Severe Palatal Myiasis in a Young Patient With Neurological and Physical Disabilities: A Case Report.

Abstract

Aims: Myiasis can be particularly debilitating in pediatric patients with neurological impairments, as communication challenges in expressing symptoms may delay diagnosis and appropriate treatment. We report a case of palatal myiasis in a young Latin American patient with neurological deficits.

Methods and results: A 16-year-old female with a history of severe meningitis, which resulted in neurological sequelae including spastic paralysis and epilepsy, presented with an oral lesion in the buccal cavity and episodes of fever. Upon admission, she was diagnosed with bacterial pneumonia, multiple foci of myiasis in the hard and soft palate, and dyspnea caused by larval migration to the oropharyngeal region. Larvae were manually removed, and the patient was treated with intravenous ceftriaxone, clindamycin, and ivermectin. Nitrofurazone paste was also applied topically. Four days later, surgical debridement was performed to remove necrotic mucosa from the palate. No further larvae were detected, and the patient's condition stabilized. The patient has been under follow-up for 1 year.

Conclusion: Severe palatal myiasis is a rare condition that demands prompt diagnosis and a multidisciplinary approach. This case highlights the complexity of managing myiasis in patients with physical and cognitive disabilities, especially in unfavorable socioeconomic conditions.