Just in case you needed new material for your nightmares, here’s this real-life case report of a woman in Greece who literally sneezed out maggots.
Doctors documented the spine-chilling sneeze this month in the journal Emerging Infectious Diseases. The 58-year-old woman’s nasal and sinus cavities were infested by sheep bot fly larvae caught outdoors. Despite the horrifying discovery, the doctors safely extracted all of her unwelcome houseguests with no complications.
“She was treated with nasal decongestants and made a complete recovery,” they wrote.
Nose “worms”
According to the report, the woman had been working outside next to a field of sheep on a hot September day last year when she noticed flies swarming around her.
About a week later, she started feeling worsening pain around her jawbone. Over the next two to three weeks, she also developed severe coughing fits but no other symptoms. Finally one day, she sneezed, and—in her own words—”worms” began to come out of her nose. She sought medical attention soon after, where she was examined by an ear, nose, and throat specialist. The so-called worms were actually maggots, or fly larvae, and the doctor pulled 10 squirming larvae of varying stages along with one pupa from her maxillary sinus.
Upon closer examination, the maggots were identified as that of Oestrus ovis, aka the sheep bot fly.
“Biologically implausible”
As their common name implies, these flies are usually a sheep problem.
The flies lay first-stage larvae inside the nostrils of sheep, which then migrate to the nearby sinuses and grow into their third stage of life. At that point, the maggots typically go back to the nostrils to be sneezed out, where they’ll burrow into the soil and turn into pupae, the cocooned stage of life practiced by some other insects like butterflies. Finally, they burst out as adult flies, ready to start the cycle anew.
Human infestations of the sheep bot fly are known to rarely occur, but this case is perhaps the weirdest one ever documented, and not just for the maggot sneezing.
For starters, humans are an accidental dead-end host for the fly. In most recorded cases, the larvae don’t mature past the first stage of life inside people before dying or being discovered. More recently, there have been a few reports of human-infesting larvae found in the third stage of life, usually in people with weakened immune systems. But this is the first-ever case of a pupated O. ovis found inside a person—something that’s considered “biologically implausible” to happen in any mammal host at all, the case report authors say.
Normally, our sinuses simply don’t meet the right temperature, humidity, or other conditions that would prompt an O. ovis maggot to start turning into a pupa. The woman did have a severely deviated septum, the authors note. So the woman’s unusual nasal structure, coupled with an unusually heavy infestation and other unknown factors, might have created the perfect conditions for such a rare event to happen.
On the other, much more frightening, hand, the doctors also speculate that “this case may represent an early indication of evolutionary adaptation, enabling O. ovis parasites to complete their life cycle in humans.” Lovely.
In either scenario, the doctors say, more cases and data are needed to understand how this kind of infestation might have happened, and they advise other clinicians in endemic areas to be aware of the possibility of these infections.
Personally, I’m deeply hoping it’s not the scenario where sheep bot flies are evolving to turn us into common hosts for their nosey maggots.
Read the full article here
