Autochthonous furuncular myiasis in the United States: case report and literature review.

Most cases of furuncular myiasis in the United States are acquired during travel to other countries. Autochthonous cases are infrequently reported and are most often due to accidental infestation of humans by larvae of flies belonging to the genus Cuterebra, commonly known as "rabbit bot flies" or "rodent bot flies." We describe a case of furuncular myiasis due to Cuterebra larvae in the hand of a patient residing in Wisconsin. The infestation was acquired while the patient gardened near a seepage lake during August. The patient developed papular lesions on the hand and received therapy for presumed bacterial furunculosis, which did not lead to improvement. Retrieval of one of the larvae from the patient permitted identification of the causative agent, and application of an occlusive ointment resulted in complete cure. North American cuterebrid myiasis is rare, and the diagnosis is frequently delayed. Myiasis should be considered when treating patients with refractory furunculosis.