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#1
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06-02-2013, 05:10 PM
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Scalp Wound Myiasis (Maggot Infestation)
Myiasis - the infestation of living vertebrates by the larvae (maggots) of dipterous (2-winged) flies. After being treated and discharged for wounds to the head and left arm, a 67 year old white male returned to the emergency room 5 days after prior discharge. His complaint was, “something is creeping in my head.” The patient stated that since discharge, he had been taking the antibiotics but he did not remove the head dressing until the morning of his visit. At that time he noticed a foul smell. On presentation, the patient was febrile with a temperature of 101.9°C. However, other vital signs and lab values were within normal limits. Physical examination showed a foul smelling scalp wound with extensively repaired lacerations and a small area (2x2cm) of wound dehiscence with exposed calvarium and maggots present. Examination of the left wrist laceration did not show any signs of infection or infestation. Subsequently, an oral and maxillofacial surgery consult was obtained for wound management. The patient was immediately transported to the operating room for surgical debridement. In the operating room, the patient underwent general anaesthesia induction via the tracheal stoma and the patient was prepped and draped in a sterile fashion. All scalp wounds were reopened, a large number of maggots were removed manually and sent for identification analysis. Wound cultures were obtained and the necrotic wound margins were excised. The patient was discharged 24 hours after the procedure with thorough written and verbal wound care instructions. The larvae specimens that were sent for identification were confirmed as Phaenicia sericata (green bottle fly/blowfly). |
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#6
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06-03-2013, 04:18 PM
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Re: Scalp Wound Myiasis (Maggot Infestation)
Oh my. My OCD would have prevented me from leaving that bandage on that long though. I would have been all in the mirror with other mirrors checking everything out as soon as I got home and probably every hour after that lol.
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