First Report of Pharyngostomy Wound Myiasis Caused by Chrysomya bezziana (Diptera: Calliphoridae) in Iran
A 3-year-old girl who resides in a rural area in Sirik District, Hormozgan Province, south of Iran referred to the Pediatric Hospital in Bandar Abbas, in July 2011. She ingested aluminum hydroxide powder by accident. Patient underwent flexible pediatric endoscopy by a gastroenterologist on arrival, which showed severe burns of oral cavity and esophagus. She received anti-secretory agent, antibiotics, and hydrocortisone. Physicians devised a pharyngostomy tube in right side of her neck by number 32 mushroom catheter and the esophagus was closed by a prolene mesh plug which completely was filled with cyanoacrylate glue to prevent swallowing of saliva ().\nNine months after the first diagnosis, the patient referred to hospital for pharyngological follow-up. During examination of the patient, with a lateral motion of the flange of the pharyngostomy tube, many larvae observed between the tube and the pharyngeal wall. The lesion was macroscopically cleared of visible larvae by mechanical removal. The procedure had to be repeated three more times to extract all larvae. A total of 23 third-instar larvae were collected from the patient, the bed and the floor of the ward. The patient received antibiotics, anti-secretory agent and then transferred to surgical ICU for respiratory care.\nLarvae were preserved in 70% methanol and sent to the Entomology Laboratory, School of Health, Hormozgan University of Medical Sciences for identification. The larvae were 12–15 mm long, whitish and without prominent papilla. Other morphological characters of the specimens included, open peritreme, slightly pigmented tracheal trunks, posterior margin of segment 11 with dorsal spines, anterior spiracles with 4–6 papillae, and each posterior spiracles encircled by a heavily sclerotised peritreme which is incomplete ventrally and with 3 slit-like spiracular opening at about 45 degrees to the horizontal (). The full grown larvae were identified using the morphological characters based standard key ().