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A rare nasal myiasis in a patient with diabetes mellitus

  • Teguh Rahardjo ,
  • Yoseph Jappi ,
  • Sony Wibisono ,

Abstract

Background: Nasal myiasis, a type of cavitary myiasis, is an infestation of parasitic insect larvae or eggs in the nasal cavity of the human body. The risk of nasal myiasis increases in individuals with immunocompromised such as diabetes mellitus (DM). The aim of this study was to report a rare case of nasal myiasis in a patient with DM.

Case Presentation: A 54-year-old female patient was referred to Dr. Soetomo General Hospital Surabaya with a chief complaint of spontaneous anterior epistaxis from the left nostril for three days. Anterior rhinoscopy revealed a narrowed left nasal cavity covered with excessive bloody discharge and>50 larvae coming out of the nasal passage. Nasoendoscopy showed ulcerated lesions on the left nasal cavity floor and nasal lateral wall, destructions of the osteomeatal complex and lateral wall, thick bloody discharge with excessive crust, as well as a larva around the osteomeatal complex entering the maxillary sinus. Paranasal sinus CT scan showed no further infection to surrounding organs. The patient had a history of type 2 DM for the past 2.5 years. The patient was diagnosed with nasal myiasis, unregulated type 2 DM, and diabetic neuropathy. Therapies included larval removal by endoscopy, wound irrigation using antiseptic solutions, maxillary sinus irrigation, administration of the topical antiparasitic ivermectin, and insulin therapy. After seven days of the treatment, the patient was discharged from the hospital with a resolved infection and controlled blood sugar levels.

Conclusion: Awareness of risk factors for myiasis along with proper therapy is prominent. Nasal endoscopy, together with nasal irrigation and antiparasitic drug administration was effective in the management of nasal myiasis.

