Florida

Newlywed’s itchy groin was sign of ‘deeply embedded maggot’ from honeymoon

The larva of the human botfly (though not the one Florida doctors found under a newlywed’s skin) in the third and final stage of development that it takes inside a mammal’s body, according to University of Florida entomologists.
The larva of the human botfly (though not the one Florida doctors found under a newlywed’s skin) in the third and final stage of development that it takes inside a mammal’s body, according to University of Florida entomologists. University of Florida

A 36-year-old woman suffering from an itchy skin lesion went to several Florida doctors two months after her honeymoon in Belize — and learned the wound was the sign of a living creature, which had burrowed into the skin on her groin, doctors say.

The woman had gone to Tampa General Hospital telling doctors that she thought the reddish lesion could have been an insect bite. She said she had already gone to a primary care doctor about the lesion. That earlier doctor had given the women a course of the antibiotic sulfamethoxazole; but when the woman had finished her antibiotics, she said the lesion was still there, though the redness had improved, according to researchers who investigated the case.

Doctors puzzled over what it could be: Was it a cyst? An ingrown hair? It wasn’t until the woman went to Tampa’s Memorial Hospital for another opinion that she learned the truth, researchers wrote in a case report in the Journal of Investigative Medicine High Impact Case Reports earlier this month.

Dr. Enrico Camporesi, a wound healing specialist who treated the woman and authored the report, said the skin around the lesion was hard, as if there were an egg or bean below, Live Science reports. Camporesi sought a surgeon’s expertise, because he worried it could be a lymph node problem — but the surgeon suggested the lesion was actually a living creature.

The surgeon was correct: Doctors used local anesthesia and a 5 millimeter incision to remove the object beneath the woman’s skin, which was identified as a human botfly larva — essentially, a maggot — by a pathology lab. By the time the woman came back for a follow-up appointment a week later, the lesion was “completely resolved,” researchers said.

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But what is a botfly?

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A Tampa, Florida, hospital found a human botfly maggot under a woman’s skin months after she took a vacation in Belize, a case report in the Journal of Investigative Medicine said. The botfly is rare in the US but common in the tropics and easily treated. Mina Shenouda, MD, Et Al/Journal Investig Med High Case Rep./American Federation For Medical Research

It’s a bug that’s rare in the United States, but more commonly found in the tropics. The insect lays its eggs on animals like flies or mosquitoes. Those insects become hosts, carrying the human botfly eggs to human skin — the warmth of which hatches the eggs into larvae, researchers said. The larvae then burrow into the human skin, where they live for 27 to 128 days, causing itching in their hosts.

The authors wrote that sometimes “patients can feel the larvae moving when they shower or cover the wound.”

After its stay beneath the skin, the adult larva “drops to the ground where it pupates for between 27 and 78 days before maturing into an adult botfly. The adult form of the human botfly is rarely seen and ranges between 1 and 3 cm long,” researchers wrote.

A fully-grown human botfly looks somewhat like a bumblebee, and is large with thick hair, according to the University of Florida entomology department.

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The side view of an adult human botfly, Lyle J. Buss University of Florida

Not all human botfly infestations require a surgeon to intervene, though: Communities in the tropics that are more acquainted with the pests have their own home remedies, the case report authors said.

“Local residents in Belize suffocate the larvae by applying ... petroleum jelly, bacon strips, nail polish, or plant extracts” over the lesion, researchers wrote. “Several hours after occlusion the larvae will emerge head-first seeking air, at which time, tweezers may be used to physically extract it or apply pressure around the cavity aiding in the larvae expulsion. Generally, larvae emerge 3 to 24 hours after application of the occluding agent.”

The authors said skin problems are one of the medical issues travelers are most likely to bring home with them after visiting developing countries — and a skin infestation of developing larvae is the fourth most common skin disease travelers report.

A Missouri couple on their honeymoon said they could not use the bathroom in their cruise cabin aboard Carnival Cruise Line's Carnival Triumph because of "black sewage," smelling of poop, that would bubble up out of the shower drain.

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