Nasal myiasis with orbital and palatal complications

A 15-year-old girl presented with a chief complaint of bleeding from her nose. She had noticed worms emerging from her right nostril. She had a continuous dull ache on the right side of her nose, spreading over the maxillary sinus area, and on the infra-orbital margin on the same side. She complained of difficulty breathing through her right nostril and a foul smell, which was associated with orbital oedema. Intra-oral examination revealed erythema of the soft palate on the same side, which was tender on palpation. Her condition was diagnosed as nasal myiasis with orbital and palatal extension. Nasal myiasis was treated by surgical removal of the maggots and with Ivermectin and local application of turpentine. The symptoms resolved and the dangers of orbital complications and penetration into the intracranial cavity were averted. The serious short-term complications of nasal myiasis were prevented by prompt treatment.