Cutaneous myiasis in an elderly woman in Somaliland

• Type of Material: Article
• Authors: Mukhtar A. Yusuf, Amoud University College of Health Sciences; Bobbi S. Pritt, Mayo Clinic; Josette Renee McMichael, Emory University
• Language: English
• Date: 2019-07-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Published by Elsevier Inc. on behalf of Women's Dermatologic Society.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ijwd.2019.04.022
• Title of Journal or Parent Work: International Journal of Women's Dermatology
• ISSN: 2352-6475
• Volume: 5
• Issue: 3
• Start Page: 187
• End Page: 189
• Grant/Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
• Keywords: myiasis; furuncular myiasis; fly larvae; Somaliland; cutaneous myiasis; tumbu fly
• Research Categories: Health Sciences, Pathology; Health Sciences, Medicine and Surgery

Abstract

Background: Cutaneous myiasis 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 larva was extracted from an arm nodule 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 cutaneous myiasis due to Cordylobia anthropophaga. Treatment options for this infestation include occlusion with petroleum jelly to cause larvae to exit, surgical extraction, and oral ivermectin. Occlusion may not be acceptable for some patients. Extraction may 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.