To present an interesting cause of pre-auricular swelling.
We report the case of a 39-year-old woman who presented to the ENT department as an emergency with swelling in the left pre-auricular region. The patient had recently travelled to Central America, where the botfly is endemic. On examination, there was a raised, indurated area with a central orifice. A botfly larva was suspected. The larva was suffocated with paraffin paste, allowing removal without remnants being retained.
Suffocation of botfly larvae is favoured to surgical removal, due to the possibility of larval remnants being retained and acting as a nidus for infection. The increasing frequency of exotic travel means doctors need to be more aware of tropical medicine.