Head and neck myiasis: a case series and review of the literature

Objective. This study describes 9 cases of myiasis affecting the head and neck region and discusses the demographic distribution, treatment, clinical characteristics, and sequelae of the disease in light of the literature. Study Design. The study was performed in 2 steps. In the first part, 9 cases seen over a period of 10 years at the Emergency Department of Hospital da Restauracao in Brazil were studied. In the second part, a literature search was performed in PubMed for articles on head and neck myiasis published from 1975 to March 2017. Results. The case series mainly consisted of male patients in their 30s. The palate was the most commonly affected site. Myiasis was caused by Cochliomyia hominivorax in all patients, who were treated by mechanical removal of the larvae and debridement of necrotic tissue, followed by oral ivermectin. All patients had sequelae resulting from bone destruction. Conclusions. Head and neck myiasis generally affects individuals with poor hygiene habits, drug users, and individuals with neurologic and psychosocial disorders. The treatment of choice is mechanical removal of larvae and surgical debridement combined with oral ivermectin. This study provides information that could help clinicians in the diagnosis and management of this condition.