Myiasis

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Overview

Myiasis is caused by the larvae of certain botfly species whose larvae penetrate and develop in the skin. The larvae may enter the skin from the bites of other insects that carry the botfly eggs (New World), or by direct skin contact with the eggs deposited on beaches or clothing (Africa). Most cases are acquired in the tropics of Central and South America and Africa. The clinical lesions resemble an abscess or furuncle, hence the name "furunculoid myiasis." Doppler ultrasound can be used to confirm the diagnosis.

Initial Steps

1. Early recognition is important. A firm papule with a serous central discharge and a central orifice should suggest the diagnosis.
2. Inject a bolus of normal saline under the mass, then anesthetize the surface of the lesion with lidocaine. Incise the skin over the larva(e), and remove with a hemostat or curette. Multiple larvae may be in one lesion, so be certain to remove all the larvae.

Ancillary Steps

Secondary infection should be treated if present.