Abstract
Background
Two weeks following a trip to Belize, a 25-year-old male noticed an erythematous lesion on his upper left chest, which enlarged over a 6-week period and formed a central punctum with a small opening in the skin. The patient reported feeling movement and intermittent lancinating pains under the skin. The patient's exam and symptoms were consistent with human botfly infestation, or cutaneous myiasis, secondary to Dermatobia hominis.
Objective
The objective of reporting this case is to present a quick, simple, noninvasive method of extraction of a human botfly using the Sawyer venom extractor to extract the larva out of the skin. One other case report of this method of extraction was found in the literature.
Methods
The patient desired to undergo an attempt at vacuum extraction of the larva. The upper chest was prepared with alcohol scrub, and an occlusive dressing was placed over the lesion for a period of 30 minutes. The occlusive dressing was removed, and the Sawyer extractor was applied and activated.
Results
The larva was rapidly extracted in less than 1 minute, with no significant discomfort to the patient. Subsequently, the wound was dressed. After 2 weeks, the wound was fully healed without complication.
Conclusions
D hominis is a known common etiology of cutaneous myiasis endemic to Belize. The larva burrows under the skin of mammals where it develops for a period of weeks before erupting and entering the soil to pupate. The diagnosis and treatment of botfly infestation is pertinent to doctors in the United States, as Belize (among other endemic regions) is a common travel destination for North Americans. In this case, the Sawyer venom extractor was demonstrated to be a safe, noninvasive, and painless method for botfly extraction in the field without use of hospital resources.