A 42-year-old man presents to the emergency department with increasing back pain from multiple abscesses that are progressing despite treatment with flucloxacillin. Mister has no fever and on physical examination we see four red swellings on his lower back and right flank. The swellings have a small opening in the center, with white reflections and black edges (see photos 1 and 2).
When the swelling is opened, a moving tail of a larva becomes visible, which we can remove with a little traction with tweezers. The other three swellings also contain a living larva (see photos 3 and 4). To his horror, the man turned out to suffer from myiasis, or skin maggot disease.
