Rare Infection Causes Woman to Sneeze Live Larvae

A rare medical case involving a 58-year-old woman in Greece has highlighted the complexities of diagnosing parasitic infections when symptoms appear biologically implausible. The patient experienced a series of escalating respiratory and facial symptoms that culminated in the expulsion of insect larvae through her nasal passages.

The woman, who worked outdoors on a Greek island, first noticed pain centered around her face. This pain grew progressively worse over a period of time. Approximately two to three weeks after the onset of the facial pain, she developed a severe cough.

The situation escalated when the patient began sneezing worms out of her nose, which prompted her to seek immediate medical attention.

Surgical Intervention and Findings

Upon seeking care, the patient was seen by an ear, nose and throat specialist. The specialist performed a surgical procedure to remove wriggling creatures from the patient’s maxillary sinuses, which are the large sinuses located on the sides of the nose.

The surgical extraction revealed a total of 11 organisms: 10 larvae and one pupa. A pupa represents the insect life stage that occurs between the larval and adult stages.

Medical experts conducted a close examination of two of the larvae and a portion of a puparium, which is the protective outer casing where a pupa matures into an adult. The examination found that one larva was pale yellow and measured approximately 0.6 inches (15 millimeters) in length. A second larva was light brown and measured 0.8 inches (20 millimeters) in length.

Medical Context of the Infection

The infection has been identified as a parasitic fly infection. Specifically, the larvae are associated with the sheep bot fly, known scientifically as Oestrus ovis.

This case is described as highly unusual and biologically implausible, drawing attention to the potential for hidden parasitic infections in individuals with specific environmental exposures. The patient’s occupation, working outdoors on a Greek island, provided the necessary environmental context for exposure to the parasite.

The progression of symptoms—starting with localized facial pain and moving toward respiratory distress and the eventual physical expulsion of larvae—illustrates the diagnostic challenges physicians face when presenting symptoms do not align with common clinical expectations.

While the report details the surgical removal of the parasites and the physical characteristics of the larvae, it does not describe the specific methods used during the initial examination of the patient.