Abstract
BackgroundCutaneous myiasis of the breast due to infestation by the larva of Cordylobia anthropophaga is rare. To the best of our knowledge, only one case has been reported in the English literature. This rarity calls for an awareness of its possibility as a cause of furuncular breast lesions, especially in areas where the C. anthropophaga (Tumbu fly) is endemic or in patients returning from such areas. As it can be easily confused with other furuncular breast lesions (like tuberculosis, mycosis, actinomycosis, furunculosis, chronic breast abscess and fungating malignancies), this awareness is important to avoid misdiagnosis or delay in diagnosis.We present a case of furuncular breast myiasis due to the larvae of C. anthropophaga earlier misdiagnosed as mastitis in a patient living in tropical Africa (Nigeria) where the Tumbu fly is endemic.Case presentationWe report a 70 year old woman who presented with a week history of itchy multiple discharging sinuses of the right breast. The sinuses contained wriggling larvae of C. anthropophaga. Fourteen larvae were extracted from the breast and the sinuses healed quite well after the extraction.ConclusionsCutaneous myiasis of the breast is rare, hence, an awareness of its clinical features is necessary when a patient presents with furuncular skin lesions especially in endemic areas or people returning from such areas. Diagnosis is mainly clinical and lesions heal well after the extraction of the larvae.Preventive measures such as ironing after drying of dresses and a good personal hygiene are crucial in controlling C. anthropophaga infestation.
Highlights
Cutaneous myiasis of the breast due to infestation by the larva of Cordylobia anthropophaga is rare
Cutaneous myiasis of the breast is rare, an awareness of its clinical features is necessary when a patient presents with furuncular skin lesions especially in endemic areas or people returning from such areas
Diagnosis is mainly clinical and lesions heal well after the extraction of the larvae. Preventive measures such as ironing after drying of dresses and a good personal hygiene are crucial in controlling C. anthropophaga infestation
Summary
The first description of myiasis was by Hope in 1840 [4]. Many cases of myiasis affecting different human organs have been described since [5,6,7,8]. Cutaneous myiasis of the breast is very rare, only few cases have been reported in the literature and the majority of them are due to the human botfly Dermatobia hominis [9,10,11]. Forceps may be used or an incision made over the boil after injecting a local anesthetic agent like lignocaine This must be done carefully and the entire larva extracted as any remnant may provoke an inflammatory response. Cutaneous myiasis of the breast as a result of C. anthrophaga is an uncommon condition and an awareness of its clinical features is essential to avoid unnecessary delay in the diagnosis and treatment. Personal hygiene and exterminating the flies by insecticides would be helpful in prevention Simple measures such as washing clothes thoroughly, drying and ironing of clothes are necessary to reduce the risk of this human myiasis
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