Oral myiasis caused by the screwworm Cochliomyia hominivorax treated with subcutaneous ivermectin and creolin: report of six cases after trauma

Human myiasis is a rare condition that is more common in regions with a warm and humid climate. The larvae involved in myiasis are voracious; they destroy healthy tissues and may cause serious haemorrhage. The condition can be life threatening. Six patients with craniofacial trauma and oral myiasis are reported. The diagnoses were made after larvae had been extracted. Treatment consisted of subcutaneous ivermectin therapy and the application of a phenol preparation (10% creolin) as a local measure for the control of larvae. After 12 (±1) days of hospitalization, no larvae remained in the patients' mouths and the patients were discharged. The laboratory identified the larvae as those of the fly Cochliomyia hominivorax. Healing was uneventful in the six cases presented, and no undesirable reactions were observed throughout the period of treatment. Although the usual treatment for myiasis involves surgical removal of the maggots, pharmacological therapies are emerging as effective alternatives.