Comprehensive Management of Multisite Myiasis in a Critically Ill Patient: A Case Report Highlighting Challenges in Vulnerable Populations.

A 44-year-old unhoused male with a history of alcohol dependence was admitted to the emergency department with symptoms of tremors, agitation, and generalized pain. His condition rapidly deteriorated, revealing a subdural hematoma that necessitated an urgent craniotomy. Following surgery, he was diagnosed with multisite myiasis, with maggots present in his ears, nose, eye, and toenail bed. The treatment included surgical removal of the larvae, administration of ivermectin, and broad-spectrum antibiotics to prevent secondary infections. ENT evaluations confirmed further infestations, identifying the larvae as Lucilia sericata. Despite the initial severity, the patient showed significant improvement, regaining full consciousness within a week. This case highlights the critical need for early recognition and comprehensive management of myiasis, especially in vulnerable populations. Effective treatment involves a multidisciplinary approach, including stabilization, surgical intervention, and infection prevention. It underscores the importance of coordinated medical care and preventive strategies to manage myiasis effectively in at-risk groups.