West Jonathan K
Department of Radiology and Medical Imaging, University of Virginia Health System, 1412 Cherry Avenue, Charlottesville, VA 22903, USA.
Wilderness Environ Med. 2013 Mar;24(1):17-22. doi: 10.1016/j.wem.2012.09.007. Epub 2012 Dec 14.
After a trip to Belize, a 25-year-old man noticed an erythematous papule on his upper right chest that enlarged over a 6-week period and formed a central aperture. The patient reported feeling movement and intermittent lancinating pains under the skin. The history and examination were consistent with cutaneous myiasis, likely secondary to the human botfly, Dermatobia hominis. The objective of reporting this case is to present a simple method of extraction of a botfly larva using a commercial venom extractor. The patient's upper chest was prepared, and an occlusive dressing was placed over the lesion for 30 minutes. The Extractor Pump (Sawyer Products, Safety Harbor, FL) was applied and activated, and the larva was rapidly extracted completely intact with no significant discomfort to the patient. The wound fully healed without complication. D hominis is a 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 falling to the soil to pupate. The diagnosis and treatment of botfly infestation is pertinent to doctors in the United States as Central and South America are common travel destinations for North Americans. In this case, a commercially available venom extractor was demonstrated to be a safe, noninvasive, and painless method for botfly extraction in the field without use of hospital resources.
一名25岁男子在前往伯利兹旅行后，注意到其右上胸部出现一个红斑丘疹，该丘疹在6周内不断增大，并形成了一个中央小孔。患者称能感觉到皮下有蠕动和间歇性刺痛。病史和检查结果符合皮肤蝇蛆病，可能继发于人肤蝇，即嗜人瘤蝇。报告该病例的目的是介绍一种使用商用毒液提取器提取蝇蛆幼虫的简单方法。对患者的上胸部进行准备后，在病变部位放置了一个封闭敷料30分钟。应用并启动了提取泵（索耶产品公司，佛罗里达州安全港），幼虫迅速被完整取出，患者无明显不适。伤口完全愈合，未出现并发症。嗜人瘤蝇是伯利兹特有的皮肤蝇蛆病的常见病因。幼虫在哺乳动物的皮肤下打洞，在那里发育数周，然后破出皮肤落到土壤中化蛹。由于中美洲和南美洲是北美人常见的旅游目的地，因此人肤蝇感染的诊断和治疗对美国医生来说很重要。在这个病例中，证明了一种商用毒液提取器是在野外无需使用医院资源即可安全、无创且无痛地提取蝇蛆的方法。
