Primer reporte de miasis cerebral por Cochliomyia hominivorax en Perú: caso clínico y revisión bibliográfica

Abstract

Cerebral myiasis (CM) is a rare form of infestation of the central nervous system by dipteran larvae and is frequently associated with high mortality. It has been described following cranial surgery or trauma and, rarely, in the setting of head and neck neoplasms. We present the first Peruvian case of transnasal CM caused by Cochliomyia hominivorax in a 40-year-old man with a history of surgical treatment for nasal chondrosarcoma. The patient presented with skull base erosion and pneumocephalus. Endoscopic removal of 70 larvae from the nasal cavity and brain was performed. In addition, we conducted a literature review of CM, from which 14 articles were ultimately selected. We examined the epidemiological findings and compared them with the characteristics of our patient, who had a favorable clinical outcome. Finally, we emphasize the importance of entomological surveillance, early diagnosis, and reporting systems as public health measures in response to this obligate myiasis, which affects both rural communities and visitors to endemic areas.