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

Abstract

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 in Northern Tanzania: a clinical report from Qameyu village, Babati District, Manyara Region

“…The penetration of T. penetrans is asymptomatic: it is only when the insect increases in size that the inflammatory phenomena develop, leading to pain and pruritus. Pain can cause marked limitation in walking [1]. Bacterial superinfections are the most frequent complications.…”

“…Bacterial superinfections are the most frequent complications. Lymphangitis, lymphadenitis, cellulitis, osteomyelitis, gangrene, sepsis, loss of nails and spontaneous amputation of the toes have also been described [1]. Risk of tetanus should also be taken into consideration [1].…”

“…T. penetrans currently lives in Central and South America and sub-Saharan Africa [1]. Tungiasis is characterized clinically by papular or nodular lesions, either single or multiple: cases with dozens, sometimes even hundreds, lesions are not rare; lesions can be white, grey or yellowish in colour, with a small brown-black central opening corresponding to the posterior portion of the flea abdomen [1]. Characteristic locations of tungiasis are toes, periungual and subungual folds, interdigital folds, sole and heel [1].…”

First report of furuncular myiasis caused by the larva of botfly, Dermatobia hominis, in a Taiwanese traveler

“…In addition, a Tunga flea invades the host's skin may cause a furuncular nodule which can also resemble as furuncular myiasis. However, tungiasis is often observed on the toes and soles of the foot [16,17] , where furuncular myiasis caused by D. hominis is rarely found. Although medical device of ultrasonography and dermoscopy have been described as an aid in the diagnosis of furuncular myiasis caused by D. hominis [18,19] , diagnosis is made primarily on clinical observation of furuncle-like skin lesion with particular attention to the patient's travel history.…”

Got the Travel Bug? A Review of Common Infections, Infestations, Bites, and Stings Among Returning Travelers

“…As the organism grows and becomes symptomatic, itching may result in superinfection. In communities without established vaccination programs, infection with Clostridium tetani can also occur [30,31].…”