What is a mouth larva?

Oral myiasis is a rare disease caused by larvae of certain dipteran flies. It is mostly reported in developing countries and in the tropics. Herein, a case of oral myiasis in the maxillary anterior region of a 14-year-old mentally challenged boy is being reported. The myiasis was caused by the larvae of Chrysomya bezziana species. The clinical findings are presented. Etiology and the importance of oral health in special people are also discussed.

How do you get mouth larva?

According to Ankur Aggarwal (Oral Myiasis Caused by Chrysomya bezziana in Anterior Maxilla), A 70-year-old female presented with a chief complaint of swelling in relation to the upper front teeth for 3 days. She gave a history of pain which was of a pricking type radiating to the upper half of the face. Extraoral examination revealed a single diffuse swelling measuring 5 × 4 cm² involving the upper lip and the surrounding structures, Skin overlying the swelling appeared normal. On palpation, the inspection findings were confirmed and there was no local rise in temperature and no pulsation; the swelling was firm and tender. There was no numbness or paresthesia in relation to the swelling.

Extraoral photograph revealing diffuse swelling involving the upper lip and the anterior maxilla.

The patient was from a low socioeconomic background, was malnourished, and had poor oral hygiene. Intraoral examination revealed diffuse necrosis of soft tissues in the labial vestibule in relation to teeth 11, 12, 13, 14, 21, 22, and 23. The area was soft and tender on palpation. The anterior part of the hard palate showed necrosis and the mucosa covering it was completely detached exposing the underlying bone.

Intraoral photograph revealing necrosis involving labial vestibule and mucosal surface of the upper lip.

Treatment of mouth larva

Treatment of myiasis involves the physical removal of the larvae and wound cleansing with either topical or systemic medication. Agents used have included ether, chloroform, iodoform or olive oil.² Satisfactory results have been obtained using systemic Ivermectin.^2,9

the patient received surgical exposure of the affected area under general anesthesia, removal of the maggots and wound debridement (Fig. 2). The wound was closed with vicryl sutures and the patient was given co-amoxiclav and metronidazole for one week. He was reviewed seven days later and a satisfactory resolution was evident.

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