CUTANEOUS MYIASIS - REVIEW OF 13 CASES IN TRAVELERS RETURNING FROM TROPICAL COUNTRIES

Background. Cutaneous myiasis is frequently reported in patients from tropical countries. Most commonly infestation is due to Cordylobia anthropophaga and Dermatobia hominis, whereas Hypoderma lineatum is less likely to affect humans. Methods. The clinical and parasitologic aspects in a series of 13 patients with cutaneous myiasis seen in a German travel clinic are reviewed. Results. Six patients were infected with larvae of the tumbu fly, Cordylobia anthropophaga, six with larvae of the botfly, Dermatobia hominis, and one patient presented with an infection with Hypoderma lineatum. Dermatobia hominis was exclusively acquired in the American tropics and Cordylobia anthropophaga exclusively in Africa, whereas infection with Hypoderma lineatum was acquired in Nepal. The number of larvae removed from the skin was markedly higher in patients infected with the tumbu fly (average of five larvae) compared to the botfly (average of 1.7 larvae), whereas pain was more frequently reported from patients with botfly infestation. Treatment consisted in the removal of the larvae by forceps or surgical incision in tumbu or botfly infection and oral application of ivermectin in infection with Hypoderma lineatum. This led to complete recovery in all patients. Conclusions. In patients presenting with cutaneous lesions after return from tropical countries, myiasis has to be considered as a differential diagnosis, Simple and effective therapy is available through removal of the maggots.