Medical Must-See: A ‘boring’ parasitic scalp infection

A screwworm infection near the brain could have been fatal for this teenager.
Scalp ulcer containing Cochliomyia hominivorax larvae.

A chronic skin condition plus a rare parasitic fly left a US teen’s scalp teeming with “boring” worm larvae.

The 15-year-old developed an intense focal occipital headache a day after a three-week hiking trip in Peru.

Upon inspection, doctors found a 4.5mm ulcer on the girl’s scalp, with undulating movement at the ulcer’s base.

When they applied bacitracin ointment, some 45 cream-coloured larvae crawled out.