P2815 - Cutaneous Myiasis at the Feeding Gastrostomy Tube Stoma Site: A Rare Clinical Presentation

Muhammad Jahanzaib Khan, MD¹, Karina Fatakhova, MD¹, Eugene Licht, MD^2
1Mather Hospital/Northwell Health, Port Jefferson, NY; ²Mather Hospital/Northwell Health, Setauket, NY

Introduction: Myiasis is a parasitic infestation of living or necrotic tissue by dipterous larvae (maggots) of fly species. Cutaneous myiasis at a feeding gastrostomy tube stoma site has only been reported a few times in the literature, making it a rare clinical presentation.

Case Description/Methods: A 42-year-old female with a history of cerebral palsy, traumatic brain injury, and spastic quadriplegia on longstanding nutritional support through a gastrostomy tube was admitted to the hospital with aspiration pneumonia and urinary tract infection. While hospitalized, maggots were discovered at the gastrostomy tube stoma site. The larvae were removed, and the stoma site was gently irrigated with normal saline. A new gastrostomy feeding tube was inserted at the bedside. Follow-up examinations over the next several days revealed no residual larvae or signs of infection at the stoma site.

Discussion: Cutaneous myiasis is a parasitic infection caused by fly larvae that burrow into the skin and feed on underlying tissues and the surrounding areas. Poor hygiene, inadequate wound care, and environmental factors increase the risk for infection. Feeding tubes can also act as potential sites for the deposition of fly eggs, which can lead to cutaneous myiasis under favorable conditions. Diagnosis is based on the clinical presentation and identification of larvae at the stoma site. Treatment involves manual removal of the larvae, debridement of the wound if needed and ongoing care to keep the site clean and dry. Good hygiene and care of the stoma site is necessary for prevention. While cutaneous myiasis at a feeding tube gastrostomy site is quite rare, this case highlights that once identified, it can be readily managed at the bedside and related complications, including secondary bacterial infection, can be avoided.


Disclosures:


Muhammad Jahanzaib Khan, MD¹, Karina Fatakhova, MD¹, Eugene Licht, MD². P2815 - Cutaneous Myiasis at the Feeding Gastrostomy Tube Stoma Site: A Rare Clinical Presentation, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.