Case report: - A case report on pediatrics nasal myiasis with angioedema and literature review

Abstract

IntroductionNasal myiasis refers to the presence of the larvae (maggots) within the nasal cavity. This rare condition occurs when the larval stage of certain dipteran flies invades the nose. Case presentationWe report a case of Nasal myiasis with Angioedema in a 7-year-old girl from rural Ethiopia. The patient presented with worsening facial swelling and expulsion of worms from both nostrils for three days, preceded by foul-smelling nasal discharge for three years. Examination revealed bilateral periorbital edema, upper lip edema, and bilateral nasal cavities filled with maggots and blood‑tinged discharge. After investigations including blood tests and a head CT scan, the patient was diagnosed with nasal myiasis. She was treated with broad-spectrum antibiotics, dexamethasone, endoscopic maggot removal, and debridement. She was discharged with improvement and scheduled for a follow-up. On follow there was no recurrence, the posterior septal perforation was asymptomatic and did not require surgical intervention. This case report adheres to SCARE criteria. Clinical discussionNasal myiasis with angioedema is a rare clinical condition. Diagnosis relies on clinical examination to identify the larvae. Endoscopic larvae extraction combined with over-nasal saline irrigation and systemic broad-spectrum antibiotic was considered appropriate and effective management of nasal myiasis. ConclusionNasal myiasis, an infestation of the nasal passages by fly larvae, is a rare clinical condition, particularly in pediatric populations. Prompt and complete eradication of myiasis minimizes damage to intranasal tissues and reduces the risk of complications. Maintaining good hygiene practices is crucial in preventing this condition.