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#1
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04-14-2023, 07:58 PM
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Neglected Cancer Patient.
Source: An 80 years-old female patient was brought to Accident & Emergency Department of a hospital in southern Poland by ambulance, presenting with a large ulcerative lesion covering most of the right side of her face and the nose. The wound was approximately 15x12 cm and encompassed the right eye socket with missing eye bulb; one could see moving maggots surrounded by liquefied tissues. The patient was in poor general status, not able to move and with very little mental contact, severely dehydrated with yellowish skin colour and visibly malnourished and hygienically neglected (Figure 1). The patient was found by accident during a police intervention in a flat inhabited by her alcoholic son. By accounts of her son, she was recently bedridden and an ulcerating lesion on her face was possibly noted many months before. There was no medical care sought and the sanitary conditions in the living quarters were very poor. The lesion was washed with saline and the maggots were removed mechanically with tweezers (Figure 2). After further saline cleansing, the large wound was covered with an Argosulfan (Jelfa, Poland) dressing. No oral or i.v. antibiotics were used. Treatment of the patient also included correction of her electrolyte imbalance with i.v. rehydration and electrolyte replenishment followed by thorough hygienic procedures. Upon improvement of her general status, the patient was then transferred to a medical ward awaiting full diagnostics and possible surgical cosmetic workup of the lesion. Having in mind the most probable tumorous and malignant background of her facial lesion, she will need to undergo full histopathological examination to see whether any wider surgical intervention is needed. In our opinion the patient is suffering from basal cell carcinoma (Ulcus rodens) which is rarely fatal unless it is met with such neglect. The patient lost her eye and extensive damage to all facial tissues was present. Maggot Debridement Therapy (MDT) is an FDA approved form of treatment in USA with high rates of success. In such case, the sterile MDT larvae are purchased and placed over hard-healing wounds in special dressings. In this case the “maggot therapy” was atypical, unlike MDT, not only for the fact that the patient had substantial tissue damage with exposure of cavities, eye socket, etc. which may be a contraindication for MDT, but also for the fact that maggot infestation was natural, being therapeutic in itself. We consider that owing to this natural maggot infestation, which resulted in spontaneous debridement of the necrotic, cancerous tissues the patient was able to survive. |
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#6
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04-15-2023, 04:59 PM
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Re: Neglected Cancer Patient.
Please tell me the son can be prosecuted for such gross negligence. I would never dream of allowing this to happen to either of my parents. I might not be the best daughter in the world, but I love them both with all my heart.
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