DR.MOHAMMED IRFAN SHEIKH8 months ago

Myiasis from Larvae of Human Botfly

Myiasis from Botfly Larvae A 62-year-old woman presented to the dermatology clinic with pruritic, draining nodules on the back and buttocks. She reported an associated biting sensation that worsened at nighttime. Two months earlier, she had traveled to Colombia and recalled receiving several mosquito bites. She had initially been evaluated at a different clinic and had received treatment with oral amoxicillin–clavulanate and doxycycline but had no improvement in the lesions. Physical examination showed six erythematous nodules with clear drainage and a central punctum (Panel A), within which larval movement was observed. The lesions were anesthetized with lidocaine, and the larvae were removed (Panel B and video). In total, six larvae were extracted and identified as larvae of the human botfly (Dermatobia hominis). Although uncommon in the United States, myiasis is important to consider when the characteristic cutaneous lesions develop in a returning traveler. At 1-week follow-up, the lesions had partially resolved and the patient reported a 70% reduction in her symptoms.