Case #21:

Clinical Presentation:
56 year old man develops a a draining skin nodules one week after returning from a vacation on the coast of Belize, Mexico. He recalls getting multiple mosquito and sandfly bites.
Clinical Diagnoses:
Furuncle (Staphylococcal or Streptococcal)
Leishmania sore
Mycobacterium marinum cellulitis

Discussion:
Microbiologic Diagnosis:
Dermatobia hominis (Botfly) parasitzation
This larva emerged from the skin when the man obstructed the lesions with a bandage (Case 21 Image 1). Furuncular Myiasis is caused by skin infection with the human botfly larva. Botflies deposit eggs on other insects or ticks. Humans and livestock can be infected when bitten by these insect vectors. Botflies breed in coastal areas, jungles and inland plains of tropical South America.