Oftalmomiasis externa por Dermatobia hominis. A propósito de un caso

Resumen

Caso clínico

Mujer de 46 años, sin antecedentes de interés, natural de Honduras y residente en España desde hace un mes y medio. Acude a urgencias por inflamación del párpado superior del ojo derecho, con zona que simula absceso. Se procede a drenado del mismo (sin obtener apenas contenido purulento), se prescribe tratamiento con antibióticos y antiinflamatorios tópicos y orales. A la semana siguiente acude con mejoría del cuadro inflamatorio, pero con molestias y erosiones corneales. Tras eversión del párpado superior se observa parásito tipo «gusano» emergiendo del tarso. Se completa extracción del mismo con pinza, identificándose como Dermatobia hominis (Dh) mediante examen en fresco. La evolución posterior de la paciente resultó favorable.

Discusión

La celulitis preseptal en pacientes procedentes de zonas tropicales y subtropicales puede ser causada por Dh.

Abstract

Clinical case

A 46-year-old woman with no relevant medical history, native of Honduras and resident in Spain for one and a half months. The patient went to the Emergency Department due to inflammation of the upper eyelid of the right eye, with an area that simulated an abscess. This was drained (obtaining hardly any purulent content). Treatment was prescribed with oral and topical antibiotics, as well as an anti-inflammatory drug. One week later the patient returned, with improvement of the inflammatory signs, but with discomfort and corneal erosions. After eversion of the upper eyelid, a «worm» type parasite emerged from the tarsus. The extraction was completed with a clamp, and was later identified as Dermatobia hominis (Dh) by examination of a fresh specimen. The subsequent outcome of the patient was favourable.

Discussion

Preseptal cellulitis in patients from tropical and sub-tropical areas can be caused by Dh.