Dawadi B R, Sherpa M T, Shrestha R
Department of Emergency Medicine, Institute of Medicine, Kathmandu, Nepal.
Department of Medicine, Nepal Medical College Teaching Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2015 Oct-Dec;53(200):288-290.
Myiasis occurs in humans and vertebrate animals mostly due to dipterous flies of the genera Chrysomyia and Cochliomyia. There have been reported cases of myiasis of skin, breast, intestine, eyes and ear but very few cases of vulvar myiasis have been reported in the medical literature. We report a case of a 20 years old female with vulvar myiasis. A 20-year old unmarried girl presented to our hospital with complains of vaginal discharge and vulvar irritation for 3 days with evidence of some worms around her vulvar region. Her menstrual history revealed the use of folded cloths instead of sanitary pads during her menstruation. Moreover, she washed those clothes with water and hanged them in the clothesline outside to let them dry before reuse. Examination of the external genitalia multiple ulcers measuring 1X1 cm on the inner surface of the labia minora, heavily infested with large number of maggots. The patient was admitted for 4 days during which she was given antibiotics, analgesics and anti-inflammatory medication. Daily local asepsis of the wound with antiseptic solution, betadine was done. We removed more than 30 larvae by the fourth day after which no more larvae were seen and she gradually recovered in the following days. It is our opinion that the cause of vulvar myiasis in our patient was her poor sanitary hygiene. Simple measures such as washing clothes thoroughly, drying and ironing of clothes are also necessary to reduce the risk of this human myiasis.
蝇蛆病主要发生在人类和脊椎动物身上，多由金蝇属和丽蝇属的双翅目苍蝇引起。已有皮肤、乳房、肠道、眼睛和耳朵蝇蛆病的病例报道，但医学文献中报道的外阴蝇蛆病病例非常少。我们报告一例20岁女性外阴蝇蛆病病例。一名20岁未婚女孩因阴道分泌物增多和外阴瘙痒3天前来我院就诊，外阴区域可见一些蠕虫。她的月经史显示，她在月经期间使用折叠布而不是卫生巾。此外，她用水清洗这些布，然后挂在室外晾衣绳上晾干后再使用。检查发现，小阴唇内表面有多个1×1厘米的溃疡，大量蛆虫寄生。患者住院4天，期间给予抗生素、镇痛药和抗炎药治疗。每天用碘伏消毒液对伤口进行局部消毒。到第四天，我们清除了30多条幼虫，此后未再发现幼虫，患者在接下来的几天里逐渐康复。我们认为，该患者外阴蝇蛆病的病因是其卫生习惯差。彻底清洗衣物、烘干和熨烫衣物等简单措施对于降低这种人类蝇蛆病的风险也很有必要。
