International Medical Case Reports Journal (Dec 2022)

Myiasis in a Neglected Elderly: Urgent Action Needed in South America

  • Espinosa H,
  • Salgado OJ,
  • Espinosa-Martin L,
  • Salazar-Torres K

Journal volume & issue
Vol. Volume 15
pp. 719 – 724

Abstract

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Hermel Espinosa,1,2 Octavio J Salgado,2,* Lizette Espinosa-Martin,2,* Katherine Salazar-Torres2,* 1Department of Internal Medicine, Hospital José Carrasco Arteaga, Cuenca, Ecuador and Medical Research Department, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador; 2Medical Research Department, Universidad Católica de Cuenca (UCACUE), Cuenca, Ecuador*These authors contributed equally to this workCorrespondence: Hermel Espinosa, Medical Research Department, Universidad Católica de Cuenca (UCACUE), Avenida de Las Américas y Humbolt, Cuenca, 010101, Ecuador, Tel +5930998000983, Fax +593 074134750, Email [email protected]: Myiasis is an infestation by fly larvae. Some species exclusively affect humans, contaminating wounds, mucous membranes, and other tissues. It is a disease with marked socioeconomic connotations.Case Presentation: The current case involves a 95-year-old woman, an inhabitant of the Andean region of Ecuador with a history of resection of basal cell carcinoma in the left zygomatic region and a diagnosis of chronic leukemia. The surgical wound was secondarily infested with Cochliomyia hominivorax fly larvae and the patient was readmitted to the hospital to treat this complication. A marked clinical improvement was observed after surgical debridement, removal of larvae and administration of ivermectin and antibiotics.Conclusion: The determinants of this infestation were advanced age, neglect, and destitution in a patient with an open wound on the face after resection of a basal cell carcinoma. This case illustrates the appalling reality of the marginalized and excluded population of South America. Also of concern is the expansion of myiasis-producing fly populations to areas outside their natural humid and warm habitat. South American governments are called upon to act jointly and effectively against this ominous disease.Keywords: C. hominivorax larvae, infestation, Andean region, marginalized population

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