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Comprehensive Management of Multisite Myiasis in a Critically Ill Patient: A Case Report Highlighting Challenges in
Aryan Shiari1, Mohamed Muhanad2, Adel Zurob1
1Pulmonology, Critical Care, and Sleep Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin, USA, mayoclinichealthsystem.org.
Case Reports in Infectious Diseases
|December 22, 2025
Summary
This case study details a patient with alcohol dependence who developed a subdural hematoma and multisite myiasis. Early recognition and multidisciplinary treatment, including surgery and ivermectin, are crucial for managing myiasis in vulnerable individuals.
Area of Science:
- Medical Case Report
- Parasitology
- Infectious Diseases
Background:
- A 44-year-old unhoused male with alcohol dependence presented with neurological symptoms.
- Rapid deterioration revealed a subdural hematoma requiring emergency craniotomy.
Purpose of the Study:
- To report a complex case of multisite myiasis in a vulnerable patient.
- To highlight the importance of early diagnosis and comprehensive management of myiasis.
Main Methods:
- Surgical removal of maggots (Lucilia sericata).
- Pharmacological treatment with ivermectin and broad-spectrum antibiotics.
- Multidisciplinary care involving surgical, infectious disease, and ENT specialists.
Main Results:
- Successful eradication of myiasis and resolution of neurological symptoms.
- Patient regained full consciousness within a week post-intervention.
- Demonstrated the efficacy of combined surgical and medical treatment.
Conclusions:
- Myiasis requires prompt recognition and aggressive management, particularly in immunocompromised or vulnerable populations.
- A multidisciplinary approach is essential for optimal patient outcomes.
- Preventive strategies are vital for at-risk groups to reduce the incidence of myiasis.
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