title: Ultrasound Visualization of Atypical Abscess Ultimately Containing Bot Fly Larva.
abstract: BACKGROUND
  Because of the rise in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), presentations to the emergency department for the evaluation of cutaneous abscesses have risen dramatically over the past 2 decades. Soft tissue point of care ultrasound (POCUS) differentiates abscess from cellulitis, determines the size and shape, and characterizes the contents of the abscess. It has been shown to improve medical decision-making and therefore the emergency management of cutaneous abscesses over physical examination alone.
  
  
  METHODS
  We report a case of an unusual nonhealing abscess in an 18-year-old woman with a recent history of foreign travel where soft tissue POCUS identified motion within the abscess pocket. This changed the management of the case, leading to the diagnosis of bot fly myiasis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clinicians should entertain a broader differential for an apparent abscess and consider liberal use of soft tissue POCUS in these cases.
authors.affiliation: Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.
authors.forename: Patrick
authors.initials: P
authors.lastname: Bovino
authors.affiliation: Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.
authors.forename: John
authors.initials: J
authors.lastname: Cole
authors.affiliation: Department of Emergency Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.
authors.forename: Mark
authors.initials: M
authors.lastname: Scheatzle
mesh_terms: D000038:Abscess / Q000175:diagnosis; D000293:Adolescent; D000818:Animals; D005260:Female; D006801:Humans; D007814:Larva; D009198:Myiasis / Q000000981:diagnostic imaging* / Q000469:parasitology; D019095:Point-of-Care Systems; D012536:Scalp Dermatoses / Q000000981:diagnostic imaging* / Q000469:parasitology
keywords: abscess; bot fly; myiasis; point of care ultrasound