Tunga penetrans in south Florida

Revision on tungiasis: treatment options and prevention

The parasitic skin disease tungiasis occurs in many resource-poor communities in Latin America, the Caribbean and sub-Saharan Africa. The sand flea, Tunga penetrans, most commonly penetrates into the skin of the feet. Many individuals harbor a large number of embedded parasites and show significant morbidity. Standard treatment consists of surgical extraction of the flea and application of a topical antibiotic. There are no drugs available with proven effectiveness. Clinical trials performed in the last few years did not show very promising results. Thus, surgical extraction still remains the treatment of choice in patients with a low parasite load, such as tourists returning from endemic areas. Probably the best approach to reduce tungiasis-associated morbidity in heavily affected individuals is the application of a repellent to prevent the penetration of sand fleas. In the future, we should see new exciting data on the biology, epidemiology, therapy and control of tungiasis.

Imported tungiasis: a report of 19 cases and review of the literature

Tungiasis is an infestation caused by penetration in the skin of the gravid female of the flea Tunga penetrans. In the period 1991-2006, 19 patients with imported tungiasis were observed at our Institute. All patients were subjected to general and dermatological examination, laboratory tests (including bacteriological examinations) and surgical excision of the lesions with histopathological examination. In all patients tetanus prophylaxis was made. All patients were followed up for at least six weeks. Thirteen patients were males (68.4%) and 6 females (31.6%). The age ranged from 3 to 71 years (average age: 37.8 years). Eleven patients (57.9%) contracted the infestation in Central and South America and 8 (42.1%) in Africa. In 17 patients (89.5%) tungiasis was localized to the feet, in one to the hands and in one to a thigh. In 13 patients (68.4%) the infestation was characterized by a single lesion; in the other 6 patients (31.6%) the lesions were two. In 15 patients (78.9%) tungiasis was characterized by a papular or nodular lesion. Crusted (2 patients), pustular (2 patients) and bullous (1 patient) lesions were also observed; furthermore, one patient presented with a plantar wart-like lesion. In only one patient bacteriological examinations showed the growth of Staphylococcus aureus and Escherichia coli. All patients healed without complications.

Tungiasis

Tungiasis is a neglected parasitic skin disease caused by the permanent penetration of the female sand flea (also called jigger flea) Tunga penetrans into the skin of its host. After penetration, most commonly on the feet, the flea undergoes an impressing hypertrophy, and some days later the abdominal segments of the flea have enlarged up to the size of about 1 cm. The flea infestation is associated with poverty and occurs in many resource-poor communities in the Caribbean, South America and Africa. In this review, a historical overview on tungiasis is given. The natural history, pathology, epidemiology, diagnosis, therapy and control of the parasitic skin disease are discussed. It is concluded that tungiasis is an important parasitosis causing considerable morbidity in affected populations. Future studies are needed to increase the knowledge on the biology, pathophysiology, epidemiology, therapy and control of the ectoparasite.

Tungiasis: more than an exotic nuisance

Tungiasis is a parasitic and zoonotic skin disease caused by the sand flea Tunga penetrans-also called the jigger flea, which burrows into human skin, usually on the feet. The ectoparasitosis occurs in many economically depressed communities in the Caribbean, South America and Africa, and affects sporadically travellers to endemic areas. Usually, only one or two lesions are found in travellers, whereas the local populations commonly harbour dozens, sometimes even hundreds of lesions, associated with severe morbidity. We review case reports of tungiasis in returned travellers in terms of history, epidemiological and clinical aspects, and the importance of the ectoparasitosis for travel medicine is discussed. It is concluded that tungiasis is more than merely an exotic nuisance, since it is an important health problem in endemic areas. Untrained dermatologists can diagnose and treat tungiasis properly; fleas should be extracted as early as possible to avoid secondary infections.

Tungiasis: report of one case and review of the 14 reported cases in the United States

Tungiasis is a cutaneous parasitic infestation by the fertilized female sand flea Tunga penetrans. It is prevalent in tropical Africa and in Central and South America. Despite increasing air travel to and from these countries, surprisingly the disease is rarely reported in the United States. This report describes another case of tungiasis and reviews the 14 previously reported cases in the United States. Clinical features, differential diagnosis, treatment, and prophylaxis of tungiasis are discussed.