Mahal Jacqueline J, Sperling Jeremy D
Department of Emergency Medicine, New York-Presbyterian: Weill-Cornell Medical Center, New York, New York 10065, USA.
J Emerg Med. 2012 Oct;43(4):618-21. doi: 10.1016/j.jemermed.2009.11.030. Epub 2010 Feb 1.
Travelers to tropical regions are at risk for a myriad of exotic illnesses. Malaria and dengue are diagnoses that are associated with insect bites, in particular, mosquito bites, acquired while traveling in foreign, tropical countries. Infestation with Dermatobia hominus, the human botfly, endemic to South and Central America, is usually transferred via a mosquito vector. The human botfly should be considered in patients who have traveled to these endemic regions and present with a mosquito bite history and non-healing skin lesions.
We present this case to increase awareness among emergency physicians regarding furuncular myiasis from the human botfly.
A 39-year-old pregnant woman presented to the Emergency Department (ED) with an intensely pruritic lesion to the right calf and mild systemic symptoms 6 weeks after travel to Belize. The lesion she thought was a mosquito bite had persisted despite escalating treatment modalities and had been incorrectly diagnosed by multiple physicians.
Parasitic disease is not always a systemic process. Botfly infestation presents as local boil-like lesions that are irritating and uncomfortable. Once correctly identified, it can be easily treated in the ED.
前往热带地区的旅行者面临多种外来疾病的风险。疟疾和登革热是与昆虫叮咬相关的诊断，特别是在国外热带国家旅行期间感染的蚊虫叮咬。人皮蝇（Dermatobia hominus）在南美洲和中美洲为地方病，其感染通常通过蚊虫媒介传播。对于前往这些地方病流行地区且有蚊虫叮咬史和皮肤损伤不愈合的患者，应考虑人皮蝇感染。
我们报告此病例以提高急诊医生对人皮蝇所致疖肿性蝇蛆病的认识。
一名39岁孕妇在前往伯利兹6周后因右小腿剧烈瘙痒性损伤和轻度全身症状就诊于急诊科。她认为是蚊虫叮咬的损伤尽管治疗方式不断升级仍持续存在，且被多位医生误诊。
寄生虫病并不总是全身性疾病。人皮蝇感染表现为局部疖样损伤，伴有刺激感和不适感。一旦正确诊断，在急诊科即可轻松治疗。
