Topic outline

  • Grand Rounds

    A patient with PMHx of HTN and POHx of basal cell carcinoma involving the right lateral nasal wall s/p wide resection and orbital exenteration with subsequent reconstruction (complicated by a chronic open wound along the superior lateral nasal wall extending into the right frontal/ethmoid sinus as well as osteomyelitis requiring 6 weeks of IV antibiotics) presented with a one-day history of right orbital pain. Examination revealed the orbit was found to be infested with maggots, but without visible necrotic tissue or eschar. The patient was diagnosed with orbital myiasis and underwent bedside procedure for maggot removal. MRI of the brain and orbits showed MRI of the brain and orbits showed post-surgical changes with multiple communicating fistulas to the nasopharyngeal cavity as well as pachymeningeal thickening predominantly along the posterior border of the cavity representing reactive and inflammatory changes. After appropriate culturing and cleansing was performed, meticulous removal of maggots was performed with forceps and suction via a bedside procedure.

    Presentation Date: 03/13/2025
    Issue Date: 05/16/2025