Wednesday, June 15, 2011
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
- Early recognition is important. A firm papule with a serous
central discharge and a central orifice should suggest the
- 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
Secondary infection should be treated if present.