A 65-year old man presented with skin lesions on his chest and left arm and shoulder six weeks after returning from a cacation in Belize at the beach in the fain forest. The lesions occasionally stung, drained a dark exudates, and enlarged despite two weeks of treatment with cephalexin. The patient had no constitutional symptoms. Physical examination reveed five nodules of varying sizes with surrounding erythema and a central pore through which a single, moving larva was observed. The larvae coming out of the pores are-
The human bot fly, Dermatobia hominis, is a parasite of humans, cattle, swine, cats, dogs, horses, sheep, and other mammals and a few birds in Mexico and Central and South America. The larvae feed under the skin, causing often episodically painful, swollen, draining cutaneous lesions with a typical air-pore . Ref Harrison20th edition pg 1078
Dermatobia hominis
Diphyllobothrium latum
Loa loa
Dracunculus medinensis
Infection