A Case of Furuncular Myiasis Due to Cordylobia anthropophaga in a Korean Traveler Returning from Uganda

Abstract

A fly larva was recovered from a boil-like lesion on the left leg of a 33-year-old male on 21 November 2016. He has worked in an endemic area of myiasis, Uganda, for 8 months and returned to Korea on 11 November 2016. The larva was identified as Cordylobia anthropophaga by morphological features, including the body shape, size, anterior end, posterior spiracles, and pattern of spines on the body. Subsequent 28S rRNA gene sequencing showed 99.9% similarity (916/917 bp) with the partial 28S rRNA gene of C. anthropophaga. This is the first imported case of furuncular myiasis caused by C. anthropophaga in a Korean overseas traveler.

Furuncular myiasis in Italian traveler returning from Kenya

“…Skin diseases, together with systemic febrile illness and acute diarrhea, are the leading causes of health problems in travelers and account for 8% to 12% of all tourist-related medical problems. Myiasis is usually among the five most common dermatologic conditions, representing 7.3% to 11% of cases [4,7].…”

“…Its most frequent form, furuncular myiasis, is defined as the penetration of the larvae in the healthy skin and subsequent development of a boil-like nodule. It is common in tropical countries and can be caused by the human botfly (Dermatobia hominis) in Latin America [3], and by the Tumbu fly (Cordylobia anthropophaga) and Lund's fly (Cordylobia rodhaini) in Africa [2,4].…”

“…The eggs hatch and larvae can survive without food for approximately 9 days. Upon exposure to warmth or vibration, they penetrate into the skin areas covered by the contaminated clothes [4].…”

“…The penetration of C. anthropophaga into the skin is usually asymptomatic, although the area of penetration can be slightly itchy up to two days after the infestation. In a few days, a reddish papule develops and takes on a boil-like appearance when fully developed [2,4]. An intense inflammatory reaction in the tissue surrounding the lesions develops over a period of six days [2].…”

Furuncular myiasis for the Western dermatologist: treatment in outpatient consultation

“…Furuncular myiasis can be easily mistaken for furunculosis or cellulitis . Some authors proposed using Doppler ultrasound to characterize the lesions, and others proposed polymerase chain reaction to identify the species involved, but these methods are not available to most dermatologists. On the contrary, dermoscopy is a useful and easily available tool to help establish the diagnosis.…”