Cutaneous manifestation of myiasis in malignant wounds of the head and neck.

UNLABELLED: Parasitic infestation of the body by dipterous larvae belongs to the most undesirable events in cancer patients with malignant cutaneous wounds. Human myiasis is rare in developed countries of the northern hemisphere but occurs more often in tropical and subtropical regions. Advanced age, poor hygiene, bad housing conditions, vascular disease and diabetes seem to be predisposing factors for myiasis. We report a case of myiasis in an extensive skin metastasis resulting from a primary cancer located in the oropharynx. In the literature there are few reports on myiasis in malignant wounds resulting from malignancies of the head and neck area. Furthermore, guidelines or recommendations for standard treatment options are not available. Therefore a review of the literature with a focus on therapeutical aspects was performed.
CONCLUSION: At present the treatment of choice for human myiasis in malignant cutaneous wounds comprises mechanical removal of maggots and, if possible, surgical excision of the lesion. Most important in the treatment of malignant wounds is a thorough rinsing procedure with antiseptic- and/or antibiotic solutions before consistent dressing changes on a daily basis. Here, a complete covering of the wound is indispensable, especially in the summer months.