Case repo rt 
K E Y 
'1VORDS 
cutaneous 
myiasis, 
furuncle-like, 
Dermatobia 
hominis 
Cutaneous myiasis due to Dermatobia hominis 
Cumneous myiasi,s due to 
Dermatobm lwmini,s 
N. Martinovič" and M. Gajic 
SUMMARY 
Cutaneous myiasis is extremely rare in Europe. The imported case from Brasi! with furuncle-like 
lesions in 47-years old Yugoslav tourist is presented. 
Introduction 
Furuncular dermal myiasis is a rare form of the 
infestation by the larva of Diptera. Dermatobia hominis 
larvae infestation of the skin is extremely rare in Europe, 
North America and Japan and the cases are imported 
from Central and South America (1-4 ). 
The adult Dermatobia hominis is a fly with com-
plicated life cycle in which intermediary carriers of their 
eggs like mosquito or a biting fly are included. If the 
eggs are deposited on the skin surface the first stage 
larvae penetrate into the skin and then undergo their 
second and third stage. There follows an inflammatory 
reaction due to larvae excretes or secondary infection. 
Extremely rare, larva can move deeper into the subcutis 
or even into the muscle tissue (1). 
The larval phase lasts two or three months and the 
three-stage larva leaves the lesion through the same 
central orifice that was made during penetration into 
the host dermis. In Europe larval leaving the hosts 
(human) skin means the end of Dermatobia hominis 
life cycle, because there are no future optimal conditions 
for survival, as there are in forest areas of Central or 
South America. 
Case report 
A 47-year old Yugoslav man is presented with three 
painful furuncle-like and four pustular lesions on the 
right buttock (Fig. 1). The lesions occurred about two 
months after he arrived from Brasi!, where he spent two 
weeks as a tourist. The correct diagnosis was not initially 
made. Bacteriological examination revealed Staphy-
lococcus pyogenes and peroral erythromycine (500 mg 
every 6 hours) was administered during two weeks, 
without any clinical improvement. 
Except E.S.R. 40 mm/h and slight leucocytosis 
(without eosinophilia), all laboratory findings were 
acta dermatovenerologica A.P.A. Vol 8, 99, No 1 --- ------------------- ---------- 33 
Cutaneous myiasis due to Dermatobia hominis 
within normal limits. Patient's general condition was 
unchanged ancl no regional lymphaclenopathy was 
founcl. 
Surgical excision of one pumlent fumncle-like lesi on 
cliscoverecl a thircl stage larva of Dermatobia hominis 
(Fig. 2 ancl Fig. 3). By this unsuspectecl fincling, the 
correct diagnosis was establishecl. 
Three weeks after surgical removal of the parasites 
from each lesion ancl local application of gentamycine 
o intment 0.3 %, furuncular-like lesions healed with 
cliscrete resiclual scars 0.2-0.4 cm in cliameter. 
Discussion 
In Europe, all publishecl cases of furuncle-like 
cutaneous myiasis clue to Dermatobia hominis were 
importecl. As they are extremely rare and ve1y similar 
to the furuncular lesions correct diagnosis could be 
overlooked, as it was in our case. 
Patients can feel unpleasant moving, local pruritus 
or pain (1, 2, 4) in the affected area. In the observed 
patient the pain was intense and permanent, until the 
surgical removal of the thircl sfage larva from each lesi on. 
Headache, lethargy, malaise , fever, regional lympha-
denopathy and eosinophilia (1 , 2) often accompany 
furuncl e -like dermal myiasis due to Dermatobia 
hominis. None of them were found in the patient under 
observation. 
Conclusion 
In patients presenting with furuncular lesions after 
return from tropical countries, furuncular form of dermal 
myiasis due to Dermatobia hominis shoulcl be consi-
dered in differential diagnosis. Otherwise, like in our 
case, correct diagnosis could be missed. 
34 
Fig. 1 . Furuncle-like and pustular lesions on the 
buttock. 
Fig. 2. Dermatobia hominis- third stage of larva. 
Case r e p o rt 
acta dermatovenerologica A.P.A. Vol 8, 99, No 1 
Cutaneous myiasis due to Dermatobia hominis C ase re po r t 
Fig. 3. Dermatobia 
hominis- magnified 
larva. 
REFERENCES 
AUTHORS' 
ADDRESSES 
36 
l. Hubler RW, Rudolph HA, Dougherty FE. Dermal myiasis. Arch Dermatol 1974; 110: 109-10. 
2. Veraldi S, Gorani A, Stiss L, Tadini G. Cutaneous myiasis caused by Dermatobia hominis. Pediatr 
Dermatol 1998; 15:116-8. 
3. Jelinek T, Nothdurft HD, Rieder N, Loscher T. Cutaneous myiasis: review of 13 cases in travellers 
returning from trapica! countries. Int J Dermatol 1995; 349:624-6. 
4. Taniguchi Y, Yamazaki S, Ando K, Shimizu M. Cutaneous myiasis due to Dermatobia hominis in Japan. 
J Dermatol 1996; 23: 125-8. 
Nevenka Martinovič MD, PhD, Associate Projessor oj Dermatology, Institute 
jor Dermatovenereology, Clinical Center oj Serbia, Pasterova 2, 11000 
Belgrade, Yugoslavia 
Milorad Gajič MD, dermatologist, same address 
acta dermatovenerologica A.P.A. Vol 8, 99, No 1