Cutaneous myiasis in an elderly woman in Somaliland

Authors: Mukhtar A. Yusuf, Bobbi S. Pritt,  Josette R. McMichael

International Journal of Women Dermatology, 2019


Background: Cutaneousmyiasis is a self-limited skin infestation by developing fly larvae,with three clinical  subtypes: furuncular, migratory, and wound myiasis. Furuncular myiasis is endemic throughout much of Africa; however, few reports are from the Horn of Africa.

Clinical presentation: An 85-year-old woman in Somaliland presented with a 12-day history of multiple painful and pruritic nodules on the temple, arm, chest, breast, flank, and legs. The posterior of a larva was visible within several lesions. One larvawas extracted froman armnodule and identified as Cordylobia anthropophaga (tumbu fly) by morphologic examination. The patient was instructed to occlude the other nodules with petroleum jelly and return in 3 days. Instead, she visited a traditional healer who extracted the remaining larvae.

Conclusions: We present a case of furuncular cutaneousmyiasis due to Cordylobia anthropophaga. Treatment options for this infestation include occlusion with petroleumjelly to cause larvae to exit, surgical extraction, and oral ivermectin. Occlusionmay not be acceptable for some patients. Extractionmay cause significant inflammatory response if the larva is damaged during the process. To our knowledge, this is the first published report of myiasis in Somaliland, although it is probably underreported. Myiasis is a common dermatosis associated with travel to endemic areas. Furuncular myiasis can easily be misdiagnosed as furunculosis or cellulitis. Dermatologists must be familiar with the clinical features and management of this dermatosis.

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