PMC9759993_01
View of the cutaneous cavitary defect in the zygomatic region. Larvae can be seen embedded in the posterior wall of the cavity (arrows). In the inset, the image of a partially extruded larva at the bottom of the lesion has been zoomed in. The posterior spiracles can be clearly discerned.
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A 5x5 cm cavitated lesion with necrotic margins surrounded by edematous hyperemic skin was observed in the right zygomatic-malar region with necrotic margins with foul-smelling purulent discharge and apparent bone involvement (Figure 1).
Larva of Cochliomyia hominivorax being removed from the lesion with hemostatic forceps (left panel). Some of its taxonomic features can be identified: (a) the posterior spiracles, (b) the anal tubercles, and, in particular, (c) the pigmented tracheal trunks, which are the hallmark of this larval species. For comparison, (right panel) an image of a C. hominivorax larva is shown. Adapted from Paez-Diaz Ruth, Villa-Arteta Luisa C. Identification of myiasis-producing larvae from the Universidad Colegio Mayor de Cundinamarca. NOVA. 2022;15(28). Available from: https://revistas.unicolmayor.edu.co/index.php/nova/article/view/571/940. Open Access.
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Surgical debridement was performed with removal of all larvae, whose macroscopic taxonomic characteristics matched those of Cochliomyia hominivorax (Figure 2).
Appearance of the cutaneous lesion on 12th day of inpatient treatment.
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Improvement of the lesion under inpatient treatment was observed in the following days (Figure 3).