic reactions are the commonest clinical manifestations of the disease. In the present case, gingiva of maxillary anterior region was affected by larval infection in a 13-year-old mentally retarded patient.

Oral Myiasis: A Rare Case Report and Literature Review

Myiasis is a rare disease caused by infestation of tissue by larvae of flies. Oral myiasis is still "rare" and "unique" owing to the fact that oral cavity rarely provides the necessary habitat for a larval lifecycle. Herein, we present a case of extensive gingival myiasis in a 12-year-old mentally retarded, epileptic child as well as a literature review.