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Identification of Subcutaneous Myiasis Using Bedside Emergency Physician Performed Ultrasound

Elissa Schechter, MD, DTMHCorresponding Author Information, Jeffrey Lazar, MD, MPH, M. Eric Nix, MD, NREMT-P, William K. Mallon, MD, Christopher L. Moore, MD, RDMS

Received 24 October 2007; received in revised form 15 November 2007; accepted 17 November 2007. published online 24 October 2008.
Corrected Proof

Abstract 

Background: Subcutaneous myiasis, a maggot infiltration of human tissue, is common in tropical countries. However, physicians in the United States may be unlikely to consider this etiology of dermatologic abnormalities even when a travel history suggests the diagnosis should be included in the differential. Case Report: We report the case of a patient who returned from Sierra Leone with an infestation of a maggot of Cordylobia anthropophaga (tumbu fly) that was diagnosed and appropriately treated based on ultrasound findings. Conclusion: As international travel increases, clinicians should maintain a high level of suspicion for tumbu fly infestation in returned travelers from endemic areas. The increasing use of ultrasound in the Emergency Department for evaluation of skin and soft tissue infections may aid the physician in making the diagnosis of subcutaneous myiasis.

 Department of Emergency Medicine, Los Angeles County and University of Southern California Medical Center, Los Angeles, California

 St. Vincent's Manhattan Medical Center, New York, New York

 Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut

Corresponding Author InformationReprint Address: Elissa Schechter, MD, DTMH, Department of Emergency Medicine, Los Angeles County and University of Southern California Medical Center, 1200 North State Street, Room 1011, Los Angeles, CA 90033

PII: S0736-4679(08)00232-1

doi:10.1016/j.jemermed.2007.11.095