My patient had bugs crawling under his skin

My patient had sores and boils all over his skin and he told me he spent hours every night pulling half-inch black larvae out of his painful eruptions.
He was not delusional. He was not on drugs. I had never seen anything like it before. He had already talked to a doctor who gave him his diagnosis: Bot fly infestation. He had also been told there is no real treatment for this.
The only bots I knew of were computer bots that spread viruses.
Bot flies are usually found in Central America, but my patient hadn’t been south of New Hampshire, US.