A Rare Case of Primary Myiatic Cerebral Abscess Due to Maggot Infestation in the Mileau of Squamous Cell Carcinoma Scalp Along with Review of Literature

Myiasis is a condition in which the maggots feed and develop in the tissues of living organisms. It is most common in tropical and subtropical regions. Human myiasis is prevalent among individuals in close association with domestic animals and those inhabiting unhygienic conditions. Other factors that contribute to its prevalence include immunocompromised status, diabetes mellitus, unhygienic conditions, delay in seeking medical attention, mental retardation, alcoholism, nevoid basal cell carcinoma syndrome, poor social conditions, old age, and vascular occlusive disease. Head- and neck-specific risks include open-mouthed breathing, a history of tooth extraction, a history of maxillofacial trauma, an open bite, and head and neck cancer. The majority of known cerebral myiasis cases in higher-income countries were consequent to neglected skin tumors, while in lower-income countries, they were mostly attributable to inadequate wound care. We report a case of a 72-year-old single, abandoned woman who was brought to the emergency department of Siddhartha Medical College, Vijayawada, Andhra Pradesh, India, in August 2025 with complaints of severe headache, intermittent fever, and discharge from the scalp wound for 1 week. This differential diagnosis should be remembered, particularly when the classic signs of inflammation are not present and brain CT shows round, regular, hypodense lesions on imaging. This case emphasizes the importance of timely and aggressive intervention in these cases, as any inadvertent delay could result in damage to vital structures in the head and neck region. Healthcare professionals should possess the knowledge and skills to identify these cases to reduce morbidity and mortality.