Imported furuncular myiasis in Germany

Furuncular myiasis is a parasitic infestation of human and other vertebrate tissues by fly larvae of primarily two species: Dermatobia hominis (human botfly, t6rsalo, or berne) in Mexico and South and Central America and Cordylobia anthropophaga (tumbu fly or mango fly) in Africa. Cuterebra species (rabbit and rodent botflies) are also rarely reported to cause furuncular myiasis only within the United States. Although these species inhabit different geographic regions and have different life cycles, their clinical presentations can be similar. We describe a case of "imported" human botfly (D. hominis) furuncular myiasis in a U.S. Army soldier stationed in Germany. We review the life cycles of human botflies and key aspects of their clinical presentation, differential diagnosis, and various therapeutic modalities. Most physicians may never encounter myiasis and attribute a patient's complaints to an insect bite or skin infection that will heal without treatment. However, the diagnosis of furuncular myiasis should be considered by remembering the basic elements of this condition: recent travel history to the tropics and a sterile, persistent furuncle with sensations of movement and pain.