Nosocomial nasal myiasis in an intensive care unit

Area of Science:

• Medical Entomology
• Infectious Diseases
• Hospital Epidemiology

Background:

• A 73-year-old male patient presented with respiratory distress and altered consciousness.
• The patient was admitted to the intensive care unit (ICU) of a Malaysian hospital.

Observation:

• Maggots were discovered in the patient's nasal cavity six days post-admission.
• Morphological analysis identified the maggots as third-instar larvae of Lucilia cuprina (Diptera: Calliphoridae).

Findings:

• The case was diagnosed as nosocomial myiasis, an infection acquired during hospitalization.
• The larval stage suggested an infestation duration of 3-4 days.
• An adult Parasarcophaga ruficornis fly, found in the ICU, indicated a potential source of infestation.

Implications:

• This case highlights the risk of nosocomial myiasis in healthcare settings.
• It underscores the importance of environmental control and surveillance to prevent insect-borne infections in ICUs.
• Early identification and source control are crucial for managing such infestations.