Affiliation:
1. Department of Orthopedics and Trauma Surgery
2. Department of Emergency Medicine, Sindhuli Hospital, Kamalamai
3. Department of Orthopedics and Trauma Surgery, Bajrabarahi Chapagaon Hospital, Chapagaon, Nepal
Abstract
Introduction and importance:
Myiasis of an open fracture wound is very rare but can occur due to neglect of wound care.
Case presentation:
A 12-year-old boy from a low socio-economic background, following an impact injury in his right great toe 10 days back presented with complaints of pain, swelling, and a foul-smelling odor from his right great toe. On examination, a swollen, tender puncture wound was noted over the dorsal aspect of the great toe revealing part of live larvae and serosanguinous discharge. Management was done with the complete removal of maggots, wound debridement, wound lavage, administration of systemic antibiotics, and toe guard slab application.
Clinical discussion:
Wound myiasis results from a facultative or obligatory parasite that is initiated when flies oviposit in hemorrhagic, necrotic, or pus-filled lesions. The possible complications of myiasis include local destruction, invasion into deep tissues, and secondary infection, which could result in amputation of the affected area, especially where obligatory parasites are concerned.
Conclusion:
Myiasis commonly occurs due to poor hygiene and neglect of wound care along with many other risk factors. Early proper wound care prevents the development of wound myiasis and early diagnosis and treatment of myiasis prevent complication of local tissue destruction and amputation of affected parts.
Publisher
Ovid Technologies (Wolters Kluwer Health)
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