Furuncular cutaneous myiasis in Saudi Arabia

Myiasis is the infestation of a living vertebrate by a fly's larva, completing its obligate life cycle. Exposed skin remains the most affected site. The botfly, Dermatobia hominis, is the most common cause of cutaneous furuncular myiasis in tropical areas. Few cases have been reported in Saudi Arabia, mainly in the Southern region. A one-year-old medically free child presented to our pediatric surgery clinic with a painful, itchy discharging nodule on the inner aspect of his right forearm for one-week. The patient's mother and sibling had a similar former presentation after visiting Taif city. We dilated the central punctum and extracted the larva fully intact. The larva was identified morphologically as Dermatobia hominis by a parasitologist. The lesion was left to heal secondarily, which resulted in an acceptable cosmetic result and minimal scarring. Raising this clinical entity's awareness between pediatric surgeons will set aside misdiagnosis, delayed management, and possible complications. A high level of suspicion and careful history taking are required to recognize myiasis, particularly in patients with a recent history of global traveling or those with close contact with cattle.