MYIASIS IN THE DISABLED AND ELDERLY AS A POTENTIAL MARKER OF MEDICAL NEGLECT

J. Musayev, S. Javadli, S. Musayeva, E. Talibov

Abstract: Background. Myiasis is a parasitic infestation caused by dipterous fly larvae, typically affecting individuals with poor hygiene or chronic wounds. In vulnerable populations—such as the elderly, disabled, or non-verbal—its presence may signal more than a clinical issue, potentially indicating systemic neglect. Histopathological examination plays a key role in confirming infestation and determining its timing relative to death.
Case Reports. We present three cases of myiasis discovered through surgical or biopsy specimens. Case 1 involves a 9-year-old boy with congenital deafness and mutism, presenting with a ruptured cervical lesion. Case 2 features a 68-year-old hemiparetic woman with a non-healing postoperative leg wound. Case 3 concerns an 83-year-old blind, diabetic man living alone, with larval activity noted in ulcerated leg lesions. In all cases, diagnosis was confirmed histologically, revealing larval structures surrounded by eosinophilic and neutrophilic infiltrates.
Conclusion. These cases highlight the medicolegal relevance of myiasis in dependent individuals. The diagnosis, especially when made via histopathology, may indicate inadequate caregiving and warrants broader forensic and ethical evaluation. Clinicians should maintain a high index of suspicion in such patients and consider mandatory reporting in cases suggestive of neglect.
Keywords: myiasis, medical neglect, vulnerable patients, histopathology, forensic pathology.