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Case Reports
. 2024 Nov:124:110452.
doi: 10.1016/j.ijscr.2024.110452. Epub 2024 Oct 11.

Case report: - A case report on pediatrics nasal myiasis with angioedema and literature review

Hailemariam Kassaye Alebie  1 , Bisrat Getachew Yihun  2 , Waltengus Demissie Birhanu  3 , Hikma Amin Aliye  3 , Alebachew Melkamu Aschenkew  3
Affiliations
Case Reports

Case report: - A case report on pediatrics nasal myiasis with angioedema and literature review

Hailemariam Kassaye Alebie et al. Int J Surg Case Rep. 2024 Nov.

Abstract

Introduction: Nasal myiasis refers to the presence of the larvae (maggots) within the nasal cavity. This rare condition occurs when the larval stage of certain dipteran flies invades the nose.

Case presentation: We report a case of Nasal myiasis with Angioedema in a 7-year-old girl from rural Ethiopia. The patient presented with worsening facial swelling and expulsion of worms from both nostrils for three days, preceded by foul-smelling nasal discharge for three years. Examination revealed bilateral periorbital edema, upper lip edema, and bilateral nasal cavities filled with maggots and blood‑tinged discharge. After investigations including blood tests and a head CT scan, the patient was diagnosed with nasal myiasis. She was treated with broad-spectrum antibiotics, dexamethasone, endoscopic maggot removal, and debridement. She was discharged with improvement and scheduled for a follow-up. On follow there was no recurrence, the posterior septal perforation was asymptomatic and did not require surgical intervention. This case report adheres to SCARE criteria.

Clinical discussion: Nasal myiasis with angioedema is a rare clinical condition. Diagnosis relies on clinical examination to identify the larvae. Endoscopic larvae extraction combined with over-nasal saline irrigation and systemic broad-spectrum antibiotic was considered appropriate and effective management of nasal myiasis.

Conclusion: Nasal myiasis, an infestation of the nasal passages by fly larvae, is a rare clinical condition, particularly in pediatric populations. Prompt and complete eradication of myiasis minimizes damage to intranasal tissues and reduces the risk of complications. Maintaining good hygiene practices is crucial in preventing this condition.

Keywords: Case report; Endoscopic debridement; Maggot; Myiasis; Nasal myiasis; Pediatrics nasal myiasis.

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Conflict of interest statement

Conflict of interest statement All authors declare no conflicts of interest in this article.

Figures

Fig. 1
Fig. 1
Preoperative examination revealed the bilateral nostrils filled with larvae and facial swelling.
Fig. 2
Fig. 2
Head CT scan, opacification of bilateral maxillary and ethmoid sinuses, bilaterally atrophied inferior and middle turbinate and defect in the posterior nasal septum.
Fig. 3
Fig. 3
Intraoperative images include maggot in the cavity proper, nasal septum perforated (SP), and necrotic tissue over the lateral nasal wall.
Fig. 4
Fig. 4
After treatment clean nasal cavity with a perforated posterior nasal septum (SP).
See this image and copyright information in PMC

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