View larger version (37K):
[in this window]
[in a new window]
|
A 65-year-old man presented with skin lesions on his chest and left arm and shoulder six weeks after returning from a vacation in Belize at the beach and in the rain forest. The lesions occasionally stung, drained a dark exudate, and enlarged despite two weeks of treatment with cephalexin. The patient had no constitutional symptoms. Physical examination revealed five nodules of varying sizes with surrounding erythema and a central pore through which a single, moving larva was observed (Panel A). The pores were occluded with petrolatum for two hours. After lidocaine was injected around the nodules, five Dermatobia hominis larvae at various developmental stages were extracted with the use of manual pressure and tweezers (Panel B and Video Clip 1). Larvae can also be extracted with suction or surgically. The patient recovered fully.
Distributed throughout Latin America, D. hominis begins its life cycle when adults lay eggs on porter zoophilic insects. The eggs hatch in response to the host's body heat, followed by larval penetration into the skin. Mature larvae then emerge from the host and pupate in the soil.
|
Previous
