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[One catches not only mice with bacon. An atraumatic treatment for cutaneous myiasis]
1Abteilung für Infektions- und Tropenmedizin, Medizinische Klinik Innenstadt der Ludwig-Maximilians-Universität München, Germany. clemens.schulte@medizin.uni-ulm.de
History And Admission Findings:
A 37 year old patient was admitted because of four prurigous furunculoid swellings on his right upper knee. The patient had a history of traveling in Brasil for 6 weeks, returning 2 weeks before admission. The nodular skin lesions, 2.5 cm in diameter, had a central opening, from where under little pressure a seropurulent fluid discharged. In the central opening moving, whitish structures were visible.
Treatment And Course:
A piece of raw bacon, serving as occlusion-material, was fixated on the affected skin for two hours. The larvae emerged due to oxygen deficiency. After retraction of the bacon it was possible to grasp the emerged end of the larvae with tweezers and pull them out completely. The larvae were identified as third instar of dermatobia hominis.
Conclusion:
Cutaneous myiasis is a worthy differential diagnosis in patients presenting with furunculoid skin lesions after traveling to endemic areas. The treatment with bacon as an occlusion-material offers an atraumatic alternative to surgical excision.
