Shakeel Mohammad, Khan Iram, Ahmad Imteyaz, Iqbal Zafar, Hasan Syed Abrar
E.N.T. Department, Hind Institute of Medical Sciences, Lucknow, India.
Ear Nose Throat J. 2013 Jul;92(7):E38-41. doi: 10.1177/014556131309200721.
We report a case of pseudomyiasis (accidental myiasis) in a 52-year-old man who had previously undergone surgery and placement of a tracheostomy tube for laryngeal cancer. The patient presented to our outpatient department with a foul-smelling, blood-stained discharge and frequent and severe episodic pain at the site of the tracheostomy. He also reported the discharge of many whitish larvae from the site. On clinical examination, 3 of these larvae were removed from the tracheostomy wound and later identified as Musca domestica (housefly) larvae. The patient underwent further mechanical removal twice daily for 3 days, during which time 23 more larvae, or maggots, were removed. His condition improved, and he returned for regular follow-up with no recurrence or complications. Myiasis is an infestation of humans and vertebrate animals by insect larvae that feed on both dead and living tissue. Myiasis is most common in hot and humid climates in tropical and subtropical regions, such as the underdeveloped areas of India, Africa, and Southeast Asia, which provide favorable breeding grounds for flies. Myiasis is classified as specific, semispecific, or accidental, depending on whether the fly larvae require a host in order to develop. We review the literature on myiasis and its entomologic aspects in general. We also discuss the need for the proper care of tracheostomy wound myiasis because the site of such an infestation is close to vital organs in the neck. To the best of our knowledge, only 3 cases of tracheostomy wound myiasis have been previously reported in the English-language literature; 2 of them involved infestation with Chrysomyia bezziana larvae and 1 with Lucilia caesar larvae. We believe our case is the first case of tracheostomy wound pseudomyiasis attributable to M domestica larvae.
我们报告一例52岁男性的假性蝇蛆病（意外蝇蛆病），该患者此前因喉癌接受过手术并放置了气管造口管。患者前来我院门诊，主诉气管造口处有恶臭、带血的分泌物，且频繁发作严重疼痛。他还报告从该部位排出了许多白色幼虫。临床检查时，从气管造口伤口处取出了3条幼虫，后来鉴定为家蝇幼虫。患者连续3天每天接受两次进一步的机械清除，在此期间又清除了23条幼虫或蛆。他的病情有所改善，并回来进行定期随访，无复发或并发症。蝇蛆病是昆虫幼虫对人类和脊椎动物的侵袭，这些幼虫以死组织和活组织为食。蝇蛆病在热带和亚热带地区炎热潮湿的气候中最为常见，如印度、非洲和东南亚的欠发达地区，这些地区为苍蝇提供了有利的繁殖地。根据蝇幼虫发育是否需要宿主，蝇蛆病分为特异性、半特异性或偶然性。我们综述了关于蝇蛆病及其昆虫学方面的文献。我们还讨论了妥善护理气管造口伤口蝇蛆病的必要性，因为这种感染部位靠近颈部的重要器官。据我们所知，英文文献中此前仅报道过3例气管造口伤口蝇蛆病；其中2例涉及被贝氏金蝇幼虫感染，1例被凯撒绿蝇幼虫感染。我们认为我们的病例是首例由家蝇幼虫引起的气管造口伤口假性蝇蛆病。
