Get you up to speed: Greek woman treated after sneezing out parasitic fly larvae from nose
A 58-year-old woman in Greece sought medical attention after sneezing bugs out of her nose, caused by the larvae of the parasitic fly Oestrus ovis. Doctors surgically removed ten larvae and one pupa from her maxillary sinus, and she made a complete recovery.
Dr Ilias Kioulos from the Agricultural University of Athens reported that a 58-year-old woman in Greece experienced a severe parasitical infestation of Oestrus ovis larvae in her nasal passages, leading to her seeking medical attention after sneezing them out. Following surgical removal of 10 larvae and one pupa, she was treated with nasal decongestants and made a complete recovery, with no similar cases reported among her co-workers.
The Greek woman has since made a complete recovery after the surgical removal of larvae and treatment with nasal decongestants. Dr Ilias Kioulos and his team indicated that the long-term effects of the parasitical infection are minimal, and none of her co-workers reported similar symptoms.
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A sample of the bugs which came out of the woman’s nose (Picture: Ilias P. Kioulos, Emmanouil Kokkas, and Evangelia-Theophano Piperak et al/Cover Media)
Look away now if you’re squeamish.
A Greek woman had to seek medical attention after sneezing bugs out of her nose.
The unusual ailment, which terrified those who witnessed it, was caused by a parasitic fly’s larvae.
Doctors removed an entire larval colony from her nose and she has since recovered.
They believe she became infected with the bug – Oestrus ovis (Diptera: Oestridae) or the sheep bot fly – due to her close proximity to sheep.
It is a cosmopolitan parasite in hot and dry regions, including countries bordering the Mediterranean Sea. Accidental human infestations are rare to unheard of but not impossible.
‘The patient was a 58-year-old woman in Greece who worked outdoors on a Greek island, adjacent to a field with grazing sheep,’ Dr Ilias Kioulos, a medical entomologist at the Laboratory of Pesticide Science, Agricultural University of Athens writes.’It was September, during hot and dry weather, and she noticed numerous flies swarming around her face.
‘Approximately one week later, she had onset of progressive maxillary pain, followed over the next two to three weeks by severe coughing. She reported no other symptoms.
‘On October 15, she sought medical attention after she sneezed and ‘worms’ started coming out of her nose.’
The broken puparium was black and wrinkled and contained remnants of the pupa (Picture: Ilias P. Kioulos, Emmanouil Kokkas, and Evangelia-Theophano Piperak et al/Cover Media)
Kioulos and his team say other than bugs coming out of your nose there is little to worry about in terms of the long-term effects of the parasitical infection.
‘An otolaryngologist surgically removed 10 larvae of various stages and one pupa from her maxillary sinusm,’ he added.
‘She was treated with nasal decongestants and made a complete recovery. None of her co-workers reported similar symptoms.’
While the unpleasant condition is rare in humans, it is fairly common in livestock that go unchecked.
‘The O. ovis life cycle within its natural hosts, sheep and goats, is well-documented,’ the team said. ‘O. ovis bot flies infrequently affect humans, most often depositing larvae in the conjunctival sac and rarely into the nostrils, mouth, or external auditory meatus.
‘The most common clinical manifestation is acute catarrhal conjunctivitis, typically preceded by the sudden sensation of a foreign body.’
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‘The patient we report had a severely deviated nasal septum and appears to have been inoculated with a large larval burden.’ Dr Kioulos said.
‘From a purely anatomic perspective, we hypothesise that the combination of high larval numbers and septum deviation impeded normal egress from the nasal passages, permitting progression to pupation.’
The situation was unusual, as normally temperature and climatic requirements do not allow for pupation.
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