Dear Dr Ombeva,
Greetings from Zimbabwe. I read your article on the Internet about botflies and maggots in children. I have a case here which may interest you.
After reading your article, I was almost sure that there was a similarity in the following case. I am a mother of three daughters; the first is six years old and the twins are four years old.
When I gave birth to the twins in 2016, they were a little less than 2.4kg. At seven months, Twin 1 was heavier than Twin 2 (this was the case since birth).
Suddenly, she started having an infestation of maggots all over her body; abdomen, buttocks, legs, neck, hands, feet, head... everywhere. I took her to the doctor but the doctor dismissed it as a myth... so I got home and squeezed the maggots out one by one amidst unbearable screams... only then did she start sleeping well.
But her body changed almost instantaneously as she stopped gaining weight. The growth pattern has been slow. Now, her other twin weighs 17kg while she is only about 14kg. She complains of tummy aches occasionally and throws up a lot.
I took her to a specialist paediatrician but all tests came out negative except for mild inflammation of the gut. Is it possible they see it as an inflammation when it is actually maggots?
All medicine prescribed to her don’t seem to work. In winter, the pains seem worse. Kindly assist. I will be very grateful.
Worried mother
Answer
Thank you for your question. As you have described above, and as I wrote earlier, I think strongly that your daughter has myasis, which manifests as maggots, i.e. those whitish fat short worms coming from your baby’s skin. This follows parasitic infestation of the body of a live animal by fly larvae (maggots) that includes the botfly, blowfly, and screw fly.
Larvae or eggs can reach the stomach or intestines if they are swallowed with food and cause gastric or intestinal myiasis, which may appear as inflammation. Affecting the skin, it causes painful, slow-developing ulcers or boil- like sores that can last for a prolonged period.
In the nose, it can cause obstruction of nasal passages and severe irritation. The face may swell with edema, and fever may occur. In the ear, it may cause ear discharge and buzzing ear noise. In the eyes, it may cause very severe irritation, edema, and pain.
To control this, prevention and eradication of flies or early treatment for the child is important. If this is the case, the doctor needs to prescribe ivermectin, which is the drug of choice.
In general, improvement of sanitation, personal hygiene, and eradication of flies by insecticides is important. The clothes should be washed thoroughly, preferably in hot water, dried away from flies, and ironed thoroughly. The heat of the iron kills the eggs of myiasis-causing flies.
Other measures include applying petroleum jelly on the holes. This suffocates and forces the larvae onto the surface.
Dr Ombeva Malande is a specialist paediatrician; Reach him on ombevaom@gmail.com What is the first thing you notice about a person?