A strange gingival swelling in an Italian child: a case of oral myiasis.

Oral myiasis is a condition in which tissues of the oral cavity are invaded by the larvae of flies. It is a rare disease in humans, often associated with very poor dental and oral hygiene. In children the main predisposing factors are incompetent lips, thumb sucking habits and continuous mouth breathing. The condition has been reported mainly in Asia and South America and rarely in more developed countries. The cases recorded in Italy concern adults with ocular or cutaneous manifestations alone. We describe an unusual infestation of the oral cavity of a five-year-old Italian boy with a severe congenital heart defect. He presented a gingival swelling and, after a few hours, some larvae could be seen moving through his oral cavity. They were removed manually and an oral antibiotic was given to avoid a bacterial superinfection. Three days after, oral examination of the patient revealed a gradual decrease in gingival swelling; complete clinical resolution was achieved about two weeks later. This case is reported as a reminder to consider oral myiasis in the event of suspected gingival swelling in children, especially if they have predisposing factors or if they come from an endemic area.