Dr.Prgya Prakash, P16948
Introduction: This case report demonstrate invasive parasitic larvae almost invariably cause massive destruction of orbital tissue, extending to the sinuses mimicking midline destructive patology . A 40 year old male was brought to emergency in unconscious state with complaints of swelling both eyes and midline skin destruction. On examination, both eyelids had periorbital edema with midline massive destruction of skin and underlying bones of nose and face involving periorbital region. There was gangrenous necrotic tissue involving whole nose invading inferiorly into mandible and laterally to zygomatic bone. On consultation with ENT , provisional diagnosis of gangrenous nasal perforation with suspected midline destructive malignancy was made and was started on IV antibiotics and fluids. On debridement of lesion, multiple small white worms were found in gangrenous and necrotic midline tissue and final diagnosis of rhinoorbitalmyiasis was made.
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