Gupta Saroj, Sunder Rajamathangi, Pandey Ashish, Mishra Utkal Priyadarshi
Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India
Ophthalmology, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India.
BMJ Case Rep. 2025 Feb 5;18(2):e261693. doi: 10.1136/bcr-2024-261693.
A young man presented in the emergency department for pain and loss of vision in the right eye. On examination, a deformed globe with a massive infestation of orbit with live maggots and necrotic slough was noted. The vision showed no light perception in the right eye, with a normal left eye examination. Several live maggots were removed from the right orbit. The maggots were identified as species larvae. MRI of the brain and orbit showed a markedly deformed globe with mucosal thickening of the ethmoid sinus with disrupted lamina papyracea. Despite having no identifiable immunocompromised state, the patient showed rapid progression along with superadded bacterial infection of the necrotic slough. The patient was treated by exenteration of the right orbit with the removal of necrotic tissue and larvae. This case report elaborates on the comprehensive management of a challenging scenario of fulminant orbital myiasis in a young immunocompetent patient.
一名年轻男子因右眼疼痛和视力丧失到急诊科就诊。检查时，发现眼球变形，眼眶内有大量活蛆虫寄生且伴有坏死性腐肉。右眼视力无光感，左眼检查正常。从右眼眶取出了几只活蛆虫。这些蛆虫被鉴定为某种幼虫。脑部和眼眶的磁共振成像（MRI）显示眼球明显变形，筛窦黏膜增厚，纸样板中断。尽管患者没有可识别的免疫功能低下状态，但病情迅速进展，坏死性腐肉还出现了继发细菌感染。患者接受了右眼眶内容剜除术，切除了坏死组织和幼虫。本病例报告详细阐述了一名免疫功能正常的年轻患者暴发性眼眶蝇蛆病这一具有挑战性情况的综合管理。
