Case #231 – July, 2008

A 25-year-old man, who recently returned from a trip to Brazil, presented to his health care provider with a festering lesion on his forehead. The patient also complained of feeling things moving under his skin. Surgical removal of the outer surface of the lesion revealed several maggot-like organisms (Figure A) beneath the skin. Specimens were sent to the CDC for diagnostic assistance. Figure B shows a close-up of the anterior end of one of the organisms; Figure C shows a close-up of the posterior end. Figures D and E show structures dissected out of the anterior end of one of the organisms. What is your diagnosis? Based on what criteria?

Figure A

Figure B

Figure C

Figure D

Figure E

Images presented in the DPDx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit