Pelvic organ myiasis.

Abstract

Myiasis is infestation with dipterous larvae, which feed on the host's dead or living tissue, liquid body substances, or ingested food. A 76-year-old, multiparous woman presented at a tertiary care hospital in India with vaginal discharge and itching for 3 weeks. The patient had a health care attendant who apparently failed to notice the problems she was experiencing. Pelvic examination revealed grade 2 uterine prolapse. Vaginal discharge was purulent, foul smelling, and contained several 8-10-mm white maggots of Musca domestica (housefly). Turpentine oil was instilled locally, and maggots were removed manually. The patient was treated with broad spectrum antibiotics. Maggot removal was repeated weekly for 3 weeks until no further maggots were present. Hysteroscopy was normal. The prolapsed uterus was replaced in its anatomic position with vaginal pessary. Decreased physical and mental capabilities due to old age and poor care by health providers can lead to maggot infestation of prolapsed pelvic organs.