Case Report: Furuncular Myiasis in Malawi

Abstract

Furuncular myiasis results when the larva penetrates healthy skin to cause a furuncle like nodule which may mimic common dermatoses like insect bites and pyoderma leading to misdiagnoses. Tumbu fly (Cordylobia anthropophaga) is the most common cause in Africa and is endemic in Malawi. We describe a case of C. anthropophaga furuncular myiasis from a 6-month-old baby who presented with an acute history of a rash and was initially misdiagnosed on two occasions. Treatment consisted of manual removal of the larva and subsequent local wound care with a good outcome. We believe that much as Malawi is in the endemic region of the Tumbu fly, the disease’s clinical mimicking of common dermatoses and the patients’ preference to treat themselves at home may result in clinicians gaining less experience in managing furuncular myiasis cases in their daily practice leading to misdiagnoses. This report therefore demonstrates the practical challenges which unwary clinicians and patients in Malawi might encounter when faced with this otherwise common condition. It further highlights the importance of dermatologists and other non-dermatologist clinicians to consider furuncular myiasis among differential diagnoses in like lesions which in turn will reduce the unnecessary use of antibiotics and delay correct patient treatment.