An unexpected surprise in a common boil

Cutaneous myiasis (myia: Greek word for fly) is an infestation of fly maggots in the skin. A case of human botfly (Dermatobia hominis) myiasis presenting to a Canadian emergency department is described. Typically, it presents as an apparent persistently infected skin abscess or insect bite. As the botfly is indigenous only to Central and South America, the condition is unfamiliar to most North American physicians. However, the rapidity of international air travel permits this exotic tropical infestation to present in any region. Obtaining a history of recent travel to an endemic area is the key to making the diagnosis and instituting appropriate treatment.