The mangoworm is the larval stage of the Cordylobia anthropophaga fly, also known as the tumbu fly or mango fly. This parasite infests mammals, including humans, and is common in sub-Saharan Africa. Its larvae burrow into the skin, causing cutaneous myiasis. While not typically life-threatening, these infestations cause discomfort and can lead to complications if not properly addressed.
Life Cycle and Environment
The tumbu fly’s life cycle begins when the female lays approximately 300 eggs in sandy soil, often contaminated with feces or urine, or on damp clothing and bedding. These eggs hatch into larvae within one to three days. The larvae can remain viable for up to 15 days, actively seeking a host.
Upon finding a mammal, such as a human, dog, or rodent, the larvae penetrate the skin. Once inside, they develop through three larval stages, feeding on tissue and bodily fluids for 8 to 12 days. During this period, the larvae create a breathing hole on the skin’s surface. After reaching maturity, the mangoworm exits the host, falls to the ground, and buries itself to pupate. The pupal stage lasts 8 to 10 days, after which the adult fly emerges, completing the cycle in three to four weeks.
Recognizing Infestation
A mangoworm infestation, or myiasis, typically begins with small, red papules resembling mosquito bites within days of exposure. These quickly develop into firm, boil-like sores, or furuncles, over two to six days. Each boil usually features a distinct central pore or tiny black dot, which is the larva’s breathing hole.
The lesions can enlarge to about an inch, with surrounding skin becoming red and inflamed. Patients often report sensations like itching, pain, or a feeling of movement within the boil. Pain can intensify as the larva matures, and clear fluid or bloody discharge may emerge from the central opening. Less commonly, infested individuals may experience systemic symptoms like fever or an increased heart rate.
Addressing an Infestation
Safe removal of mangoworms is important to prevent complications. One common approach involves applying an occlusive dressing, such as petroleum jelly or wax, over the boil’s breathing hole. This suffocates the larva, compelling it to emerge. Once the larva surfaces, it can often be gently removed.
For complex cases, multiple larvae, or if initial methods fail, seeking professional medical advice is advisable. Medical professionals may inject lidocaine and epinephrine near the lesion to force the larva out. Surgical removal, involving a small incision to enlarge the breathing hole and extract the larva with forceps, is also an option.
Improper removal attempts, such as squeezing too forcefully or using unsterile instruments, can cause the larva to break apart, leading to infection or further complications. After removal, the affected area is cleaned with an antiseptic solution, and antibiotics may be prescribed to prevent or treat secondary bacterial infections.
Protective Measures
Preventing mangoworm infestations involves specific hygiene practices, especially where the tumbu fly is common. Careful laundry management is key; clothes line-dried outdoors, particularly in endemic regions, should be ironed thoroughly. The heat effectively kills any eggs or larvae deposited on the fabric.
Avoid direct contact with contaminated soil, such as sitting or lying on the ground. In areas with tumbu fly activity, use insect repellents on exposed skin to deter adult flies. Maintaining good sanitation, including regular cleaning of animal bedding and prompt removal of feces, reduces breeding grounds. Travelers to affected regions should be vigilant, taking precautions like wearing protective clothing and cleaning all clothing and luggage thoroughly upon return.