Shrestha Abhigan Babu, Hoque S M Samiul, Nawaz Muhammad Hassnain, Pokharel Pashupati, Shrestha Sajina, Mahaseth Abhishek
M Abdur Rahim Medical College, Dinajpur, Bangladesh.
Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Int J Surg Case Rep. 2023 May;106:108138. doi: 10.1016/j.ijscr.2023.108138. Epub 2023 Apr 7.
Genital myiasis in females is a parasitic infection of the vulval region with the larva of various files species. Only a few cases of urogenital myiasis have been reported in the literature.
We present a case of 55 years postmenopausal, farmer female otherwise healthy presenting to the outpatient department with complaints of maggots and severe itching in the vulval region. Examination revealed erythema in the labia major and groin without lymphadenopathy. In the vaginal examination; inflammation and a large number of maggots were observed in the urethral meatus, labia minora, and vaginal canal, progressing to the cervix. With this, she was diagnosed to be a case of urogenital myiasis. She was managed with the extraction of maggots using turpentine oil, along with broad-spectrum antibiotics and Foleys catheterization for a week. Later during follow up, she was asymptomatic and examination revealed no maggots, and the lesions were healed.
Extraction of maggots along with symptomatic management is the mainstay of treatment of myiasis. A significant number of the adult population in the rural areas of developing countries are illiterate and are not familiarized with education regarding genital hygiene. So, along with physicians, policy makers should also be involved in public awareness for genital hygiene.
Despite being rare, urogenital myiasis is preventable and treatable condition. Efforts at increasing genital hygiene awareness in a low resource country are utmost for its prevention.
女性生殖器蝇蛆病是一种由各种蝇类幼虫引起的外阴部寄生虫感染。文献中仅报道了少数泌尿生殖系统蝇蛆病病例。
我们报告一例55岁绝经后、身体健康的农民女性，因外阴部有蛆虫及严重瘙痒前来门诊就诊。检查发现大阴唇和腹股沟有红斑，无淋巴结肿大。阴道检查时，在尿道口、小阴唇和阴道内观察到炎症和大量蛆虫，病变进展至宫颈。据此，她被诊断为泌尿生殖系统蝇蛆病。对其进行了用松节油提取蛆虫的处理，并给予广谱抗生素治疗及留置 Foley 导尿管一周。之后随访时，她无症状，检查未发现蛆虫，病变已愈合。
提取蛆虫并进行对症处理是蝇蛆病治疗的主要方法。发展中国家农村地区有相当数量的成年人是文盲，不了解生殖卫生方面的知识。因此，除医生外，政策制定者也应参与到生殖卫生的公众宣传中。
尽管泌尿生殖系统蝇蛆病罕见，但它是可预防和可治疗的疾病。在资源匮乏的国家，提高生殖卫生意识对于预防该病至关重要。
