People return from vacation with all kinds of things. They come home with souvenirs, photos, or sun-kissed skin, just to name a few. But imagine bringing back something not so pleasant, like maggots living in your scalp. That's what happened to a woman from the UK when she returned home from a trip to Argentina. Yikes.
The case report in the British Medical Journal tells us that shortly after arriving back home, the unnamed woman went to see a doctor complaining of pain in her left ear and swollen lymph nodes in her neck. She was given antibiotics for the ear infection and sent on her way.
About a week later, the woman, who is in her 50s, went back to the doctor with two small, itchy lumps on her head. The doctor said they were cysts and gave her antibiotics to treat them. Over the next three weeks, however, the cysts grew and started to cause stabbing pains. They were also leaking a clear, odorless fluid.
The woman wrote in the report that although a friend suggested early on that she may have a parasitic infection, she didn't take the possibility seriously because she had been told the lumps were just cysts. But when the pain became unbearable, she suggested the possibility of a human botfly—or maggot—infection to her doctor. (The case report didn't explain what the doctor's response was, however.)
Then, seven weeks after she returned home from her trip, she was admitted to the hospital. Her blood tests came back normal, but she told doctors she could feel something moving around in her scalp. By that point, the lumps were less than one inch in diameter and had tiny openings called punctums. She was finally properly diagnosed: She was infected with two human botfly larvae.
Doctors planned to remove the larvae by smothering the lumps with Vaseline; this covers the punctum and cuts off their air supply, forcing them to come to the skin surface for oxygen. One was successfully removed by this method, but the other had died and needed to be surgically removed. Both wounds were then washed out with saline, and antibiotic ointment was applied to the scalp.
Botflies deposit their eggs on mosquitoes, meaning their larvae can be transmitted to humans if they're bitten by the insects. The warmth of the human body triggers the fly eggs to hatch, and the larvae then burrow into the innermost layer of skin. The woman said she was bitten by mosquitoes several times during her trip.
Bottom line: If you start feeling unwell shortly after returning from a vacation to the tropics, ask your doctor to consider the possibility of a human botfly infection (or any parasitic infection, for that matter). It might sound crazy considering how unlikely this is here in the States, but it is relatively common warmer parts of the world.
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