Human botfly infestation: the tip of the iceberg.

A retired man in his 60s was referred to the on call orthopaedic team by his general practitioner following several attempts to extricate a human botfly larva from his forearm. While on holiday in Belize with his daughter 8 weeks previously they both were bitten by some insects. She developed an infestation which was treated locally. Once back in the UK, he subsequently reported of localised itching and discomfort. A botfly larva was successfully removed in the emergency department following local anaesthetic infiltration.