Myiais

1. Etiology: Vectors
   1. Botfly in south america
   2. African Tumbu
2. Pathophysiology: African Tumbu
   1. Tumbu lays eggs on clothing or ground
   2. Once eggs hatch, larvae invading skin rapidly (minutes)
   3. Lesions develop under skin over 8-12 days follow by emergence of organism
3. Pathophysiology: South American Botfly
   1. Botfly lays eggs on other insects such as Mosquitos or leaves
   2. Eggs hatch in response to heat when insects land on skin
   3. Larvae invade the skin within 10 minutes and develop over 10 week course
4. Signs
   1. Presents as a cutaneous abscess-like swelling
   2. Central skin opening (breathing hole for larvae)
5. Management
   1. Apply occlusive ointment (e.g. vaseline) and larvae will emerge over days
   2. Surgical excision
      1. Remove larvae whole
      2. Do not cut into larvae (results in severe inflammatory response)
6. References
   1. Martin (2010) Park Nicollet Primary Care Update CME