Priya Satyala Satya, Gaithaoliu Singuang Kamei, Verschueren Kim Johanna Catharina, Koduri Parishuddharao
Department of Obstetrics & Gynaecology, Makunda Christian Leprosy and General Hospital, Bazaricherra, Karimganj, Assam, 788727, India.
Department of Obstetrics, Wilhelmina Children's Hospital, University Medical Center of Utrecht, Utrecht of University, Lundlaan 6, 3584 EA Utrecht, The Netherlands.
Case Rep Womens Health. 2025 Apr 18;46:e00709. doi: 10.1016/j.crwh.2025.e00709. eCollection 2025 Jun.
Myiasis refers to an infestation by maggots or fly larvae. Urogenital myiasis, particularly in the uterine cavity, is extremely rare. Previously reported cases involved uterine prolapses, typically managed with hysterectomy. We describe the successful conservative management of myiasis in an episiotomy wound with extension into the uterine cavity. The case involved a woman in her 30s who gave birth to her third child eight days prior and presented with a painful and infected episiotomy site with "worms" emerging from her vagina. Her poverty had led to her malnourishment and poor hygiene; she was being treated for pulmonary tuberculosis. She required 11 days of inpatient care, which included broad-spectrum antibiotics, a three- to five-day course of ivermectin, clindamycin and albendazole, larvae extraction, manual vacuum aspiration, uterine cavity irrigation and the daily application of a menstrual pad soaked in turpentine oil. No further maggots were detected near the end of her hospital stay, nor at follow-up. This case demonstrates that conservative treatment can be effective, though it requires patience. Ensuring proper nutritional status and personal hygiene in the postpartum period is critical to preventing wound infections complicated by myiasis.
蝇蛆病是指由蛆虫或苍蝇幼虫引起的感染。泌尿生殖系统蝇蛆病，尤其是子宫腔内的蝇蛆病极为罕见。此前报道的病例涉及子宫脱垂，通常采用子宫切除术治疗。我们描述了1例成功地对延伸至子宫腔的会阴切开伤口蝇蛆病进行保守治疗的病例。该病例为一名30多岁的女性，她在8天前产下第3个孩子，因会阴切开部位疼痛且感染，伴有从阴道“钻出”的“虫子”前来就诊。她的贫困导致营养不良和卫生条件差；她正在接受肺结核治疗。她需要住院治疗11天，治疗措施包括使用广谱抗生素、为期3至5天的伊维菌素、克林霉素和阿苯达唑疗程、幼虫摘除、手动负压吸引、子宫腔冲洗以及每天使用浸有松节油的月经垫。在她住院接近尾声时以及随访时均未发现更多蛆虫。该病例表明，保守治疗可能有效，但需要耐心。确保产后适当的营养状况和个人卫生对于预防伤口感染并发蝇蛆病至关重要。
