Woman goes to the doctor with a swollen forehead... only for doctors to pull out two MAGGOTS that burrowed into her skin during a trip to Africa

January 24, 2019 18:25

A painful lump on the forehead may, for most of us, be a sign we've banged our head on the kitchen cupboard.

But for one woman who recently returned from a holiday in Uganda, a red swelling on her hairline turned out to be a pair of maggots living under her skin.

The 55-year-old went to hospital with swelling on her head, which doctors thought was an infected insect bite, so they sent her home with antibiotics.

But three days later she returned with 'shooting pains' in her face. The swelling had also spread down to her eyes.

Medics conducted tests and found a maggot burrowed inside her forehead. Further scans then revealed another was still there.

They removed both maggots and the woman made a full recovery from her 'rare' ordeal, which begun after she wrapped a towel with fly eggs on it round her head.

The patient went to hospital while suffering concerning symptoms after a trek through a rainforest in Kibale National Park, Uganda.

The swelling continued to get worse after her first visit to a hospital in York, and she was kept as an inpatient for four days when she returned.

The woman, whose name is not known, had the first insect removed after it was smothered with petroleum jelly.

But an ultrasound scan afterwards revealed one maggot remaining under her forehead skin near the hairline, doctors said in the British Medical Journal Case Reports.

In this instance, medics cut open the skin to remove the creature and clean out the wound.

'I returned to hospital after phoning up to say my symptoms had got worse/my face more swollen and I was in great pain,' the patient said.

'I was seen quickly and admitted to the maxillofacial ward where they were just great—extremely helpful.

'I have previously been used to having lots of things running through my mind – ideas, particularly, would often pop out [but] maggots were a first!'

Once the larvae had been removed they were sent to the London School of Tropical Medicine, where experts identified them as Lund's fly offspring.

Myiasis – infection with maggots – from Lund's flies is rare, they said, with only one other case being recorded since 2015.

And it was also rare for the larvae to burrow into the forehead because fly eggs are usually transferred to the skin of the legs or abdomen on clothing.

The woman revealed she had wrapped her head in a damp towel which had been left outside, on which doctors believe a fly had laid its eggs.

In myiasis cases fly eggs usually get under someone's skin through a small surface wound like a scratch or graze, then develop into maggots before dropping off on their own.

'Also, a friend of my son who joined us in Uganda had the same infestation on his back when he left to come home to UK.

'But the walk-in centre in London where he lives did not believe the lump on his back was anything more than an infected bite. He also had a maggot which came out when he took the Elastoplast off!'

The doctors said the lesson in this patient's case was to always take into account a patient's recent travelling history.

Although the woman's case was unlikely, delayed diagnosis could cause extra pain and inconvenience, they said.