Oral Myiasis-A Case Report

Case Report

Austin J Clin Case Rep. 2014;1(8): 1039.

Oral Myiasis-A Case Report

Navneet Sharma1, Divye Malhotra2, Manjunatha BS3 and Jasjit Kaur4*

1Department of Oral Medicine and Radiology, Himachal Dental College, India

2Department of Oral and Maxillofacial Surgery, Himachal Dental College, India

3Department of Oral and Maxillofacial Pathology, KM Shah Dental Collage & Hospital, India

4Department of Prosthodontics and Crown & Bridge, Himachal Dental College, India

*Corresponding author: Jasjit Kaur, Department of Prosthodontics and Crown & Bridge, Himachal Dental College, Sunder Nagar, Himachal Pradesh, India

Received: July 25, 2014; Accepted: August 20, 2014; Published: August 22, 2014

Abstract

Myiasis is a rare condition caused due to larvae infestation of body tissues. This can be caused by several species of Dipteran fly larvae and may be secondary to serious medical conditions. Common predisposing factors for oral myiasis are incompetent lips, poor oral hygiene, severe halitosis, anterior open bite, mouth breathing, facial trauma, extraction wounds, ulcerative lesions and carcinoma. Here, we describe a case of oral myiasis in the anterior palatal region in a mentally challenged patient caused by the larvae of Musca Nebulo whose clinical features, management and treatment outcome are discussed and case was followed up periodically.

Keywords: Oral myiasis; House fly; Necrosis

Introduction

The term myiasis (Greek: myi= fly, asis= disease) is applied to infestation of living tissues of humans and animals, by dipterous larvae [1]. Zumpt descriptively defined myiasis as “the infestation of live human and vertebrate animals with dipterous larvae, which, at least for a certain period, feed on the host’s dead or living tissue, liquid body substances, or ingested food” [2]. Myiasis is well recognized in the animals, but rare in humans [2,3]. Human myiasis is extremely rare in developed countries, but it is not an uncommon parasitic infestation in the tropics and subtropics [4]. Myiasis can target any body tissue or cavity that is accessible to egg-laying and development of larvae, but most common anatomic sites involved are the nose, eye, lung, ear, anus, vagina, and more rarely, the mouth [3,5].

Oral myiasis was first described by Laurence in 1909 [5]. Predisposing factors for development of oral myiasis are anterior open bite, mouth breathing, neglected mandibular fractures, Cancrum Oris, extraction sockets and patient with neurologic deficit, diabetes, and peripheral vascular disease [3].

In this article a case of oral myiasis in the anterior palatal region in a patient with neurological deficit is presented.

Case Presentation

A 22 years old, mentally challenged male patient was referred to the Department of Oral Medicine, from a regional community health centre for assessment of the intraoral necrotic lesion. The patient’s mother stated that this condition started just a few days back and they showed to some local dentist, but his condition continued to worsen. There was no history of intraoral trauma or any evident previous lesion. On general physical examination patient was malnourished, anaemic, disoriented, and unable to communicate. Intra oral examination revealed presence of necrotic and ulcerative lesion on the palate, extending from incisors to first molar region (Figure 1). Lesion was painful and was accompanied by putrid and penetrating odor. The patient had an anterior open bite, inability to contact upper and lower lip, and poor oral hygiene. Necrotic lesion was cleaned with 10% hydrogen peroxide. On manipulation of tissue, several larvae were seen moving inside the lesion (Figure 2). These larvae were segmented, cylindrical, headless, and grayish-white in color. Whole of anterior hard palate was infected with larvae, causing separation of mucoperiosteum from underlynig bone, and the whole mass was hanging down from the roof of the oral cavity. There was evidence of tunneling produced by these larvae inside the necrotic mass. With all these clinical findings, this was an evident case of oral myiasis and the patient was hospitalized.