Preseptal cellulitis secondary to ocular myiasis in pediatrics: Case report

Abstract

Introduction: Preseptal cellulitis secondary to ophthalmomyiasis is a rare but documented condition in the medical literature. Ophthalmomyiasis refers to the infestation of fly larvae in the ocular area, which can lead to complications such as preseptal cellulitis. This type of infestation is more common in certain regions of Latin America, where the Dermatobia hominis fly is endemic. Treatment of preseptal cellulitis secondary to ophthalmomyiasis generally involves larval removal, which may require surgical intervention, and the use of antibiotics to treat any secondary bacterial infection. Clinical Case: We present the case of a 4-year-old preschooler from a rural area of ​​Tuluá, with a history of conjunctival injection, epiphora, erythema, and edema in the right eye. Biomicroscopy revealed a larva, and the child developed preseptal cellulitis due to ophthalmomyiasis associated with methicillin-resistant Staphylococcus aureus (MRSA) infection, confirmed in subsequent cultures. Surgical removal of the larva was required, and the child was treated with clindamycin with a favorable clinical outcome. Discussion: Preseptal cellulitis affects the soft tissues anterior to the orbital septum. Although its most common cause is bacterial, in rare cases it can be due to ophthalmomyiasis. Symptoms include edema, erythema, purulent discharge, and ptosis. Treatment includes antibiotics, antiparasitics, and, occasionally, surgical drainage. Conclusion: Ophthalmomyiasis requires comprehensive management. It is essential to promote hygiene and consider this diagnosis when ocular inflammations occur in rural or vulnerable populations. Despite a low prevalence, early recognition and a detailed medical history are essential to prevent complications.