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effect complete removal of the fly larva, and essential communication between surgeon and the pathologist to achieve
prompt diagnosis.
.....................
Figure 2 Intradermal abscess centred on organism (haematoxylin
and eosin stained).
A review of the literature revealed several reports of D hominis from Europe, Scandinavia, Australia, and the Americas,
reflecting the widening experience of infectious disease as
foreign travel increases. In a review of 13 cases in Munich,
Germany, all cases of D hominis infection were related to travel
to the Central American tropics.1 The most frequent differential diagnoses are infected sebaceous cyst, or a furuncle with
associated lymphadenopathy. Almost all cases are present on
limbs, although two papers detailed D hominis infection of the
eye: both of which caused palpebral swelling,2 3 and one report
described a woman with a long standing breast mass, excision
biopsy of which revealed granulomatous inflammation
centred around a fly larva.4
This case highlights the importance of the clinical history
(including travel history), meticulous surgical technique to
Authors affiliations
L J Harbin, E M Thompson, R D Goldin, Departments of Pathology
and Surgery, St Marys Hospital, London W2 1NY, UK
M Khan, Department of Surgery, St Marys Hospital
Correspondence to: Dr R D Goldin, Department of Histopathology,
St Marys Hospital, London, W2 1NY, UK; r.goldin@ic.ac.uk
Accepted for publication 9 May 2002
REFERENCES
1 Jelinek T, Nothdurft HD, Rieder N, et al. Cutaneous myiasis: review of
13 cases in travellers returning from tropical countries. Int J Dermatol
1995;34:6246.
2 Bangsgaard R, Holst B, Krogh E, et al. Palpebral myiasis in a Danish
traveller caused by the human bot-fly (Dermatobia hominis). Acta
Ophthalmol Scand 2000;78:4879.
3 Goodman RL, Montalvo MA, Reed JB, et al. Photo essay: anterior
orbital myiasis caused by human bot-fly (Dermatobia hominis). Arch
Ophthalmol 2000;118:10023.
4 Kahn DG. Myiasis secondary to Dermatobia hominis (human botfly)
presenting as a long-standing breast mass. Arch Pathol Lab Med
1999;123:82931.
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Notes