Tumbu myiasisB87.9

Parasitosis caused by larvae of the tumbu fly (Cordylobia anthropiphaga), which bores into the skin of warm-blooded animals (main host = rat).S.a. Myiasis.

Common in Africa. Occasionally brought to Europe by migrants.

Occurs mainly among children, travellers or migrants.

Furunculoid granulomas around the larva stuck in the skin. After 2 weeks the larva hatches and pupates outside the human organism.

Removal of all fly larvae, first cleaning, then removal of crusts and pus remains, followed by occlusive dressing with an ointment (e.g. Vaselinum alb., paraffin, pig fat, beeswax) over a few hours. Due to O2 deficiency, the larvae move out of their crypts. Afterwards, they are cleaned again and fly larvae are removed by light pressure or with a needle or tweezers. In case of failure, icing of the affected area with chlorethyl spray and removal of the larvae with a scalpel. In the case of single small granulomas, removal can be done by punch biopsy.

After removal of all larvae, external antibiotic therapy with tetracycline-containing ointments (e.g. R250, Achromycin ointment), fusidic acid (e.g. fucidine ointment or cream), 2% clioquinol-containing topicals (e.g. R049, Linola-Sept).

In case of severe infestation systemic antibiotics such as erythromycin (e.g. Erythro-Hefa) 1.5-2 g, divided into 2-3(-4) ED, doxycycline (e.g. Doxy-Wolff) 2 times/day 100 mg p.o. or flucloxacillin (e.g. Staphylex Kps.) 3 times/day 1 g p.o. in 3 ED.