Record of oral myiasis by Cochliomyia hominivorax (Diptera: Calliphoridae): case evidencing negligence in the treatment of incapable.

Cases of myiasis in man associated with preexisting lesions are quite common. However, in the forensic field, certain behavioral habits related to insects may be useful to ratify mistreatment. This is a register of a case of oral myiasis by Cochliomyia hominivorax (Diptera: Calliphoridae), an obligate parasite of warm-blooded animals, in a 95-year-old man with Alzheimer's and Parkinson's disease. The identification of immatures removed (n = 87) was based on their morphological characteristics. Considering the developmental time and length of the maggots, it was possible to estimate an infestation of at least 143 h. Undoubtedly, the poor state of health was one of the cofactors for the infestation; however, the long time of infestation observed denotes negligence in the conduct of patient care. In terms of prophylaxis, it would be recommended that individuals who need special care must have access to more comprehensive physical examinations and periodicals, as well as hygienic conditions should be meticulously observed. Additionally, the immatures causing myiasis after being removed must be stored and forwarded for analysis, since their identification can be crucial to determine the exact time and circumstances of an infestation, and consequently its pathogenesis. If we consider the aggressiveness of C. hominivorax, a fast and reliable diagnosis becomes even more important for an adequate treatment. Finally, it is expected that this study encourages the health care professionals to improve the treatment of incapable patients.