Abstract
A 93-year-old man attended the urgency service with a caregiver because of pain in the floor of the mouth. The patient had advanced-stage Alzheimer's, under controlled medication. Surprisingly, the clinical examination revealed a fissure on the back of a tongue filled with larvae. The larvae were removed manually in 2 sessions, followed by irrigation with saline and cleaning of the region. Ivermectin was prescribed twice daily, in addition to analgesic and amoxicillin. The caregiver received guidelines for maintaining the patient's oral hygiene. The patient has been in follow-up for 2 months with good oral health. Oral myiasis is uncommon, with most cases reported in developing countries, affecting men in the fourth and fifth decades of life, with some neurological and/or locomotor condition. Management usually is manual removal of the larvae and use of ivermectin and antibiotics as in the case presented. Oral and hygiene guidelines for patients’ caregivers in these conditions are crucial to avoid recurrence. A 93-year-old man attended the urgency service with a caregiver because of pain in the floor of the mouth. The patient had advanced-stage Alzheimer's, under controlled medication. Surprisingly, the clinical examination revealed a fissure on the back of a tongue filled with larvae. The larvae were removed manually in 2 sessions, followed by irrigation with saline and cleaning of the region. Ivermectin was prescribed twice daily, in addition to analgesic and amoxicillin. The caregiver received guidelines for maintaining the patient's oral hygiene. The patient has been in follow-up for 2 months with good oral health. Oral myiasis is uncommon, with most cases reported in developing countries, affecting men in the fourth and fifth decades of life, with some neurological and/or locomotor condition. Management usually is manual removal of the larvae and use of ivermectin and antibiotics as in the case presented. Oral and hygiene guidelines for patients’ caregivers in these conditions are crucial to avoid recurrence.
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