TungiasisB88.1

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Sand flea infestation; Tunga penetrans infection

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DefinitionThis section has been translated automatically.

Non-European epizoonosis caused by the penetration of the mated female sand flea (Tunga penetrans) into human skin. Rarely occurring as a travel disease, the parasitosis is often found in poor residential areas of the sub-Sahara (called "jiggers" there, in South America and the Caribbean.

Occurrence/EpidemiologyThis section has been translated automatically.

Tropical regions of Africa and America/Mexico/Argentina, Caribbean islands, subtropical areas of Asia. Also applies to returning travellers.

LocalizationThis section has been translated automatically.

Preferably on the feet (plantae, subungual, interdigital), other parts of the body (when lying on the ground) can also be affected.

Clinical featuresThis section has been translated automatically.

A few days after penetration of the fleas (1-100), formation of inflammatory, moderately painful to pea-sized, reddish, bulging papules or nodes. A black porus (= parasite) often appears centrally. Itching, pressure pain. Complicated are furunculoid abscesses.

The parasite reaches a size of up to 0.5 cm within 7-14 days. The rear end of the flea with the respiratory and genital openings protrudes from the skin. After ejection of the eggs (up to 300 eggs) and the dead flea, a dimple-like depression remains.

More rare are clinical pictures with disseminated strongly itchy papules on the contact surfaces.

Complication(s)This section has been translated automatically.

General therapyThis section has been translated automatically.

First kill the sand flea with a swab soaked in ether, turpentine oil or paraffin, then remove the sand flea with a needle or fine tweezers. Occasionally an excision is necessary.

In case of multiple infestation: therapy with ivermectin, metrifonate, thiabendazole

External therapyThis section has been translated automatically.

The flea body can be removed with a scalpel and tweezers. Further antiseptic therapy e.g. with Clioquinol (e.g. Linola-Sept) once/day in the evening or fusidic acid (e.g. Fucidine ointment).

Internal therapyThis section has been translated automatically.

In cases of purulent secondary infection, systemic antibiotics after antibiogram, in severe cases internal antiparasitic therapy with Tiabendazole (Mintezol) 25-50 mg/kg bw/day for 2-4 days.

ProphylaxisThis section has been translated automatically.

Travellers should be informed about the occurrence of the disease in rural areas. It is recommended to wear stockings and closed shoes in places with high parasite load (poor residential areas).

Note(s)This section has been translated automatically.

The sand flea goes through its development from egg, larva, pupa to adult flea in the ground. The infection occurs when the flea penetrates the skin. It can jump up to 40 cm high.

LiteratureThis section has been translated automatically.

  1. Caumes E et al (1995) Dermatoses associated with travel to tropical countries: a prospective study of the diagnosis and management of 269 patients presenting to a tropical disease unit. Clin Infect Dis 20: 542-548
  2. Eisele M et al (2003) Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: I. Natural history of tungiasis in man. Parasitol Res 90: 87-99
  3. Gelmetti C et al (2000) Tungiasis in a 3-year-old child. Pediatric Dermatol 17: 293-295
  4. Heukelbach J et al (2002) Ectopic localization of tungiasis. Am J Trop Med Hyg 67: 214-216
  5. Khan Durani B, hard shoe W (2007) Slippery knot on the outer edge of the right foot. JDDG 5: 417-418
  6. Richarz U et al (1985) Tungiasis-a long-distance tourism infection. Act Dermatol 11: 181-182
  7. Schuller-Petrovic S, Mainitz M, Böhler-Sommeregger K, (1987) Tungiasis-an increasingly common holiday dermatosis. dermatologist 38: 162-164
  8. Veraldi S et al (2000) Tungiasis has reached Europe. Dermatology 201: 382
  9. v. Stebut E et al (2015) Rice dermatoses. Nude Dermatol 41: 433-439

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Last updated on: 29.10.2020