Imported cutaneous myiasis in a child and her father

A 5 years old female presented to the Emergency Department com plaining a pruritic and painful nodular lesion on the left preauricular area of the face which appeared about two weeks before the admission to the hospital. While in lack of fever or any other constitutional symptoms, she reported an uncomfortable “movement” sensation localized within the lesion. At the physical examination, the lesion appeared erythematous with an ulcerated surface, firm but mobile on the underlying stages (Fig. 1, A). The remaining findings were normal except for a slight cervical and bilateral lymphadenopathy. The echog raphy showed an hypointense area of 2 × 1 cm, including an hyperin tense formation with vascularization and apparent inherent movements (Fig. 1, B). The history revealed a recent travel in Costa Rica and the presence of a similar lesion on the scalp of the patient’s father. When the parent’s lesion was examined, it showed a draining central stoma on the surface from which a fusiform maggot could be seen protruding peri odically (Fig. 1, C1–C2). The surgical procedure performed on the girl resulted into the excision of a stage III larva of Dermatobia hominis and led to an immediate relief of the described symptoms