Furuncular myiasis by Cordylobia anthropophaga in three Italian children: First case series and implications for non-endemic regions.

Cordylobia anthropophaga, commonly known as the tumbu fly, is a leading cause of cutaneous myiasis in sub-Saharan Africa. This condition is characterized by a papulopustular lesion that evolves in a painful boil-like nodule with central ulceration. Human infestations typically occur on covered body parts, due to the fly's habit of laying eggs on damp clothing. This report describes the first cluster of three pediatric cases of furuncular myiasis caused by C. anthropophaga, diagnosed at the Bambino Gesù Children's Hospital (Rome, Italy) between April 2024 and April 2025. All patients had recent travel history to endemic African regions and presented with cutaneous nodules, some accompanied by systemic signs such as fever or regional lymphadenopathy. Diagnosis was confirmed through clinical evaluation and morphological identification of the extracted larvae. Treatment consisted of occlusive therapy to facilitate larval expulsion or surgical extraction of the maggots and systemic antibiotics. One patient also exhibited a family cluster, with larval extraction from a parent. Laboratory results were largely unremarkable, consistent with localized infection. These cases highlight the growing relevance of imported myiasis in non-endemic countries like Italy, due to increased international travel and potential climate-driven changes in vector distribution. Enhanced awareness among travelers and healthcare providers, together with proactive public health measures, is crucial. By documenting these cases, we hope to contribute to the understanding of emerging parasitic diseases in non-endemic regions and reinforce the need for vigilance in this time of global environmental changes.