Oral Myiasis: A Structured Review of Risk Factors, Clinical Presentation, and Treatment

Oral myiasis is an uncommon parasitic infestation caused by dipteran larvae that invade living or necrotic oral tissues, and it is associated with poor oral hygiene, periodontal disease, neurological or psychiatric disability, malignancy, and social vulnerability. This structured review aimed to characterize the risk factors, clinical presentation, and therapeutic alternatives for strictly oral myiasis. A literature search was conducted in PubMed/MEDLINE, SciELO, and Scopus to identify case reports and case series involving humans with disease restricted to the oral cavity, published in Spanish or English between 2000 and 2026. To focus on contemporary evidence, only cases published from 2020 onward were included. Fourteen primary studies were analyzed. There was a slight male predominance, and the patients ranged from a five-month-old infant to a 91-year-old adult, with most presenting a neurological, psychiatric, or oncological predisposing condition. The most frequently affected sites were the anterior maxilla and the palate. In most reports, the larva was not identified to the species level; when identified, the agents were Chrysomya bezziana, Musca domestica, and Sarcophaga ruficornis. Management was consistently multimodal, combining mechanical removal of larvae with systemic antibiotics, antiparasitic therapy (ivermectin), surgical debridement, and topical agents. Oral myiasis mainly affects medically and socially vulnerable patients and can be life-threatening in critically ill hosts; its management requires a multidisciplinary approach, and awareness among healthcare professionals is essential for early diagnosis and reducing associated morbidity.