Myiasis in a Traveler: A Moving Story

Joshua P. Fogelman; Doris J. Day; Robert J. Cohen

doi:10.7326/0003-4819-138-6-200303180-00031

Letters |18 March 2003

Myiasis in a Traveler: A Moving Story

Joshua P. Fogelman, MD; Doris J. Day, MD; Robert J. Cohen, MD

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TO THE EDITOR:

Case Report: A 22-year-old man presented to the Bellevue Hospital Clinic of the New York University Department of Dermatology with four painful nodules on the gluteal region. The patient first noted these nodules, which had been present for 5 months, during travel through South America. He reported no fever, chills, or other symptoms. One month earlier, in an emergency department, he had received oral cephalexin for bacterial furunculosis, but symptoms and signs were not relieved.

On physical examination, four tender, indurated, erythematous nodules measuring approximately 0.5 cm were noted, each with a central punctum draining serosanguinous exudate. On 10 magnification, movement of foreign bodies was observed. After many attempts to asphyxiate and thereby lure the foreign bodies from the nodules by occluding the puncta with petrolatum, elliptical excisions were made and a single yellow larva, measuring approximately 1.5 cm 0.8 cm 0.7 cm, was extracted from each nodule (Figure on page 522). The patient was treated with oral cephalexin for 14 days and received topical wound care with bacitracin ointment. His symptoms quickly improved, and the nodules resolved fully without complication.

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2003 American College of Physicians

Letters |18 March 2003

Myiasis in a Traveler: A Moving Story

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Letters |18 March 2003

Myiasis in a Traveler: A Moving Story

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