A Rare Case of Nasal myiasis following Kidney Transplantation

Abstract

In this case report, we present a 63-year-old man with a history of diabetes mellitus and kidney transplantation who was diagnosed with nasal myiasis. The patient presented with symptoms of nasal myiasis infestation, including epistaxis, nasal obstruction, nasal discharge, and the presence of larvae. The patient had risk factors for poor wound healing, such as hyperglycemia, and the presence of diabetes mellitus, hypertension, and kidney transplantation indicated the presence of predisposing factors for myiasis. The myiasis was observed subsequent to the traumatic insertion of a nasogastric tube. The patient exhibited symptoms of myiasis infestation in the nasal region, including epistaxis, nasal obstruction, and nasal discharge, along with the presence of larvae. Our findings highlight the occurrence of nasal myiasis in a patient with a complex medical history, and emphasize the need for clinicians to remain vigilant for this infection. After the insertion of the nasogastric (NG) tube, 3-5 mm cream-colored larvae were removed from his nose, mouth, and eyes. Despite continued medical treatment the patient died 48 hours after removing the larvae.Axial CT scan showed no mucosal thickening, and T1 weighted cervical MRI showed no abnormal signal intensity, except for spondylopathy and modic changes. Diffusion Weighted-MRI (DWI) revealed no abnormal signal in the brain parenchyma. Our findings highlight the importance of clinicians being vigilant for nasal myiasis in patients with predisposing risk factors, such as diabetes mellitus and kidney transplantation. Managing nasal myiasis can be challenging, particularly in patients with multiple conditions. The management of nasal myiasis can be challenging, particularly in patients with multiple comorbidities.