Monday, August 8, 2022

Case of the Week 691

This week's case was generously donated by Dr. Nicole Brammer Hubbard. Several of the following objects were removed from ear of a child after the parents noticed a bloody discharge (!)  Identification?











6 comments:

Anonymous said...

botfly larvae?

Anonymous said...

? Cochliomyia hominovorax

Anonymous said...

Myiasis - third instar fly larva.
These can be identified by the pigmentation of the dorsal tracheal trunks (see 2), the posterior spiracles with closed (see 1 and 5) or incomplete peritreme and shape of slits (straight, see 5) etc.
I suggest a member of the family Calliphoridae (blowflies). Identification based on morphological characteristics is difficult, PCR would do the job.
Cochliomyia hominivorax (the New World primary screwworm), once a major pest in Southern US, has been eradicated from the US, Mexico, and Central America through an extensive release program by the USDA of sterilized males. Currently, this species is limited to lowland tropical countries in South America and some Caribbean islands. Thus, a travel history oft he patient would have been helpful. In contrast to the images of #691, C. hominivorax would have incomplete peritremes and bands of small dark spines on each body segment.

Anonymous said...

Myiasis isn't something I'm overly familiar with, but using the DPDx website, my best guess would be Lucilia species.

Anonymous said...

Indeed, “ I love Lucy”. My bet will be for Lucilia too.
Florida Fan

Raul Castro said...

It must be a relief to get that out of the child's ear! I wonder how much space it took up in the ear? I'm really curious as to what the smaller body is; is it a separate entity or a product of the first?