Images in Clinical Medicine

Myiasis Due to Dermatobia hominis (Human Botfly)

Francisco M. Marty, M.D., and Kristen R. Whiteside, B.S.

N Engl J Med 2005; 352:e21June 9, 2005

• Slide

Article

Video

Extraction of Human Botfly Larvae.

A 65-year-old man presented with skin lesions on his chest and left arm and shoulder six weeks after returning from a vacation in Belize at the beach and in the rain forest. The lesions occasionally stung, drained a dark exudate, and enlarged despite two weeks of treatment with cephalexin. The patient had no constitutional symptoms. Physical examination revealed five nodules of varying sizes with surrounding erythema and a central pore through which a single, moving larva was observed (Panel A). The pores were occluded with petrolatum for two hours. After lidocaine was injected around the nodules, five Dermatobia hominis larvae at various developmental stages were extracted with the use of manual pressure and tweezers (Panel B and Video Clip 1). Larvae can also be extracted with suction or surgically. The patient recovered fully.

Distributed throughout Latin America, D. hominis begins its life cycle when adults lay eggs on porter zoophilic insects. The eggs hatch in response to the host's body heat, followed by larval penetration into the skin. Mature larvae then emerge from the host and pupate in the soil.

Francisco M. Marty, M.D.
Kristen R. Whiteside, B.S.
Brigham and Women's Hospital, Boston, MA 02115

Citing Articles (4)

Citing Articles

1. 1

   Matthew Peters, Morgan Katz. (2011) An “Infected Sebaceous Cyst” in a 42-Year-Old Man With Recent Travel to South America. The American Journal of the Medical Sciences1
   CrossRef

2. 2

   Kerri Robbins, Amor Khachemoune. (2010) Cutaneous myiasis: a review of the common types of myiasis. International Journal of Dermatology 49:10, 1092-1098
   CrossRef

3. 3

   Adriana Calderaro, Simona Peruzzi, Chiara Gorrini, Giovanna Piccolo, Sabina Rossi, Eugenio Grignaffini, Stefano Gatti, Edoardo Caleffi, Giuseppe Dettori, Carlo Chezzi. (2008) Myiasis of the scalp due to Dermatobia hominis in a traveler returning from Brazil. Diagnostic Microbiology and Infectious Disease 60:4, 417-418
   CrossRef

4. 4

   E. Bassi, I. Bournerias, M. Bagot, J. Revuz. (2006) Myiase furonculoïde. Annales de Dermatologie et de Vénéréologie 133:8-9, 734
   CrossRef