Pandey Triptesh Raj, Shrestha Gulshan Bahadur, Sitaula Ranju Kharel, Shah Dev Narayan
Institute of Medicine, B.P. Koirala Lions Centre for Ophthalmic Studies, Maharajgunj, Kathmandu, Nepal.
Case Rep Ophthalmol Med. 2016;2016:2904346. doi: 10.1155/2016/2904346. Epub 2016 Aug 9.
Introduction. Orbital myiasis is the infestation of the orbital tissues by fly larvae or maggots. Compromise of periorbital tissues by malignant disease, surgery, ischemia, or infection may predispose the patient to orbital myiasis. Case Report. A 73-year-old male patient with neglected recurrent basal cell carcinoma of the eyelid invasive into the orbit presented with complaints of intense itching and crawling sensation with maggots wriggling and falling from the wound of left orbit. The patient improved following manual removal of the maggots along with oral Ivermectin treatment. Recurrence of the basal cell carcinoma was confirmed by punch biopsy from the wound and extended exenteration of the orbit followed by reconstructive surgery was done. Conclusion. Orbital myiasis is a rare and preventable ocular morbidity that can complicate the malignancies resulting in widespread tissue destruction. The broad spectrum antiparasitic agent, Ivermectin, can be used as noninvasive means to treat orbital myiasis. In massive orbital myiasis and those associated with malignancies, exenteration of the orbit must be seriously considered.
引言。眼眶蝇蛆病是指蝇类幼虫或蛆虫对眼眶组织的侵袭。恶性疾病、手术、缺血或感染导致眶周组织受损可能使患者易患眼眶蝇蛆病。病例报告。一名73岁男性患者，患有被忽视的复发性眼睑基底细胞癌并侵犯眼眶，主诉左眼眼眶伤口处剧烈瘙痒并有蠕动感，有蛆虫扭动并掉落。手动清除蛆虫并口服伊维菌素治疗后，患者病情好转。通过对伤口进行穿刺活检确诊基底细胞癌复发，随后进行了眼眶扩大切除术及重建手术。结论。眼眶蝇蛆病是一种罕见且可预防的眼部疾病，可使恶性肿瘤复杂化，导致广泛的组织破坏。广谱抗寄生虫药伊维菌素可作为治疗眼眶蝇蛆病的非侵入性手段。在严重的眼眶蝇蛆病及与恶性肿瘤相关的病例中，必须认真考虑眼眶摘除术。
