Occipital epidermoid cyst of furuncular myiasis presenting with spontaneous bleeding: a case report.

Abstract

A 77-year-old female patient was presented to the emergency department with swelling and bleeding in the occiput. It was learned from the patient that the soft tissue swelling on her head had been present for 1 year, and she had no history of trauma. The patient had diabetes mellitus and hypertension and a history of breast cancer 15 years ago. An epidermoid cyst, approximately 5x5 centimeter in size, bleeding in the form of leakage was observed on the patient's occipital scalp. There was no intracranial pathology in the brain computerized tomography. Wound debridement revealed that the cyst contained approximately 30 live larvae. All larvae were cleaned from the tissue defect. When looking from the outside, the larvae were 8-12 millimeters in size, yellow-white, spiral in shape, and were thought to be compatible with the larva of Lucilia sericata diptera. Myiasis is an ectoparasitic infection of diptera larvae by settling in human and animal tissues. When flies leave their larvae in the tissue, the larvae that invade and develop in that area cause infection. Cutaneous myiasis is the most common clinical form and can be seen on the scalp and cause furuncular myiasis. Immunosuppression, lack of self-care, travel to endemic areas and trauma have been reported as risk factors for myiasis. It was thought that the history of diabetes and old malignancy might be predisposing in our patient. In this case report, it is aimed to present a case of furuncular myiasis that settled down without any trauma to the occiput and presented with spontaneous soft tissue bleeding.

Keywords

• myiasis
• furunculous myiasis
• scalp
• bleeding