Answer to Case 505

Answer: Dermatobia hominis, the human botfly

There are several helpful features in this case that allow for an identification to be made:

1. Overall "robust" and somewhat pear-shaped body with a narrow posterior.
2.  Large spines on all but the terminal 3 body segments
3. Supportive travel history (Bolivia)

We unfortunately don't have a view of the posterior respiratory spiracles which would have sealed the diagnosis, but the rest of the features are sufficient to call this D. hominis. You can look at a previous case to see what the spiracles would have looked like: Case of the Week 347. There is also a link there to an old, but still useful, key for identifying botfly larvae commonly seen in humans.