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Botfly Myiasis Masquerading as Dacryocystitis.

Collin A Rozanski1, Joseph D DeSimone2, Tatyana Milman3

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|February 28, 2023
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Summary
This summary is machine-generated.

Cutaneous myiasis, caused by botflies, is a rare orbital infection. This case highlights the clinical, imaging, and pathological features of a North American botfly infestation in a human.

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Area of Science:

  • Medical Entomology
  • Parasitology
  • Ophthalmology

Background:

  • Cutaneous myiasis is a parasitic infection caused by fly larvae, with Dermatobia hominus and Cuterebra being common causative agents in Central/South America and North America, respectively.
  • Orbital involvement, while rare, presents a diagnostic challenge and requires prompt management to prevent complications.

Observation:

  • A 44-year-old male presented with a month of severe, boring pain, progressing to swelling and redness around the nose and right orbital region.
  • CT imaging revealed a rim-enhancing collection with surrounding inflammation near the medial canthus, extending to the skin.
  • Histopathology showed characteristic pigmented material and eosinophilic inflammation, confirming botfly myiasis.

Findings:

  • The case illustrates the clinical presentation, radiographic findings, and histopathological characteristics of orbital myiasis caused by a North American botfly.
  • The diagnosis was confirmed through pathological evaluation of the excised material.
  • This presentation underscores the importance of considering myiasis in the differential diagnosis of orbital infections.

Implications:

  • This report expands the understanding of botfly myiasis pathogenesis and its rare orbital manifestation in humans.
  • Early recognition and appropriate treatment are crucial for managing orbital myiasis and averting potential vision-threatening complications.
  • The case emphasizes the need for increased awareness among clinicians regarding this parasitic infection, particularly in endemic or travel-associated regions.