Cerebral Myiasis Secondary to Burr Hole Evacuation: A Rare Illustrative Case Report.

Rama Chandra Deo, Abhijit Acharya, Souvagya Panigrahi, Satya Bhusan Senapati, A K Mahapatra, Sumirini Puppala
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Abstract

Myiasis (maggot infestation) is a condition in which fly maggots feed off and develop in the tissues of living organisms. Most common in tropical and subtropical regions, human myiasis, is prevalent among individuals in close association of domestic animals and those inhabiting the unhygienic conditions. We, hereby, describe a rare case of cerebral myiasis (17th in the world, 3rd in India) that presented to our institution in Eastern India secondary in the operated site of craniotomy and burr hole few years back. Cerebral myiases are exceedingly rare conditions, especially in high-income countries with only 17 previously published cases with the reported mortality as high as 6 out of 7 cases dying of the disease. We additionally also present a compiled review of previous case literatures to highlight the comparative clinical, epidemiological features and outcome of such cases. Although rare, brain myiasis should be a differential diagnosis of surgical wound dehiscence in developing countries where conditions do exist in this country that permit myiasis. This differential diagnosis should be remembered, particularly when the classic signs of inflammation are not present.

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脑蝇蛆病继发于脑洞引流:一例罕见的病例报告。
蝇蛆病(蛆感染)是指蝇蛆以生物体的组织为食并发育的一种情况。人蝇蛆病最常见于热带和亚热带地区,流行于与家畜有密切联系的个体和居住在不卫生条件下的人。我们在此报告一例罕见的脑蝇蛆病(世界排名第17位,印度排名第3位),几年前在我们位于印度东部的机构,在开颅和钻孔的手术部位出现。脑病是极为罕见的疾病,特别是在高收入国家,以前仅公布了17例病例,报告的死亡率高达7例中有6例死于该病。此外,我们还对以往的病例文献进行了综述,以强调这些病例的比较临床、流行病学特征和结果。虽然罕见,但在发展中国家,脑蝇蛆病应该是外科伤口裂开的鉴别诊断,因为这些国家确实存在允许蝇蛆病发生的条件。应记住这种鉴别诊断,特别是当典型的炎症症状不存在时。
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