Myiasis: A Traveler's Dilemma

Abstract

Myiasis is a tropical infection most often caused by Dermatotobia hominis, also known as the botfly. It is rarely seen in the United States. The infection has a slow evolution and often presents with painful lesions that mimic furunculosis, boils, and infected cysts. The mechanism of infection is based on the deposition of botfly eggs onto an arthropod, which acts as a vector of transmission. The arthropod infects various hosts and botfly eggs are concomitantly deposited on the host. The Dermatobia eggs transform into their larval form and penetrate the skin through adjacent adnexal structures or through the arthropod-based site of inoculation itself. Growth of the organisms within the tissues causes painful cystlike lesions. This article describes cutaneous furuncular myiasis and discusses patterns of recognition and treatment modalities, with a case presentation of an individual diagnosed with the condition attained from a visit to Belize.

Figure 1

Initial presentation of painful nodules on the scalp

Figure 2

Dermatobia larvae; one extracted from each of the three scalp nodules