Pelvic organ myiasis.

BACKGROUND: Myiasis is infestation with dipterous larvae, which feed on the host's dead or living tissue, liquid body substances, or ingested food.

CASE: A 76-year-old, multiparous woman presented at a tertiary care hospital in India with vaginal discharge and itching for 3 weeks. The patient had a health care attendant who apparently failed to notice the problems she was experiencing. Pelvic examination revealed grade 2 uterine prolapse. Vaginal discharge was purulent, foul smelling, and contained several 8-10-mm white maggots of Musca domestica (housefly). Turpentine oil was instilled locally, and maggots were removed manually. The patient was treated with broad spectrum antibiotics. Maggot removal was repeated weekly for 3 weeks until no further maggots were present. Hysteroscopy was normal. The prolapsed uterus was replaced in its anatomic position with vaginal pessary.

CONCLUSION: Decreased physical and mental capabilities due to old age and poor care by health providers can lead to maggot infestation of prolapsed pelvic organs.