Abstract

A 51 year old severe morbidly obese female 1 week s/p tracheotomy with fenestration and PEG complicated by IDDM, ARF, CHF, COPD, OSA, and HVS was readmitted to hospital for tracheostomy wound myiasis and cellulitis. The patient had been admitted to a local long term assisted care facilty where the infection was noted. The patient was taken back to the OR where the tracheotomy tube was removed and oral ETT was placed. Wound debridement along with larvae removal was performed. Airway endoscopy was done to rule out presence of intra-luminary larvae. It was noted that the Bjork flap had become devitalized with the infection, leaving a 2 ring defect. The wound was packed with Dakin’s Solution and daily wound care was done until no further larvae or necrotic tissue was seen. The patient was then taken back to OR where an anterior tracheal wall reconstruction was performed and replacement of trachostomy tube with removal of oral ETT. She was then transferred back to the ICU and long-term assisted care living.

Keywords

myiasis, dipterous larvae, cellulitis, chemical pneumonitis