Intranasal myiasis: a rare complication of transnasal skull base surgery

Area of Science:

• Otorhinolaryngology
• Parasitology
• Neurosurgery

Background:

• A 57-year-old female patient with a history of atypical intracranial meningioma underwent multiple cranial and skull base surgeries.
• Recurrent meningiomas can lead to complex anatomical changes and potential complications.

Observation:

• The patient presented with symptoms of nasal discharge containing larvae.
• Organisms were isolated from the nasal cavity and maxillary sinus.
• Identification confirmed the presence of blow fly larvae (Family: Calliphoridae).

Findings:

• The case represents intranasal myiasis, a rare infestation of the nasal passages by fly larvae.
• Treatment involved transnasal debridement to remove the larvae and subsequent antibiotic therapy.
• The patient achieved complete eradication of the organisms and resolution of infection.

Implications:

• Intranasal myiasis is an uncommon but significant complication following anterior skull base surgery.
• This case underscores the importance of vigilance for unusual infections in patients with a history of complex head and neck surgeries.
• Early diagnosis and appropriate management, including surgical and antimicrobial interventions, are crucial for successful outcomes.