Management of maggots in a child’s nose:
Correct Answer: Conservative treatment with oil and removal
Description: Maggots in nose/ Myiasis narium/ Maggots in nose/ Larvae in nose Myiasis is the infestation of tissue with fly larvae, commonly referred to as maggots. Maggots infest nose, nasopharynx and paranasal sinuses causing extensive destruction and obvious deformity. Flies especially of genus Chrysomyia - Chrysomia beziarma (other common species are Lucilia hominivora or Sacrophaga Georginia) are attracted by the foul smelling discharge emanating from case of atrophic rhinitis, syphilis, leprosy or infected wounds and lay eggs about 200 at a time, which within 24 hours hatch into larvae The predisposing factors for Nasal Myiasis are: - Poor nourishment with poor hygiene - Atrophic rhinitis - Leprosy in the nose - Diabetes with purulent sinus infections - Midline granulomatous lesions involving the nose - Malignancy involving the nose - Syphilitic disease involving the nose Clinical features (Signs and Symptoms): 1st 3-4 days: - intense irritation, sneezing, lacrimation - headache blood-stained discharge from nostrils - puffy eyelids and lips - epistaxis 3rd or 4th day: - maggots may crawl out of nose foul smelling serosanguinous discharge - extensive destruction of nose, sinuses, soft tissue of face, palate and eyeball - fistulae may form in the palate or around the nose - death may occur from meningitis Treatment: - Visible maggots should be picked up with forceps - Instillation of chloroform water/ether and oil (liquid paraffin) kills them - docuhe with warm saline is used to remove slough, crusts and dead maggot - Avoid contact of the patient with flies by use of mosquito nets - Nasal hygiene for prevention
Category:
ENT
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