Oral myiasis: a case report

Objective: report a case of oral and maxillofacial myiasis in a patient who was found in a forest region inside the city of Belem, Para, in Brazil. Case report: a male patient, of unknown age, indigent, was found in a forest area inside the city of Belem, Para, in the Brazilian Amazon region, and his mouth and the lower third of his face were covered in larvae. He was referred for care at the Municipal Emergency Hospital. Physical examination revealed a large area of necrosis that involved most of the lower third of his face and showed the presence of many live larvae, measuring about three millimeters on average and with fetid odor. The patient was febrile, malnourished and dehydrated. Anamnesis could not be properly conducted because the patient could not communicate at all, neither verbally or using writing. The initial procedure was the manual removal of the larvae, then, the patient was sent to surgery. Final considerations: health professionals, including dental surgeons, must be alert to episodes of myiasis in humans, since Brazil has favorable conditions for the proliferation of the main species of flies that cause this condition.(AU) Objetivo: relatar um acaso de miiase oral e maxillofacial em um paciente encontrado em uma regiao de mata fechada na cidade de Belem, Para, no Brasil. Relato do caso: homem, idade desconhecida, indigente, foi encontrado em uma area de mata fechada dentro da cidade de Belem, Para, e sua boca e o terco inferior da face estavam cobertos de larvas. Ele foi encaminhado para o Pronto Socorro Municipal. O exame fisico revelou uma extensa area de necrose envolvendo a maior parte do terco inferior da face, mostrando inumeras larvas vivas, medindo cerca de tres milimetros, em media e com odor fetido. O paciente estava febril, desnutrido e desidratado. A anamnese nao pode ser adequadamente conduzida, devido o paciente nao conseguir comunicar-se, nem verbalmente, nem atraves de escrita. O procedimento inicial foi a remocao mecânica das larvas, sendo que, posteriormente, o paciente foi encaminhado para cirurgia. Consideracoes finais: profissionais de saude, incluindo cirurgioes-dentistas, devem estar atentos para a ocorrencia de miiase em humanos, pois o Brasil possui condicoes favoraveis a proliferacao de varias especies de moscas causadoras desta condicao.(AU)