![]() 1 The adult female fly can lay up to 300 eggs on ground or on wet clothing. The tumbu fly is endemic to sub-Saharan Africa and can be identified as a large, brownish-yellow fly with black abdominal spots and brown wings. Furuncular myiasis is rarely observed outside of endemic areas, which may hamper accurate diagnosis. Physical examination revealed a 1.5-cm nodule with minimal erythema and a central operculum, through which a larval body could be identified ( Figure 1).Ĭutaneous furuncular myiasis results from skin invasion by fly larvae of the order Diptera, including the tumbu fly, C anthropophaga. Three weeks after its initial appearance, the patient reported feeling and seeing movement within the nodule. ![]() She was seen in follow-up for the next 3 days with resolution of fever.ĭespite this, the nodule persisted and became increasingly more painful. ![]() The patient was diagnosed as having an abscess with surrounding cellulitis and prescribed oral doxycycline. Findings of blood smears were negative for malaria, and blood culture findings were also negative. After her return to the United States, 2 weeks after the nodule’s initial appearance, the patient developed a fever and went to a local emergency department, where she was noted to be febrile and tachycardic with a fluctuant nodule and significant surrounding erythema. She reported that the nodule first appeared during her trip as a small papule that increased in size over time and became painful. She had recently returned from travel in Uganda, where she had hand washed her clothing and hung them to dry. Shared Decision Making and CommunicationĪ woman in her 30s presented to the dermatologist with a 3-week history of a painful nodule on her right inner thigh. ![]()
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