Flesh Fly Maggot-Infected Abscess in a Burn Victim Patient in the United States Without a History of International Travel: A Case Report.

This case report describes an uncommon occurrence of myiasis, specifically a maggot-infected abscess, in a patient with reduced skin sensitivity resulting from severe burns. Myiasis is the infestation of live animal tissue by fly larvae, and while it is primarily associated with tropical and subtropical regions, cases acquired within the United States are rare. The presented case involves a 70-year-old male who arrived at the emergency department with an intensely painful, non-healing wound in the left elbow. Upon examination, the wound was found to be infested with numerous live maggots, and subsequent investigations revealed the larvae to be of the flesh fly species (Sarcophagidae). The patient's history of reduced skin sensitivity, previous burn injuries, and exposure to outdoor environments, coupled with poor hygiene and homelessness, likely contributed to the infestation. This report emphasizes the importance of considering myiasis caused by flesh fly larvae even in non-travel-related cases within the United States. Early recognition and prompt treatment are vital to preventing complications and secondary infections. Healthcare providers should remain vigilant in identifying and managing myiasis, and patients with decreased skin sensation should be educated about the need for regular skin surveillance and the utilization of preventive measures to mitigate potential infestations.