The maggot was submitted to histopathological analysis. On gross examination, the larvae appeared as a cylindrical, yellow to brownish maggot with evident hooks in the cephalic portion and rows of cuticular spines surrounding its body. At the caudal end, posterior spiracles were observed (Fig. 2). Microscopically the larvae exhibited thick acellular body walls with cuticle spines, with prominent internal striated muscles and posterior spiracles (Fig. 3), consistent with the species Dermatobia hominis. Considering the clinical features and the larvae, the final diagnosis was of furuncular myiasis. The exploratory surgery was both diagnostic and curative. Successful healing was observed in the following appointment. After 3 years of follow-up, the patient is recovered, with no clinical signs or symptoms of the disease (Fig. 4).
A and B: Swelling affecting the lower lip of a young male. C: Extra-oral aspect depicting a furuncular-like skin lesion with central pore. During clinical evaluation, was observed an intermittent presence and absence of the caudal respiratory spiracle of the larvae in the cutaneous pore. This image illustrates the moment when larva spiracle can be observed (arrow). D: In this image, in addition to the serosanguineous fluid draining from the furuncular-like lesion, it is possible to observe that the spiracle is no longer present in the central pore (arrow).