Primary Amygdala Myiasis: A Case Report

Introduction: The myiasis is a disease produced by the infestation of larvae in the skin and other tissues. The larva of hominis is periodic and obligatory parasite responsible for myiasis and nodular skin primary. It is classified into primary myiasis when the larva breaks into healthy tissue and develops. The location in the tonsils is considered rare, being most commonly found in the nose and ears.

Objectives: We present a case emphasizing the therapeutic approach made by the ENT.

Case Report: A 42-year-old patient (J.M.S.) was hospitalized for seizures, use of benzodiazepine and neurological monitoring, for 5 days. Otorhinolaryngologic evaluation was requested by foreign body in the oropharynx. The patient was sedated with nasogastric tube in right nasal cavity, showing oral breathing.

Methods: Hyperemia was displayed in oropharynx and foreign body in the left amygdala, mobile compatible with larva, with no signs of necrosis amigdaliana. A larva has been removed with tweezers by Hartmann and the cotton with chloroform was placed in the affected tissue for a few minutes. After this procedure, dozens of larvae were displayed and was opted for tonsillectomy. The patient evolved without complications.

Conclusion: In the literature, there is a case report of primary myiasis in amygdala, in the city of São Paulo, Brazil, which was published in the Journal of Otolaryngology in 1938. Although considered very rare, amigdaliana myiasis should be suspected with mobile foreign body in the oropharynx. Myiasis can be found in immunocompromised patients with poor oral hygiene. Treatment involves removal of all larvae present in the affected tissue.