Monday, December 07, 2009

More Mail Bag

Received another email from Piotr Naskrecki, a Ph. D. and director of the invertebrate diversity initiative at the Museum of Comparative Zoology at Harvard University. Piotr writes in with his experience:

Hi Jesse,

I thought you might be interested in my experience removing a bot fly larva.
I just extracted one mature larva from my arm using the same venom extractor
(Sawyer's) as described in the Boggild et al. paper. I became infected with
the flies (I still have one more) about 6 weeks ago in Costa Rica. After
talking to my tropical medicine doctor, who had little experience removing
the bots and envisioned a serious surgery, I made the decision to let them
hatch on their own (to my doctor's obvious relief.) Unfortunately, one of
them became very active and extremely painful, and I decided to remove it on
my own. The thought of using the extractor crossed my mind, and, quite
coincidentally, the same day I run across Boggild's paper in PubMed database
(and later on your blog.)

The procedure wasn't as easy and quick as the one they describe, and I had
to apply the suction for nearly 15 minutes, but eventually most of the
larva's body emerged. I was ably to pull the remainder with forceps.
However, midway through the process of sucking the larva out, its body
ruptured; luckily, only the part that was already out of the wound.
Therefore, one should be cautious applying this method as it may kill the
larva while it is still deeply embedded, which may lead to infection. I
removed the entire body of the insect (I am an entomologist and can assess
whether the body of the maggot is complete), but I can imagine a scenario
where the larva becomes ruptured, and the person doing the extraction does
not realize this, and leaves fragments behind.

All in all, however, this method is probably the best I know of, and I will
recommend it to my colleagues, many of whom work in the tropics and
sometimes become infected. I suspect that it will work even better on
younger, smaller larvae.

I hope this information is useful, and thank you for maintaining the blog on
bot fly infections. Keep up the good work!


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