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Myiasis — DTM&H MCQ

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HardDermatological tropical conditionsMyiasisDTM&H

A traveller from Belize has a painful furuncle with a central breathing punctum and intermittent movement. There is no cellulitis. What is the best initial management?

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Correct answer: B — Occlude the punctum, extract the intact larva and assess tetanus status

The best answer is “Occlude the punctum, extract the intact larva and assess tetanus status”. Dermatobia hominis uses the punctum to breathe; occlusion can encourage emergence and facilitate careful intact extraction. Blind deep incision risks damaging the larva and surrounding tissue, ivermectin alone is not the routine first mechanical solution for an accessible lesion, corticosteroid closure can trap the organism, and antibiotics are reserved for secondary infection rather than the primary infestation. Wound care and tetanus assessment complete management.

Reference: Peer-reviewed clinical review: Myiasis: https://pmc.ncbi.nlm.nih.gov/articles/PMC3255963/; UKHSA, Imported Fever Service: https://www.gov.uk/guidance/imported-fever-service-ifs