Question: Can you identify this condition?

A previously healthy adolescent presented with an intermittently painful lesion on the left ear. She had had the lesion for 2 months, beginning at the end of a 1-week trip to Honduras, where she stayed at a 4-star hotel. She had been treated unsuccessfully with topical antibacterial ointments, and 2 successive courses of oral second-generation cephalosporin antibiotics were prescribed. Examination of the reddish, mobile, 0.5-cm lesion showed a mildly tender, soft mass in front of her ear.

The most likely diagnosis is

1. Cutaneous leishmaniasis

2. Folliculitis due to skin flora

3. Dermatobia hominis infestation

4. Furuncle due to Staphylococcus aureus

Answer on page 1455

• Copyright© the College of Family Physicians of Canada