Diagnostic dilemma: Woman's 'biologically implausible' infection led her to sneeze 'worms' out of her nose
Yahoo • • health
Key Points:
- A 58-year-old woman in Greece developed worsening facial pain and a severe cough, followed by the expulsion of "worms" from her nose, leading to medical evaluation.
- An ENT specialist surgically removed 10 larvae and one pupa of the sheep bot fly (Oestrus ovis) from her maxillary sinuses; DNA analysis confirmed the diagnosis of O. ovis nasal myiasis with pupation.
- This case is unique because human infections typically affect the eyes, and pupation within a human host is considered biologically implausible, but in this patient, larvae matured to an advanced stage, possibly due to a deviated nasal septum and a high larval burden.
- The woman was treated with surgical removal of larvae and nasal decongestants, resulting in a complete recovery.
- The authors suggest that either unknown anatomical factors or evolutionary adaptation might explain this rare pupation in humans and recommend clinicians remain alert to bot fly infections in endemic areas.
