Clinical and systemic management of myiasis in a patient with advanced Alzheimer's disease
DOI:
https://doi.org/10.33448/rsd-v10i3.13145Keywords:
Alzheimer's disease; Oral health; Myiasis.Abstract
The management of patients with neurodegenerative conditions such as Alzheimer's disease presents a challenge in promoting oral health, which is mainly linked to the motor and cognitive limitations that these individuals have, making them susceptible to the development of a series of oral diseases, such as oral myiasis. The presence of larvae in the oral cavity in patients with Alzheimer's disease seems to be related to poor oral hygiene condition, to the long periods that the patient remains immobile and with the mouth ajar, facilitating the deposition of eggs. Therefore, this study aimed to report a clinical experience of a patient with Alzheimer's disease in an advanced stage and with manifestation of oral myiasis on the oral floor, vestibule bottom and inserted gum. The 81-year-old patient was debilitated, bedridden, unable to perform his activities alone, was taken to the emergency room by his caregiver, who reported having noticed the presence of larvae in the oral cavity. The patient was hospitalized and immediately administered Ivermectin, ceftriaxone and clindamycin. On the second day of hospitalization, he presented a systemic worsening due to bronchoaspiration, requiring immediate removal of the larvae under local anesthesia. Only after significant improvement in the general condition, thorough surgery was performed to debridement of the injured areas and remnants of larvae. After hospital discharge with 2-month follow-up, the patient did not have any complications related to his oral health, demonstrating that periodic follow-up to debilitated patients is an important tool for preventing opportunistic manifestations such as oral myiasis.
References
Abdo, E. N., Sette-Dias, A. C., Comunian, C. R., Dutra, C. E. A., & Aguiar, E. G. (2006). Oral myiasis: A case report. Oral Medicine and Pathology, 11, 130–131.
Cavalcanti, A. L. (2008). Miíase Oral: etiologia, diagnóstico e tratamento. Rev. Fac. Odontol. Porto Alegre, 49, 32–35.
de Arruda, J. A. A., de Oliveira Silva, L. V., Silva, P. U. J., de Figueiredo, E. L., Callou, G., Mesquita, R. A., & do Egito Vasconcelos, B. C. (2017). Head and neck myiasis: a case series and review of the literature. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 124(5), e249–e256. https://doi.org/10.1016/j.oooo.2017.06.120
de Souza Barbosa, T., Salvitti Sá Rocha, R. A., Guirado, C. G., Rocha, F. J., & Duarte Gavião, M. B. (2008). Oral infection by Diptera larvae in children: a case report. International Journal of Dermatology, 47(7), 696–699. https://doi.org/10.1111/j.1365-4632.2008.03725.x
Droma, E. B., Wilamowski, A., Schnur, H., Yarom, N., Scheuer, E., & Schwartz, E. (2007). Oral myiasis: a case report and literature review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 103(1), 92–96. https://doi.org/10.1016/j.tripleo.2005.10.075
Filho, A. O., Dias, D., Miranda, Á., & Hebling, E. (2018). Oral myiasis in older adult with severe Alzheimer’s disease. Special Care in Dentistry, 38(2), 99–106. https://doi.org/https://doi.org/10.1111/scd.12277
Freitas, D. A., Moreira, G., Jones, K. M., & Caldeira, A. P. (2012). Social exclusion and myiasis of the upper lip in a Brazilian rural resident. Rural and Remote Health, 12, 2188.
Gross, D. J., & Jitumori, C. (2019). Miíase bucal em paciente em estado vegetativo: relato de caso. Journal of Health, 1, 2178–3594.
Mengi, E., Demirhan, E., & Arslan, I. B. (2015). Aural myiasis: case report. Northern Clinics of Istanbul, 1(3), 175–177. https://doi.org/10.14744/nci.2014.96967
Naz, H., Aslan, L., Sönmez Tamer, G., & Naz, C. (2018). [Case of pneumonia associated sepsis accompaning pulmonary myiasis]. Mikrobiyoloji bulteni, 52(4), 439–443. https://doi.org/10.5578/mb.67395
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. Universidade Federal de Santa Maria.
Ribeiro, M. T. de F., Sanglard-Oliveira, C. A., Naves, M. D., Ferreira, E. F. e, Vargas, A. M. D., & Abreu, M. H. N. G. (2012). Miíase bucal e doença de Alzheimer: relato de caso clínico . In Revista Brasileira de Geriatria e Gerontologia (Vol. 15, pp. 805–811). scielo .
Sengoku, R. (2020). Aging and Alzheimer’s disease pathology. Neuropathology : Official Journal of the Japanese Society of Neuropathology, 40(1), 22–29. https://doi.org/10.1111/neup.12626
Shinohara, E. H., Martini, M. Z., Oliveira Neto, H. G. de, & Takahashi, A. (2004). Oral myiasis treated with ivermectin: case report . In Brazilian Dental Journal (Vol. 15, pp. 79–81). scielo .
Simon, L., Delaunay, P., Martinez, J. P., Hubiche, T., & Del Giudice, P. (2018). Intensive cutaneous myiasis due to Musca domestica in a patient with Alzheimer disease: a rare larval infestation in a temperate zone. Clinical and Experimental Dermatology, 43(3), 342–344. https://doi.org/10.1111/ced.13291
Thyssen, P. J., Nassu, M. P., Costella, A. M. U., & Costella, M. L. (2012). Record of oral myiasis by Cochliomyia hominivorax (Diptera: Calliphoridae): case evidencing negligence in the treatment of incapable. Parasitology Research, 111(2), 957–959. https://doi.org/10.1007/s00436-012-2856-3
Weller, J., & Budson, A. (2018). Current understanding of Alzheimer’s disease diagnosis and treatment. F1000Research, 7. https://doi.org/10.12688/f1000research.14506.1
Werminghaus, P., Hoffmann, T. K., Mehlhorn, H., & Bas, M. (2008). Aural myiasis in a patient with Alzheimer’s disease. European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 265(7), 851–853. https://doi.org/10.1007/s00405-007-0535-2
Zhang, T.-Z., Jiang, Y., Luo, X.-T., Ling, R., & Wang, J.-W. (2020). Oral myiasis after cerebral infarction in an elderly male patient from southern China: A case report. World Journal of Clinical Cases, 8(24), 6499–6503. https://doi.org/10.12998/wjcc.v8.i24.6499
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Copyright (c) 2021 William Phillip Pereira da Silva; Stéfany Barbosa; Bruno Coelho Mendes; Mateus Diego Pavelski; Anderson Maikon de Souza Santos; Mirela Caroline Silva; João Matheus Fonseca e Santos ; Osvaldo Magro Filho; Leonardo Perez Faverani
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