RESUMO
We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.
Assuntos
Hanseníase/complicações , Miíase/diagnóstico , Miíase/patologia , Rinite Atrófica/complicações , Administração Tópica , Idoso de 80 Anos ou mais , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Humanos , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Ivermectina/administração & dosagem , Ivermectina/uso terapêutico , Masculino , Miíase/cirurgiaRESUMO
CONTEXT: People living in rural or remote Brazil, as in other sub-tropical or tropical nations, are vulnerable to infections that would not normally occur in urban areas or wealthier nations. Brazil is a geographically extensive nation, historically marked by vast socioeconomic inequalities. Approximately 16% of the population live in rural areas. ISSUE: This clinical case report demonstrates the vulnerability of rural residents who are underserved by Brazil's 'universal' public healthcare system, despite social and economic challenges that increase their risk for disease. Myiasis (especially oral myiasis) is a rare health condition in humans caused by fly larvae. Oral myiasis usually appears in periodontal pockets and open wounds, such as after dental extractions. It is associated with poverty, lack of access to health care, and very poor overall health status. While myiasis has a worldwide distribution, it is particularly associated with the tropical and sub-tropical regions of North and South America. LESSONS LEARNED: This article describes a rare case of myiasis in the upper lip of a rural male patient. The case report demonstrate that rural and remote residents can be socially excluded from the benefits of technology and biomedicine, making them vulnerable to rare infections.
Assuntos
Antiparasitários/uso terapêutico , Ivermectina/uso terapêutico , Doenças Labiais/tratamento farmacológico , Mucosa Bucal , Miíase/tratamento farmacológico , Serviços de Saúde Rural , Isolamento Social , Doença de Alzheimer/diagnóstico , Anestesia Local , Brasil , Serviço Hospitalar de Emergência , Acessibilidade aos Serviços de Saúde/normas , Humanos , Doenças Labiais/parasitologia , Doenças Labiais/cirurgia , Masculino , Desnutrição/terapia , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Mucosa Bucal/parasitologia , Mucosa Bucal/cirurgia , Miíase/diagnóstico , Miíase/parasitologia , Miíase/cirurgia , Guias de Prática Clínica como Assunto , Serviços de Saúde Rural/normas , Condições Sociais , Resultado do Tratamento , Populações VulneráveisRESUMO
A case of external ophthalmomyiasis caused by the first instar larvae of the sheep nasal botfly (Oestrus ovis) has been reported for the first time from the Sultanate of Oman, Southern Arabia. Sixty larvae were removed from the left eye of a 21-year-old male student, who acquired the infection during a field trip. The manual removal of larvae using a swab stick was the only effective treatment. The larval characteristics are described with illustrations, and the status of O ovis ophthalmomyiasis in the Middle East is discussed. The folk treatment administered for fly-mediated ophthalmomyiasis in Oman is also reported. Ophthalmomyiasis may not be a serious public health problem in Oman, but a nationwide survey of all myiases may be worthwhile.