Oral myiasis involving palatal mucosa of a young female

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.

Parasitic Infections of the Skin and Subcutaneous Tissues

A variety of arthropods, protozoa, and helminths infect the skin and subcutaneous tissues and may be identified by anatomic pathologists in standard cytology and histology preparations. The specific organisms seen vary greatly with the patient's exposure history, including travel to or residence in endemic countries. Arthropods are the most commonly encountered parasites in the skin and subcutaneous tissues and include Sarcoptes scabei, Demodex species, Tunga penetrans, and myiasis-causing fly larvae. Protozoal parasites such as Leishmania may also be common in some settings. Helminths are less often seen, and include round worms (eg, Dirofilaria spp.), tapeworms (eg, Taenia solium, Spirometra spp.), and flukes (eg, Schistosoma spp.). This review covers the epidemiologic and histopathologic features of common parasitic infections of the skin and subcutaneous tissues.

Management of Recurrent Rhinomaxillary Mucormycosis and Nasal Myiasis in an Uncontrolled Diabetic Patient: A Systematic Approach

Mucormycosis is a rare but often fatal fungal infection caused by a group of fungus known as the Mucorales. This fungus can cause varieties of infections in human beings, especially in an immunocompromised condition. According to various studies, the mortality rate ranges from 10% to 100% depending on the location and site of infection accompanied by underlying diseases. Rhinomaxillary involvement is the most common form of mucormycosis predominantly occurring in patients with uncontrolled diabetes. Necrosis of the maxilla in patients with rhinomaxillary form is less evident as the maxilla is richly vascular, but in case of immunocompromised status, it becomes a common clinical finding. Due to the necrosis of the maxilla, maggots have been found in the nasal and oral cavity which adds to the deteriorating clinical condition. This case report describes a combined medical, surgical, psychological, and prosthetic approach in effectively managing one such case of rhinomaxillary mucormycosis.