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Ivermectin treatment for massive orbital myiasis in an empty socket with concomitant scalp pediculosis.

Puthran N, Hegde V, Anupama B, Andrew S - Indian J Ophthalmol (2012 May-Jun)

Bottom Line: We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis.The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery.Ivermectin was also effective in managing the concurrent scalp pediculosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Yenepoya Medical College, Mangalore, India.

ABSTRACT
We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis. The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery. Ivermectin was also effective in managing the concurrent scalp pediculosis.

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Related in: MedlinePlus

Magnetic resonance imaging axial STIR signal showing inflammation of right lateral orbital wall
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Figure 3: Magnetic resonance imaging axial STIR signal showing inflammation of right lateral orbital wall

Mentions: Immediate treatment consisted of injection Tetanus Toxoid, oral diclofenac, and instillation of 0.3% gatifloxacin eye drops, four times a day in the right orbit. Laboratory investigations and X-ray orbits were normal. Manual removal of maggots was done several times a day, initially following turpentine wash, and later under topical anesthesia [Fig. 2]. However, several maggots continued to remain deeply buried in pockets in the lids and orbit. Magnetic resonance imaging (MRI) suggested a suspicion of early erosion of the medial orbital wall on the right side. The retro-orbital compartment including the optic canal was normal [Figs. 3 and 4].


Ivermectin treatment for massive orbital myiasis in an empty socket with concomitant scalp pediculosis.

Puthran N, Hegde V, Anupama B, Andrew S - Indian J Ophthalmol (2012 May-Jun)

Magnetic resonance imaging axial STIR signal showing inflammation of right lateral orbital wall
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361823&req=5

Figure 3: Magnetic resonance imaging axial STIR signal showing inflammation of right lateral orbital wall
Mentions: Immediate treatment consisted of injection Tetanus Toxoid, oral diclofenac, and instillation of 0.3% gatifloxacin eye drops, four times a day in the right orbit. Laboratory investigations and X-ray orbits were normal. Manual removal of maggots was done several times a day, initially following turpentine wash, and later under topical anesthesia [Fig. 2]. However, several maggots continued to remain deeply buried in pockets in the lids and orbit. Magnetic resonance imaging (MRI) suggested a suspicion of early erosion of the medial orbital wall on the right side. The retro-orbital compartment including the optic canal was normal [Figs. 3 and 4].

Bottom Line: We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis.The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery.Ivermectin was also effective in managing the concurrent scalp pediculosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Yenepoya Medical College, Mangalore, India.

ABSTRACT
We report a rare case of massive orbital myiasis following recent lid injury, occurring in the empty socket of an elderly lady, who had concurrent scalp pediculosis. The orbital myiasis was effectively treated with the broad-spectrum antiparasitic agent, ivermectin, thus precluding the need for an exploratory surgery. Ivermectin was also effective in managing the concurrent scalp pediculosis.

Show MeSH
Related in: MedlinePlus