- = invasion of live human tissue by fly larvae (i.e. maggots).
- In U.S. seen mostly in travelers returning from Central or South
America (Dermatobia hominis aka "botfly") or Africa (Cordylobia
anthropopophaga aka "Tumbu fly")
- Eggs are deposited on skin and larvae burrow into skin through
follicles or other small openings, then emerge from a skin pore and to
- Typically presents late August/early September
- Usually affects only exposed areas
- Starts with a 2-4mm red papule (a "warble") which may increase to
up to 2cm diameter and/or drain; Develops small pore through which the
larve comes out for air. There is only one larva per lesion.
Can be painful or itchy; sometimes patients can feel larval
movement. Larva may die resulting within the warble resulting in
- Management involves removal of larva (can often be forced through
the central pore with manual pressure; Can also make small cruciate
incision and remove with forceps. Can also apply petrolatum over
the pore which forces the larva to come up for air. Once larva is
out, usually heals spontaneously.
(Sources include Core Content Review of Family Medicine, 2012)