Source (National Library of Medicine)

Fig 1: Uterine myasis
Fig 2: Superinfection
Fig 3: Uterine myasis after initial treatment
Fig 4: Duplicate of Fig 1, because retarded LiveGore won't let me select a thumbnail otherwise

An 82-year-old illiterate female attending gynecologic service at Valle University Hospital, Cali, Colombia, with total genital prolapse noted for the last 5 years. Four ulcers were observed in the prolapsed uterus, the biggest one with a diameter of 6 × 3 cm, with necrotic edges. These were cavitated and infested by live larvae, Sarcophagidae (fleshflies) vs Calliphoridae (blowflies) families; with fetid discharge and inflammation of adjacent tissue (Figures 1 and 2). The patient had a body mass index (BMI) of 31, personal neglect, poor hygiene, without signs of senile dementia. Antecedents of one vaginal delivery without complications. No chronic pathology. She is originally from a rural area, but has been living in an urban area for the last 5 years, in an industrial zone far from animal breeding or sanitary landfills. She was hospitalized for 7 days, received intravenous ceftriaxone-metronidazole; oral ivermectin (drops at 0.6%, 1 drop per kilogram of body weight) and topical ivermectin. Additional treatment included mechanical extraction of larvae with forceps and daily washing of lesions until obtaining granulation tissue (Figure 3). Posthospitalization, topical estrogen was applied on the genital prolapse for 1 month. Surgical correction of the genital prolapse was performed via vaginal hysterectomy with anterior and posterior colporrhaphy; a procedure without complications.