Myiasis furunculoid B87.8

Cutaneous myiasis occurring in Africa and Central South America (occasionally also in the USA) due to individual fly larvae that have penetrated the cutis and subcutis and developed stationary there.

Cordylobia anthropophaga (tumbu fly) and Wohlfahrtia vigil (found in Africa), Dermatobia hominis (Dassel fly: found in Central and South America). Larvae penetrate unnoticed into the skin and develop in the subcutis.

Specific form of fly maggot infestation(myiasis), in which the larvae (fly maggots), in cutis and/or subcutis parasitize for months.

Dassel flies have a strong host specificity. In Europe, the same bumps are found in animals such as cattle (Hypoderma bovis), deer (Hypoderma diana) and deer (Hypoderma actaeon). Dermatobia hominis infects humans but is only found in South America. Therefore, the same disease only affects tourists who have stayed in these areas.

Dasselfliegen develop a special technique. The females catch mosquitoes or other blood-sucking insects, attach eggs to the underside of the animal and release them again. When the blood-sucking insect comes into contact with humans, the eggs come off and stick to the skin or hair. The larvae hatch within a few weeks. They penetrate the skin and cause a chronic abscessing inflammation (inflammatory node with central porus). There is only 1 maggot in one node. Usually the maggots remain superficial. Only in immunocompromised patients can they expand into deeper regions of the subcutis. This leads to abscesses and the danger of sepsis.

The tumbu fly (Cordylobia anntrophaga) lays its eggs on the surface of objects such as textiles. From there, the hatching larvae reach the skin where they bore themselves. (Important for travellers: in tropical regions, textiles are often laid out on the ground or on bushes to dry after washing. The tumbu fly likes to lay the eggs on these textiles, so that they can get on the skin while carrying them.

One or more slowly increasing, painful furunculoid nodules, often with a central, crater-shaped ulceration (breathing opening of the larva). Possible swelling of the regional lymph nodes, muscle pain.

The mature larva leaves the skin. S.u. myiasis.

Incision and careful removal of the larva. Cave! Further eggs must be carefully peeled or cut! Alternatively closure of the breathing hole with Vaseline: the larvae will then emerge spontaneously within the next 48 hours. In tropical areas there are self-treatment techniques of various kinds, such as the airtight attachment of a piece of meat (e.g. bacon) to the breathing hole, into which the larva bores itself within a few hours.

1. Arosemena R et al (1993) Cutaneous myiasis. J Am Acad Dermatol 28: 254-256
2. Frieling U, Nashan D, Metze D (1999) Kutane Myiasis - a holiday souvenir dermatologist 50: 203-207
3. Safdar N et al (2003) Autochthonous furuncular myiasis in the United States: case report and literature review. Clin Infect Dis 36: e73-80
4. Ship TA (1993) Furuncular cutaneous myiasis caused by Cuterebra larva. J Am Acad Dermatol 28: 261-263
5. Szczurko C et al (1994) Ultrasonography of furuncular cutaneous myiasis: detection of Dermatobia hominis larvae and treatment. Int J Dermatol 33: 282-283
6. Tamir J et al (2003) Dermatobia hominis myiasis among travelers returning from South America. J Am Acad Dermatol 48: 630-632
7. v. Stebut E et al (2015) Rice dermatoses. Nude Dermatol 41: 433-439
8. Yusuf MA et l. (2019) Cutaneous myiasis in an elderly woman in Somaliland.
   Int J Womens Dermatol 5:187-189.