The relevance of imaging diagnosis in nasal myiasis mimicking a toothache

Nasal myiasis is an infestation by dipterous larvae within the nasal cavity, where they feed on both living tissue and fluid. This condition predominantly occurs in rural areas of tropical countries, where inadequate sanitation and a hot, humid climate create an ideal environment for larvae development. A 57-year-old, otherwise healthy male rural worker presented with a toothache in the region of the maxillary incisors. Imaging studies identified a punctiform radiopaque/hyperdense area near the nasal septum in the left nasal fossa. The larva was surgically excised and sent for histopathological analysis. Histologic sections confirmed the clinical diagnosis, and the patient remained asymptomatic after a 2-month follow-up. Nasal myiasis can mimic the symptoms of a toothache in the anterior region of the maxilla. This condition can affect even immunocompetent patients, and complementary imaging studies may be decisive in diagnosing it.