PENILE MYIASIS IN AN ELDERLY DIABETIC MALE WITH INDWELLING CATHETER: A RARE CASE REPORT
*Dr. Sandhiya Rajendran, Dr. Deepak David and Dr. D. Devaprasath Jeyasekharan
Background: Myiasis, the infestation of human tissue by fly larvae, is an uncommon clinical entity, particularly in the urogenital region. Penile myiasis is exceptionally rare and usually occurs in debilitated patients with poor hygiene or indwelling catheters. Case Presentation: We report a 73-year-old male with a history of diabetes mellitus, hypertension, coronary artery disease, and chronic kidney disease, who presented with fever, decreased urine output, and penile ulcerations. He had undergone prior urological interventions and was on long- term catheterization. On examination, paraphimosis with multiple penile ulcers infested with live maggots was noted, along with a sacral bedsore. Laboratory investigations revealed leukocytosis, hyponatremia, renal dysfunction, and hypoalbuminemia. Imaging demonstrated bilateral renal calculi with an indwelling left DJ stent. The patient underwent emergency debridement, circumcision, removal of maggots, and bladder calculi extraction. Cystoscopy excluded intravesical myiasis. He was managed with antibiotics, analgesics, supportive care, and catheter care. The patient improved symptomatically and was discharged with appropriate follow-up. Conclusion: Penile myiasis is a rare but important condition in debilitated, catheterized patients. Prompt recognition and comprehensive management are essential to prevent severe complications, including intravesical spread and sepsis. Preventive measures, including hygiene education and careful catheter care, are crucial in at-risk populations.
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