Oral Myiasis in an 11-year-old Child with Cerebral Palsy- Clinical Presentation, Microscopy, and Management

CASE PRESENTATION An 11-year-old male child with a history of painful mouth on clinical examination revealed an erythematous palatal swelling associated with maxillary central incisors [Figure 1a].[1] Eighty-six larvae were manually removed from the surrounding mucoperiosteum [Figure 1b-d]. The larvae were whitish to cream colored with lengths 8–12 mm, showing bands of dark, prominent thorn-like spines, and had three slit-like spiracles identified as Chrysomya bezziana [family Calliphoridae, Figure 2a-f].[2]Figure 3a and b shows healing at 6 months follow-up.Figure 1: (a) Preoperative clinical picture showing a midline lesion infested by larvae. (b) Immediately after debridement of the wound. (c and d) Isolated larvae are approximately 85 in number. A larva measuring about 8–10 mmFigure 2: (a) Dissecting micrograph - strong and robust mouth hook. (b) Intersegmental spines with single, darkened, and tapered tips recurved toward the body. (c) Dissecting micrograph of the posterior spiracles. (d) The posterior spiracles with the spiracular slits slightly convergent and the peritreme thick and incomplete. (e) A third-instar larva with strong mouth hook. (f) Anterior spiracle with palmate shape due to papillae arranged in single rowFigure 3: (a) Clinical picture before suture placement. (b) A 6-month follow-up clinical photograph showing complete healing at the wound site.Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.