Furuncular myiasis caused by Dermatobia hominis, the human botfly

Myiasis is a common travel-associated dermatosis. Travelers to many parts of Central and South America are susceptible to infestation by Dermatobia hominis. Despite the common name of human botfly, D hominis infests a broad range of mammals and is a severe pest to economically important farm animals in endemic regions. The adult female does not lay the eggs on the host. Instead, the adult female infests hosts indirectly by using blood-feeding arthropods to serve as phoretic vectors to transport the eggs. We present a patient who acquired Dermatobia when bitten by a day-active mosquito during a visit to Guatemala. He had a locally painful, firm furuncular lesion with a central pore that drained serosanguineous exudates. The patient applied an occlusive ointment and recovered the larva after it emerged. In this report we discuss the life cycle of D hominis, the differential diagnosis, and therapeutic approaches.