Case #379 – September 2014

A 46-year-old woman returned from a trip to Nigeria with multiple boils on her lower back and extremities. Under the care of her primary physician, several fly larvae, one from each boil, were extracted and sent to the state health department for identification. The specimens were in turn forwarded to the CDC-DPDx for further diagnostic assistance. Figure A shows two of the larvae; Figure B shows a close-up of the posterior spiracles of one of the specimens. What is your identification? Based on what criteria?

Figure A

Figure B

This was a case of furuncular (cutaneous) myiasis caused by the tumbu fly, Cordylobia anthropophaga. The main diagnostic feature was the characteristic posterior spiracles (Figure B), which are represented by three sinuous slits each and no defined peritreme. The travel history was also helpful, as this species is endemic to sub-Saharan Africa. In most cases of myiasis, removal of the larvae is curative and species-level identification is not required for patient management.