Cutaneous Myiasis in a Neglected Case of Pemphigus Vulgaris: A Case Report

Abstract

Introduction: Myiasis is an infestation of the tissues and organs of living vertebrates and humans by fly larvae, usually those belonging to the Calliphoridae family. The larvae feed on the host's necrotic or living tissue. Here, we report a 58-year-old woman with a 1-year history of biopsy-proven pemphigus vulgaris presented with an acute flare-up. Case presentation: On mucocutaneous examination, the patient had multiple sinus tracts covered with purulent necrotic slough, and cylindrical maggots were crawling out of and around the areas of slough. The patient was diagnosed with wound myiasis caused by Cochliomyia hominivorax. Turpentine oil flushes and oral ivermectin were prescribed. Discussion: Cutaneous myiasis can be papular, pustular, furuncular, and nodular. It is more common in people who have poor hygiene and intimate contact with domestic animals, such as people living in rural areas and tropical/ subtropical countries. The chief aim of management is to remove the maggots as soon as possible, kill them to prevent maturation, promote wound healing, and prevent development of secondary complications. Conclusion: In the current case, the patient's poor nursing and personal care and low socioeconomic condition predisposed her to secondary wound infection and maggot infestation. Such cases require prompt care to prevent secondary infection and septicemia.