A silent, trapped guest in the maxillary sinus: Oestrus ovis myiasis with unusual presentation (with CARE guideline)

INTRODUCTION

A sheep bot fly, Oestrus ovis, is an obligate parasite that is found worldwide, especially widespread in the Mediterranean areas and Middle Eastern. Interestingly, in this report, a case with an L3 larva trapped in the human maxillary sinus with other stage larvae is presented.

CASE SUMMARY

A 32-year-old female patient has no symptoms until the larva is expelled by sneezing. Endoscopic examination was normal on admission. Paranasal sinus computed tomography (CT) revealed left maxillary sinus soft tissue density. Uncinectomy and middle meatal antrostomy was performed to remove the infection and larvae.

DISCUSSION

Human ophthalmic and nasopharyngeal myiasis have been documented but asymptomatic maxillary sinus myiasis is unusual and not reported. Due to changes in environmental factors, this atypical infection may occur with an unexpected presentation.

Rhinomyiasis by Oestrus ovis in a tourist returning from Corsica

In the Mediterranean basin, one of the most important agents of myiasis is Oestrus ovis Linnaeus 1758 (Diptera, Oestridae). Herein, we report a rare case of nasal myiasis with a secondary infection complication in a patient from northern Italy who had been visiting Corsica. A healthy, 39-year-old Italian woman spent 2 weeks of vacation in Corsica in June 2018. During her stay, she suddenly felt a foreign body inside her nose, followed by cough, pain, burning at the pharyngeal level, cephalalgia, and nasal congestion with secretions from the nostrils. The clinical examination showed a hyperemic and irritated mucosa and endoscopic examination of the patient's nose and right maxillary sinus revealed three tiny mobile larvae, morphologically and molecular identified as L1 instar larvae of Oestrus ovis. The patient's infestation was probably imported from Corsica, as Mediterranean islands are ideal geographical areas for the development of O. ovis, and the timing of infestation match with the period of O. ovis larviposition. Although rhinomyiasis is rare, it should be considered in people returning from abroad presenting with an acute-onset and foreign body sensation in the nose.

The global and regional prevalence of oestrosis in sheep and goats: a systematic review of articles and meta-analysis

Background

Oestrosis, caused by the larvae of Oestrus ovis, commonly known as sheep nose bot, is an obligatory cavitary myiasis of sheep and goats. Oestrus ovis is a widespread parasite, but little is known about the prevalence of oestrosis at the global and broad geographical levels. The present study aimed to explore the epidemiology of oestrosis at the global and regional level to estimate prevalences and their associated factors using a systematic approach. This is, to the author’s knowledge, the first meta-analysis of oestrosis in sheep and goats.

Methods

Published articles were obtained from nine electronic databases (PubMed, CAB Abstracts, Web of Science, Scopus, UCB library, Medline, Biosis Citation Index, Indian journals and Google Scholar) reporting the prevalence of O. ovis in sheep and goats from 1970 to 2018. Pooled prevalences were estimated using a random effect meta-analysis model.

Results

Sixty-six studies were eligible, and data from 40,870 sheep and 18,216 goats were used for quantitative analysis. The random effect estimated prevalence of oestrosis at the global level in sheep was 51.15% (95% CI: 42.80–59.51%) and in goats was 42.19% (95% CI: 33.43–50.95%). The pooled prevalence estimates for Africa, Asia, Europe and the Americas were 47.85% (95% CI: 36.04–59.66%), 44.48% (95% CI: 33.09–55.87%), 56.83% (95% CI: 48.92–64.74%) and 34.46% (95% CI: 19.90–49.01%), respectively. Heterogeneity (I² > 80%) was detected in most pooled estimates.

Conclusions

Oestrosis is highly prevalent in many geographical regions of the world, especially in Europe and Africa. Factors that contribute to the pooled prevalence estimate of oestrosis need to be emphasised in any survey to estimate the true prevalence of oestrosis. Furthermore, there is a need for immunisation or implementation of other preventive measures to reduce the burden of oestrosis in sheep and goats and to improve the health and welfare status.

Electronic supplementary material

The online version of this article (10.1186/s13071-019-3597-2) contains supplementary material, which is available to authorized users.