Skin lesions are a common reason for travelers who seek treatment in our urgent care clinics. Of the travel-associated skin problems that we see, approximately 10% to 19% are due to myiasis. Myiasis is due to larvae of flies. The most common fly is Dermatobia hominis, the botfly. The larvae penetrate human skin and undergo development in subdermal tissue.

Patients typically note an insect bite that, instead of healing, slowly enlarges over time to a lump measuring ½-inch to1-inch in diameter. Scant yellowish fluid may drain from the lesion. Patients may have a sensation of irritation, skin crawling, or episodic sharp pain.

Removal of the intact larva is curative. A range of removal approaches have been successful; in our clinics, we usually cover the wound opening with petroleum jelly or strips of bacon and to coax the larva out on its own. When the larva protrudes its abdomen to reach air, the intact larva is gently extracted from the skin. We always anaesthetize the site with lidocaine.  The procedure is usually simple, but occasionally a bacterial infection can complicate the infestation. In that case, we prescribe a course of antibiotics.

Dr. Melvin Lee, Chief Medical Officer
FastMed Urgent Care
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