Myiasis isadiseasecausedby the presenceof fly larvaein the organs and/or tissuesof humans orothervertebrates, and is most oftenseen intropical countries.The occurrence ofmyiasisin the oral cavityis rare.Among thepredisposing factorsstand outsenility, neurological impairmentand halitosis. Thus, patients withneurodegenerative diseasessuch asAlzheimer's disease (AD) are more likely toacquirethis disorder.Thispaper reportsacase oforalmyiasis, involving a67-year old patientwith ADat an advanced stage, completely dependentfor activitiesof daily living(ADL), residing in along-term institution(ILP). The patient suffered from a lack of lip seal and resistance to oral hygiene care. Thediagnosis was clinically made,based on the observationof bleedingin the anteriorpalate, detachment of the oral mucosa andpresence oflarvae.We prescribedthe useof ivermectinand the patientwas hospitalized fordebridementof necrotic tissueand removalof the larvae.After hospital discharge, caregivers were orientedabout the use ofmasksby the patient, which was not effectivebecause the patientbegan tobite it,leading to its displacement andre-infestation bymaggots.After treatmentof re-infestation, it was adopted theroutineuse ofdrapery. AD patientsarearisk group fororal myiasis, beingnecessary to directcaregivers and family membersin relation tooral care to prevent this disease.The main treatmentfor the changeis based onmechanical removalof larvae andinstituting the useoforalivermectin.
Myiasis; Mouth; Elderly; Alzheimer's disease; Prevention
