title: Social exclusion and myiasis of the upper lip in a Brazilian rural resident.
abstract: BACKGROUND
  People living in rural or remote Brazil, as in other sub-tropical or tropical nations, are vulnerable to infections that would not normally occur in urban areas or wealthier nations. Brazil is a geographically extensive nation, historically marked by vast socioeconomic inequalities. Approximately 16% of the population live in rural areas.
  
  
  OBJECTIVE
  This clinical case report demonstrates the vulnerability of rural residents who are underserved by Brazil's 'universal' public healthcare system, despite social and economic challenges that increase their risk for disease. Myiasis (especially oral myiasis) is a rare health condition in humans caused by fly larvae. Oral myiasis usually appears in periodontal pockets and open wounds, such as after dental extractions. It is associated with poverty, lack of access to health care, and very poor overall health status. While myiasis has a worldwide distribution, it is particularly associated with the tropical and sub-tropical regions of North and South America.
  
  
  CONCLUSIONS
  This article describes a rare case of myiasis in the upper lip of a rural male patient. The case report demonstrate that rural and remote residents can be socially excluded from the benefits of technology and biomedicine, making them vulnerable to rare infections.
authors.affiliation: The State University of Montes Claros, Santo Expedito, Minas Gerais, Brazil. danielmestradounincor@yahoo.com.br
authors.forename: D A
authors.initials: DA
authors.lastname: Freitas
authors.forename: G
authors.initials: G
authors.lastname: Moreira
authors.forename: K M
authors.initials: KM
authors.lastname: Jones
authors.forename: A P
authors.initials: AP
authors.lastname: Caldeira
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis; D000772:Anesthesia, Local; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D001938:Brazil; D004636:Emergency Service, Hospital; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008047:Lip Diseases / Q000188:drug therapy* / Q000469:parasitology / Q000601:surgery; D008297:Male; D044342:Malnutrition / Q000628:therapy; D008507:Medically Underserved Area; D008875:Middle Aged; D009061:Mouth Mucosa / Q000469:parasitology / Q000601:surgery; D009198:Myiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000469:parasitology / Q000601:surgery; D017410:Practice Guidelines as Topic; D019035:Rural Health Services / Q000592:standards; D012924:Social Conditions; D012934:Social Isolation; D016896:Treatment Outcome; D035862:Vulnerable Populations
chemical_list: D000977:Antiparasitic Agents; D007559:Ivermectin