Nosocomial nasal myiasis.

Sixty-five fly maggots were retrieved from the nasal cavity of an unconscious 64-year-old man who had been admitted 18 days earlier with diabetic hyperosmolar coma. The larvae were identified as Cochliomyia macellaria, an organism commonly associated with myiasis in the United States. The clinical time sequence indicates that this infection was acquired in the hospital. This incident provides further evidence that immobile and debilitated patients are at risk to acquire myiasis.