Oral myiasis involving palatal mucosa of a young female
A 19-year-old female patient came with a complaint of massive, painful, and swollen with mobile upper anterior teeth with detached mucoperiosteum from the palatal mucosa since 1 month []. The swelling started slowly and attained the present size. She was associated with fever since 2 days and also complains of discomfort and unable to eat since 1 week. Patient was from a low socioeconomic back ground, residing in a rural area. She had a history of mouth breathing with poor generalized periodontal status. The swelling was extending from infra-orbital region bilaterally to the entire upper lip. Skin over the swelling appeared stretched, erythematous and there was localized rise in temperature.\nIntraoral examination revealed poor oral hygiene with severe halitosis. Swelling may be seen involving the lips, anterior portion of hard palate. Palatal flap in the premaxillary region was necrotized, detached from the underlying bone. Computed tomography revealed that there was no involvement of maxillary sinus, nasal cavity which was suspicious for involvement. Maggots were seen between the palatal bone and flap. The case was posted for surgery under local anaesthesia after taking informed consent. Turpentine oil was placed in the wound area during which maggots were coming out [Figures , and ]. Around 25-27 maggots were removed. Based on the clinical findings and the presence of maggots the provisional diagnosis was made as myiasis. The larvae were preserved in 40% formaldehyde and sent for pathological investigation. On pathological examination the diagnosis of larvae of Musca domestica was confirmed.\nComplete treatment was executed with Taxim 1 g, Metranidazole 100-ml IV injections along with intramuscular injection of Voveran injections for 10 days faster and better recovery. Postoperative healing was uneventful in the wound area. A week later patient discharged and was asked to report back after a period of 6 months to evaluate the healing status and the healing was uneventful and satisfactory [].