title: Pain and bloody ear discharge in a returning traveler.
abstract: Cochliomyia hominivorax, the New World screwworm, was a serious livestock pest in the southern United States until the 1960s, when it was successfully eradicated by the release of sterile male flies. It remains endemic in parts of the Caribbean and South America, and there is concern that climate change may extend its geographic distribution. Cochliomyia hominivorax is voracious and can cause extensive damage to soft tissue and bone. We describe the case of a 26-year-old traveler who presented with otalgia and bloody otorrhea after returning from a vacation in the Dominican Republic, where exposure to screwworm flies most likely occurred during a nap on the beach. The causative agent was recognized by its characteristic larval anatomy, which includes pigmented dorsal tracheal trunks and posterior spiracles with an open peritreme.
authors.affiliation: Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington; Department of Laboratory Medicine, Geisinger Health System, Danville, Pennsylvania; Department of Laboratory Medicine, University of Washington, Seattle, Washington sylvial2@uw.edu.
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: LaCourse
authors.affiliation: Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington; Department of Laboratory Medicine, Geisinger Health System, Danville, Pennsylvania; Department of Laboratory Medicine, University of Washington, Seattle, Washington.
authors.forename: Raquel M
authors.initials: RM
authors.lastname: Martinez
authors.affiliation: Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington; Department of Laboratory Medicine, Geisinger Health System, Danville, Pennsylvania; Department of Laboratory Medicine, University of Washington, Seattle, Washington.
authors.forename: David H
authors.initials: DH
authors.lastname: Spach
authors.affiliation: Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington; Department of Laboratory Medicine, Geisinger Health System, Danville, Pennsylvania; Department of Laboratory Medicine, University of Washington, Seattle, Washington.
authors.forename: Ferric C
authors.initials: FC
authors.lastname: Fang
mesh_terms: D000328:Adult; D000818:Animals; D004175:Diptera / Q000145:classification; D004293:Dominican Republic; D004427:Ear Diseases / Q000469:parasitology*; D005260:Female; D006801:Humans; D009198:Myiasis / Q000453:epidemiology / Q000469:parasitology*; D010146:Pain / Q000209:etiology; D014195:Travel