An Ectopic Case of Tunga spp. Infection in Peru

Maco, Vicente; Gotuzzo, Eduardo

doi:10.4269/ajtmh.2010.10-0031

Cited by 5 publications

(6 citation statements)

References 17 publications

(23 reference statements)

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“…Second, it has been taxonomically reclassified multiple times with different names by entomologists over the past 3 centuries ( 16 – 19 , 34 ). Finally, the high rates of endemicity, along with a relatively uncomplicated clinical course, have made it a disease that is underreported and neglected among physicians in Peru ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

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Evidence of Tungiasis in Pre-Hispanic America

Maco¹,

Tantaleán²,

Gotuzzo³

2011

Emerg. Infect. Dis.

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Ancient parasites of the genus Tunga originated in America and, during the first half of the 19th century, were transported to the Eastern Hemisphere on transatlantic voyages. Although they were first documented by Spanish chroniclers after the arrival of Columbus, little is known about their presence in pre-Hispanic America. To evaluate the antiquity of tungiasis in America, we assessed several kinds of early documentation, including written evidence and pre-Incan earthenware reproductions. We identified 17 written documents and 4 anthropomorphic figures, of which 3 originated from the Chimu culture and 1 from the Maranga culture. Tungiasis has been endemic to Peru for at least 14 centuries. We also identified a pottery fragment during this study. This fragment is the fourth representation of tungiasis in pre-Hispanic America identified and provides explicit evidence of disease endemicity in ancient Peru.

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Section: Discussionmentioning

confidence: 99%

“…Studies describing the entomology and pathogenesis of both species are now abundant ( 6 , 7 ). However, studies describing the recognition, proper identification, and distribution of the species in Ecuador and Peru, the only 2 countries where the second new species has been reported, are lacking ( 8 ).…”

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confidence: 99%

Evidence of Tungiasis in Pre-Hispanic America

Maco¹,

Tantaleán²,

Gotuzzo³

2011

Emerg. Infect. Dis.

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“…Ectopic tungiasis has been described involving the hands and elbows in Tanzania [ 4 ], Cameroon [ 5 ] and Nigeria [ 6 ] and the palpebrae in the Democratic Republic of Congo [ 7 ]. Conjunctival [ 8 ], thigh, elbow and gluteal infections were reported in the Caribbean and South America [ 9 , 10 ] and growths over the ischial protuberances [ 11 ] and knee [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Tungiasis presenting as a soft tissue oral lesion

Sentongo

Wabinga

2014

BMC Oral Health

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BackgroundThe sand flea Tunga penetrans usually infects the feet and affects primary school-age children and elderly persons in rural Uganda. Tungiasis occurs nationwide but disease outbreaks have been reported in the Busoga sub-Region of eastern Uganda, associated with poor sanitation and proximity between humans and domestic animals. Ectopic tungiasis, usually seen with extensive infection and at weight-bearing body surfaces often follows exposure in highly infested environments. For patients who present abroad treatment may be surgical excision or amputation.Case presentationAn adult female Musoga by tribe, resident in a Kampala City suburb presented at Mulago National Referral and Teaching Hospital’s Oral Surgery and Jaw Injuries Unit with a discoloured swollen tongue, facial cellulitis and submandibular lymphadenopathy. A swelling palpable in the body of her tongue was excised and sent for histology. Tungiasis of the tongue was diagnosed after microscopic examination of formalin-fixed paraffin-embedded Haematoxylin and Eosin-stained tissue sections.ConclusionLingual tungiasis is a rare diagnosis that was made on histological examination. Atypical presentation outside an endemic area predisposed the patient to partial glossectomy instead of the less invasive flea enucleation. Ectopic disease in a city-resident highlights the plight not only of visitors to infested areas but also of the communities and their domestic animals.

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“…4 Although it is an ancient skin infection, there are no systematic epidemiological studies on the distribution or impact in economically deprived populations in Peru. 5 The causes of underreporting possibly include the lack of interest in this ectoparasite among health care providers, the habit of the removal of the embedded insect by individuals themselves, and the lack of awareness of inexperienced physicians.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 There are only three isolated cases reported in the literature from Peru. 5,12,13 Our objectives are to describe the ex vivo dermoscopic patterns through scanning, to describe the histopathological characteristics of human tungiasis in individuals who received care in hospitals in the capital suburbs of Lima, and to apply the Fortaleza classification (Eisele and others, 2003 14 ), a clinicohistopathological staging system, to better characterize and report the stages of infection.…”

Section: Introductionmentioning

confidence: 99%

Histopathological Features of Tungiasis in Peru

Maco¹,

Tantaleán²,

Gotuzzo³

2013

The American Journal of Tropical Medicine and Hygiene

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Abstract. Tungiasis is an ectoparasitic skin disease caused by Tunga penetrans and Tunga trimamillata. There is a lack of histopathological studies that evaluate the recognition of this flea in tissues. We describe the ex vivo dermoscopic and the histopathological patterns of six cases and relate the findings to the developmental stage of the parasite as defined by the Fortaleza classification: two were classified as Fortaleza 3b, 3 as 4a, and 1 as 4b. Two dermoscopic patterns were observed: a brown pigmented ring and a radial crown with a central pore. The most common histopathological findings were an eosinophilic cuticle, eggs in different stages of development, tracheal rings (parasite), and basal hyperplasia (host). The eosinophilic cuticle, eggs in different stages of evolution, and tracheal rings can help to establish the diagnosis when other parts of the parasite are lacking. The Fortaleza staging may represent a tool for pathology reporting purposes.

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An Ectopic Case of Tunga spp. Infection in Peru

Cited by 5 publications

References 17 publications

Evidence of Tungiasis in Pre-Hispanic America

Evidence of Tungiasis in Pre-Hispanic America

Tungiasis presenting as a soft tissue oral lesion

Histopathological Features of Tungiasis in Peru

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