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INTRODUCTIONMyiasis was first described by F. Hope in 1840. CASE REPORTA 14-year-old mentally challenged boy presented to our hospital with a swelling of the upper lip and the right side of his face for the past 3 days. His parents accompanied him. The patient had a history of fits 10 days back following which he sustained fracture of the upper front teeth.

Following extraction of the fractured tooth, he developed a wound in the same location that started to increase in size. He had severe and continuous pain over the wound. The parents also noticed worms in the mouth. The patient also has a history of seizures for which he is under medication. The patient was of a low socioeconomic status, poorly built, apprehensive and febrile. Diffuse swelling was seen over the right side of the face.

Periorbital edema was present and the upper lip was swollen. Appearance of the patient at the time of presentationIntraoral examination revealed a necrotic area in the maxillary anterior region involving the vestibular sulcus and labial mucosa extending from the right canine to the left canine, measuring 6 cm × 4 cm.

A number of maggots were seen in the necrotic area. The surrounding area was erythematous and swollen.

The patient had poor oral hygiene. The teeth in the necrotic area 12 and 21 exhibited significant mobility, and 21 was decayed. Based on the clinical findings, the case was diagnosed as oral myiasis. Hematological analysis was within normal limits. Maggots in the maxillary anterior regionThe treatment was performed by oral and maxillofacial surgeons of our hospital. The patient was hospitalized for 3 days. The treatment included flushing the affected area with turpentine oil followed by the administration of local anesthesia and manual removal of maggots with tweezers.

Around 50–60 maggots were harvested. Teeth 12 and 21 were extracted. The area was then washed with saline, followed by irrigation with betadine. Broad spectrum antibiotics amoxycillin with clavaualnic acid and ibuprofen with paracetamol were prescribed. This procedure was repeated again until the maggots were completely removed. The next day the edema had subsided considerably.

The parents were given extensive environmental and personal hygiene instructions. The maggots were sent to a Veterinary Parasitology Department in Chennai Veterinary College for identification. The maggots were 12–15-mm long, whitish and without obvious body processes. The peritreme of the posterior spiracle was open and the anterior spiracle had four to six lobes. These features were compatible with Chrysomya bezziana larvae. The larvae were thus identified as Chrysomya bezziana species.

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The wound was left open to heal by secondary intention. The patient was reviewed 1 week later and the results were satisfactory. DISCUSSIONMyiasis is defined as infestation of live human and vertebrate animals with dipterous larvae that feed on the host’s dead or living tissue, liquid body substances or ingested food., They infest several parts of the body as in cutaneous, ophthalmic, oral, urogenital, nasopharyngeal and intestinal myiasis.Low socioeconomic status, immunocompromised state, debilitated and unhygienic living conditions are the main contributing factors responsible for myiasis. The risk factors for oral myiasis include suppurative lesions, facial trauma, mouth-breathers, extraction wounds, fungating carcinomas and others conditions.,In our case, the extraction wound was the most probable cause in the development of myiasis.

Lack of personal hygiene, communicating ability and negligence of the caretaker might have led to delayed presentation.Flies causing myiasis belong to the order Diptera., The genera commonly reported are Sarcophagidae, Calliphoridae, Oestridae and Muscidae from the Diptera order. Chrysomya bezziana, the Old World screw-worm fly, belongs to the genera Calliphoridae. It is an obligatory myiasis producer whose larvae develop only in living tissue, and human cases of Chrysoma bezziana infestations are uncommon. The species was first found in animal wounds in Hong Kong in the year 2000., The first case in humans was documented in 2003 in Hong Kong. Chrysomya bezziana is widely distributed throughout Asia, including China and neighboring regions of Hong Kong, such as Guangdong, Guangxi, Yunnan and Taiwan. It is also found in tropical Africa, the Indian subcontinent and Papua New Guinea.,The adult female lays eggs on live mammals.

The sites of infestation are usually superficial wounds, open sores and mucous membranes in body orifices such as the mouth, ear and nose. The eggs hatch within 24 h and the resulting larvae burrow into the host’s tissues head-downwards into the wound in a characteristic screw-like fashion, feeding on living tissue. The larvae release toxins to destroy the host tissue.

Proteolytic enzymes released by the surrounding bacteria decompose the tissue on which the larvae feed., The larvae complete their development in 5–7 days.

If you spy what looks like a giant mosquito hanging around your garden or zipping about near the back porch light, don’t panic — it’s only a crane fly. Throughout the summer, adult crane flies emerge from pupation below ground to mate and lay their eggs. Though many are beneficial decomposers, crane flies and lawn damage also go hand in hand. What are Crane Flies?Crane flies belong to the order Diptera, and are distant relatives to flies. Regardless of their less than desirable relatives, adult crane flies don’t bite or spread diseases, although crane flies in lawn grass can be problematic. These leggy flying insects lay their eggs on the lawn; the emerging larva is the stage to fear.Crane fly larvae are long, white, worm-like insects measuring up to 1 ½ inches long.

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They feed on the roots below turf grass lawns, killing crowns and causing brown patches that mar otherwise perfect seas of green grass. Crane fly larvae may also emerge to feed on crowns and grass blades on warm nights, further damaging lawns.

Most turf species can tolerate low to medium sized populations of crane fly larvae, but high feeding pressure can spell disaster. How to Get Rid of Crane FliesAdult crane flies don’t live long and aren’t dangerous, so crane fly control efforts are targeted primarily at larvae. By reducing habitat, increasing the vigor of turfgrass and using beneficial nematodes, you can significantly reduce crane fly populations effectively and without applying dangerous chemicals to the lawn.and are vital in the battle against crane flies; implement a lawn care regiment that includes both of these chores at least once a year, more often if your thatch is very thick.

Once those chores are completed, reduce the water you apply to your lawn. Crane flies need a moist environment to survive, but most grasses will do just fine with moderately dry soil as long as they receive a good drenching when they are watered.The Steinernema feltiae can reduce crane fly larvae by up to 50 percent when used correctly, but nothing reduces crane fly damage like a well-managed lawn. A springtime application of is recommended for lush, healthy grass that’s better able to resist crane fly larvae feeding.