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Infestation of ulcers and invasion of nasal cavities of leprosy-affected persons by larvae of different flies is still seen in some patients today. Leprosy-affected persons, whether active or released from control, having residual problems like atrophic rhinitis or anesthesia of the hands and feet can acquire maggot infestations especially if they are from economically weaker strata of society, have poor hygiene, suffer from general debility and have poor near vision.
The term myiasis is derived from Greek word "Myia" meaning a fly. Infestation of living tissues by larvae of dipterans flies is called myiasis. and Goldstein (2) was probably the first to report myiasis in human beings. The flies responsible for myiasis are grouped as obligatory, facultative and accidental parasites depending upon the ovi or larvipositing habits of the flies. Common genera causing myiasis in humans are Sarcophaga, Chrysomyia, Lucilla, and Calliphora. Occasionally common house flies (belonging to genus Musca) are also responsible for accidental myiasis. Based upon the affected organ, myiasis can also he classified as nasal, aural, ocular, anal, vaginal etc. Animal myiasis is well known. Human tissue myiasis involving the skin has been reported from Mexico, the Middle East. North Africa and the United States of America, but few documented reports are available (3, 7).
The maggots of certain dipterans (lies are merely scavengers and are sometimes found to be beneficial. These surgical maggots are said to help in healing wounds (9,10). However it is difficult to predict circumstances under which they act as scavengers or as a serious parasite. It has been observed that once the wounds of the extremities are cleared of maggots they granulate faster. This has been attributed to the presence of allantoin which is excreted by maggots into the wound (11).
Myiasis is more commonly seen in the tropics and subtropics where flies are present in abundance. These are the areas of the world where leprosy also exists. Myiasis causes distress, pain and increases tissue damage. Myiasis is a serious problem when it occurs, although Sreevatsa, et al. (12) found the incidence to be less than 0.5% in 3350 consecutive cases of leprosy of all types. Either sex can be affected but there has been a male predominance, probably due their involvement in outdoor activities. Poor...