A woman thought she may have had a simple bug bite in her groin — but it was really a baby fly burrowed into her skin

• A woman came back from a trip to Belize with a human botfly larva (a.k.a. Dermatobia hominis) burrowed into her skin, LiveScience reported.
• Doctors eventually removed the larva surgically.
• This type of infestation is rare in the US, but it’s common in some tropical areas.
• A human botfly larva may live inside human skin for as long as 128 days.
• Warning: This post contains graphic images.

A 36-year-old Florida woman returned from a short trip to Belize with a stomach-churning souvenir: A fly larva burrowed underneath the surface of her skin. The woman’s story was detailed in a report published October 7 in the Journal of Investigative Medicine High Impact Case Reports, LiveScience reported.

The woman came home from her trip with a small, inflamed, itchy bump in her left groin area. She thought she may have gotten an ordinary bug bite, but she wasn’t completely sure, the authors of the case report wrote.

But two months after her trip was over, it hadn’t gone away, even after she took a full course of antibiotics prescribed by her doctor. So the woman decided to get a second opinion at a wound management clinic.

In an interview with LiveScience, Dr. Enrico Camporesi, a specialist in wound healing at Memorial Hospital in Tampa, Florida and one of the doctors who treated the woman, said the bump looked small bite, with pus coming from a hole in the center. Camporesi also noticed it felt hard to the touch. He was concerned that it was a swollen lymph node and referred the woman for surgical care.

A surgeon cut the bump open, removed a foreign object trapped inside, and sent it to a pathology lab. That’s when the mysterious bump was finally identified as a human botfly larva.

You can see a photo of the bump and the larva in photos from the case report below:

Just one week later, when the woman returned to the wound care facility for a follow-up appointment, her skin was completely healed.

Human botfly infestations are common in some tropical areas

Cases of human botfly infestation are rare in the US, the authors wrote in the case report, but they are “very common” among residents and travellers in the tropical regions of the Americas.

How do the larvae actually get inside human skin? It starts when the adult female botfly lays her eggs on another insect, like a mosquito or a fly, the report explained. Then, if that intermediary insect bites a human, the warmth of the skin may prompt the eggs to hatch, and the larvae burrow beneath the skin’s surface, creating a small hole called a punctum through which they can breathe. Once below the skin, the larva doesn’t migrate very far but can stay in place between 27 and 128 days, the authors wrote. In some cases, the report added, people may feel the larva moving when they shower or if they cover the wound.

Surgical removal is the “treatment of choice” for embedded botfly larva, according to the case report, but the authors also note that many cases can be treated by patients themselves.

In Belize, for instance, people suffocate the larvae by covering the punctum with non-breathable substances, like petroleum jelly, bacon strips, nail polish, or plant extracts, the report said.

Generally, three to 24 hours later, “the larvae will emerge headfirst seeking air, at which time, tweezers may be used to physically extract it or apply pressure around the cavity,” the authors wrote.

This aspect of human botfly infestation is actually a source of enjoyment for some people: YouTube abounds with videos of botfly larvae removal. In the same way that fans of pimple popping like to watch pus and oil get squeezed out of pores, some viewers find satisfaction watching botfly larvae tugged out of the skin. Plenty of these videos have netted multiple millions of views. (But be warned: These sagas aren’t for the squeamish.)

If you think you might have a fly larva in your skin, get medical attention

If you suspect you have myiasis – the medical term for infection with fly larva – you should contact a health care provider for the appropriate treatment, which may include surgery and medications, according to the Centres for Disease Control and Prevention (CDC).

You can also take steps to prevent myiasis if you’re living in or visiting places where it’s more common, the CDC says. Cover your skin to limit the area that’s open to bug bites; use insect repellent, window screens, and mosquito nets; and iron any clothes that were dried on a clothesline in tropical areas.

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