References

  1. Salmanzadeh S, Rahdar M, Maraghi S, Maniavi F. Nasal Myiasis: A Case Report. Iran J Public Health. 2018;47(9):1419-1423. PMID: 30320018; PMCID: PMC6174051.
  2. Babamahmoudi F, Rafinejhad J, Enayati A. Nasal myiasis due to Lucilia sericata (Meigen, 1826) from Iran: a case report. Trop Biomed. 2012;29(1):175-9. PMID: 22543618.
  3. Sharma H, Dayal D, Agrawal SP. Nasal myiasis: Review of 10 years experience. J Laryngol & Otol [Internet]. 1989;103(5):489–91. Available from: http://dx.doi.org/10.1017/s0022215100156695
  4. Francesconi F, Lupi O. Myiasis. Clin Microbiol Rev [Internet]. 2012;25(1):79–105. Available from: https://pubmed.ncbi.nlm.nih.gov/22232372
  5. Dutto M, Pellegrino M, Vanin S. Nosocomial myiasis in a patient with diabetes. J Hosp Infect [Internet]. 2013;83(1):74–6. Available from: http://dx.doi.org/10.1016/j.jhin.2012.08.019
  6. Lubis RR, Albar MY, Darlan DM. Massive orbital myiasis arising from nasal myiasis in an Indonesian patient with diabetes. Am J Ophthalmol case reports [Internet]. 2019;13:147–50. Available from: https://pubmed.ncbi.nlm.nih.gov/30706000
  7. Rana AK, Sharma R, Sharma VK, Mehrotra A, Singh R. Otorhinolaryngological myiasis: the problem and its presentations in the weak and forgotten. Ghana Med J [Internet]. 2020 Sep;54(3):173–8. Available from: https://pubmed.ncbi.nlm.nih.gov/33883762
  8. Wibowo ZK, Mudjanarko SW, Khairina K. The relationship between diabetes distress and HbA1C level in type 2 diabetes mellitus therapy patients: a systematic review [Internet]. Bali Med J. 2022;11(1):476-84. Available from: DOI: https://doi.org/10.15562/bmj.v11i1.2986
  9. Pearson-Stuttard J, Blundell S, Harris T, Cook DG, Critchley J. Diabetes and infection: assessing the association with glycaemic control in population-based studies. Lancet Diabetes & Endocrinol [Internet]. 2016;4(2):148–58. Available from: http://dx.doi.org/10.1016/s2213-8587(15)00379-4
  10. Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji DW, Tjokroprawiro A. The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia. Med J Indones [Internet]. 2010;235. Available from: http://dx.doi.org/10.13181/mji.v19i4.412
  11. Wulandari I, Kusnanto K, Wibisono S, Haryani A. Family Support in Caring for Diabetes Mellitus Patient: Patient’s Perspective. Open Access Maced J Med Sci [Internet]. 2021;9(T4):199–205. Available from: http://dx.doi.org/10.3889/oamjms.2021.5778
  12. Munir M, Sutjahjo A, Sustini F. Profile Of Type Ii Diabetes Mellitus With Central Obesity In Dr. Soetomo Hospital. Folia Medica Indones [Internet]. 2016;51(3):177. Available from: http://dx.doi.org/10.20473/fmi.v51i3.2831
  13. Kamal RH, Novendrianto D, Chadijah F, Prasetya GB, Pratama GS, Ariadnya MO, et al. Diabetes Risk Factor Screening In Adults Using Perkeni Questionnaire And Oral Glucose Tolerance Test In Socah County, Bangkalan. Folia Medica Indones [Internet]. 2017;53(3):199. Available from: http://dx.doi.org/10.20473/fmi.v53i3.6448
  14. Zahra Z, Ramadhani CT, Mamfaluti T. Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic [Internet]. Narra J. 2022;2(1): e51-6. Available from: http://doi.org/10.52225/narra.v2i1.51.
  15. Pranoto A. A3243G mitochondrial dna mutation does not play an important role among dm population in indonesia. Folia Medica Indonesiana (FMI). 2007;43(3):129-35.
  16. Shah BR, Hux JE. Quantifying the Risk of Infectious Diseases for People With Diabetes. Diabetes Care [Internet]. 2003;26(2):510–3. Available from: http://dx.doi.org/10.2337/diacare.26.2.510
  17. Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, Yuwono J, Bhargah V, Prabawa IPY, Manuaba IBAP, Rina IK. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019;15:149-157. Available from: doi: 10.2147/VHRM.S209830.
  18. Sabarigirish K, Nithya V, Saxena S, Dutta A. Nasal myiasis by Chrysomya bezziana. Med journal, Armed Forces India [Internet]. 2016/12/01. 2018;74(1):82–4. Available from: https://pubmed.ncbi.nlm.nih.gov/29386739
  19. Manjunath NM, Pinto PM. Management of Recurrent Rhinomaxillary Mucormycosis and Nasal Myiasis in an Uncontrolled Diabetic Patient: A Systematic Approach. Int J Appl basic Med Res [Internet]. 2018;8(2):122–5. Available from: https://pubmed.ncbi.nlm.nih.gov/29744327
  20. Geerlings SE, Hoepelman AIM. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol & Med Microbiol [Internet]. 1999;26(3–4):259–65. Available from: http://dx.doi.org/10.1111/j.1574-695x.1999.tb01397.x
  21. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab [Internet]. 2012;16 Suppl 1(Suppl1):S27–36. Available from: https://pubmed.ncbi.nlm.nih.gov/22701840
  22. Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study. Diabetes Care [Internet]. 2018;41(3):513–21. Available from: http://dx.doi.org/10.2337/dc17-2131
  23. Singh K, Prepageran N, Mohd Nor K. Nasal cavity myiasis presenting with preseptal cellulitis. Acta Oto-Laryngologica Case Reports [Internet]. 2017;2(1):26–8. Available from: http://dx.doi.org/10.1080/23772484.2017.1291278

How to Cite

Rahardjo, T., Jappi, Y. ., & Wibisono, S. . (2022). A rare nasal myiasis in a patient with diabetes mellitus. Bali Medical Journal, 11(3), 1784–1788. https://doi.org/10.15562/bmj.v11i3.3660

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