A complex scalp wound following a myiasis infestation: cranial burr holes and negative pressure wound therapy

Myiasis is a parasitic infection common in tropical areas, such as Brazil. It is caused by infestation of maggots of various fly species in humans. Here, the case of a 38-year-old female patient, with no comorbidities, who was referred to the authors' centre due to a scalp wound infested with larvae and complete soft tissue loss, is presented. A computed tomography scan revealed no evidence of osteomyelitis or intracranial compromise. Since the initial debridement and mechanical removal of the larvae resulted in a large and complex wound, the patient underwent a combined wound approach based on cranial burr holes and negative pressure wound therapy followed by skin graft. The wound revealed excellent skin graft survival, and the patient was safely discharged home. No complications were observed in the follow-up period.